摘要
目的 探讨中西医结合治疗冠心病合并高血压的疗效及对心功能的影响.方法 92例冠心病合并高血压患者,随机分为对照组和观察组,每组 46 例.对照组使用常规西医治疗,观察组在此基础上使用中医治疗.对比两组的临床疗效、血压[收缩压(SBP)、舒张压(DBP)]及心绞痛指标(心绞痛发作次数、持续时间)、心功能指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDd)、左室收缩末期内径(LVESd)、脑钠肽(BNP)]、血清因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、内皮素-1(ET-1)].结果 观察组治疗总有效率为 95.65%,明显高于对照组的76.09%(P<0.05).观察组治疗后SBP(123.87±7.75)mm Hg(1 mm Hg=0.133 kPa)、DBP(78.73±5.49)mm Hg、心绞痛发作次数(1.87±0.64)次/周低于对照组的(135.58±9.16)mm Hg、(86.85±6.14)mm Hg、(2.93±0.82)次/周,心绞痛发作持续时间(3.39±0.73)min/次短于对照组的(5.47±1.18)min/次(P<0.05).观察组治疗后LVEF(52.37±4.42)%高于对照组的(47.84±4.58)%,LVEDd(45.69±3.90)mm、LVESd(50.16±4.13)mm小于对照组的(50.82±4.23)、(55.97±4.29)mm,BNP(306.39±56.84)ng/L低于对照组的(484.67±68.26)ng/L(P<0.05).观察组治疗后CRP(6.20±1.08)mg/L、IL-6(14.42±2.13)ng/L、TNF-α(10.38±2.05)μg/L、ET-1(41.63±5.74)ng/L均低于对照组的(12.35±2.46)mg/L、(19.07±3.32)ng/L、(14.34±2.67)μg/L、(52.12±6.81)ng/L(P<0.05).结论 中西医结合治疗冠心病合并高血压的疗效显著,能提高对血压及心绞痛的控制效果,改善心功能,抑制炎症反应,保护血管内皮,抑制病情进展.
Abstract
Objective To explore the curative effect of integrated traditional Chinese and western medicine on coronary heart disease complicated with hypertension and its influence on cardiac function.Methods 92 patients with coronary heart disease complicated with hypertension were randomly divided into a control group and an observation group,with 46 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with traditional Chinese medicine.Both groups were compared in terms of clinical efficacy,blood pressure[systolic blood pressure(SBP)and diastolic blood pressure(DBP)]and angina index(frequency and duration of angina pectoris),cardiac function index[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVESd),brain natriuretic peptide(BNP)]and serum factors[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),endothelin-1(ET-1)].Results The total effective rate of treatment in the observation group was 95.65%,which was significantly higher than 76.09%in the control group(P<0.05).After treatment,the observation group had SBP of(123.87±7.75)mm Hg(1 mm Hg=0.133 kPa),DBP of(78.73±5.49)mm Hg and frequency of angina pectoris of(1.87±0.64)attacks/week,which were lower than(135.58±9.16)mm Hg,(86.85±6.14)mm Hg and(2.93±0.82)attacks/week in the control group;the observation group had shorter duration of angina pectoris of(3.39±0.73)min/time than(5.47±1.18)min/time in the control group(P<0.05).After treatment,the observation group had higher LVEF of(52.37±4.42)%than(47.84±4.58)%in the control group;the observation group had LVEDd of(45.69±3.90)mm and LVESd of(50.16±4.13)mm,which were smaller than(50.82±4.23)and(55.97±4.29)mm in the control group;the observation group had lower BNP of(306.39±56.84)ng/L than(484.67±68.26)ng/L in the control group(P<0.05).After treatment,the observation group had CRP of(6.20±1.08)mg/L,IL-6 of(14.42±2.13)ng/L,TNF-α of(10.38±2.05)μg/L and ET-1 of(41.63±5.74)ng/L,which were lower than(12.35±2.46)mg/L,(19.07±3.32)ng/L,(14.34±2.67)μg/L and(52.12±6.81)ng/L in the control group(P<0.05).Conclusion Integrated traditional Chinese and western medicine has a significant effect on treating coronary heart disease complicated with hypertension,which can improve the control effect of blood pressure and angina pectoris,improve cardiac function,inhibit inflammatory reaction,protect vascular endothelium and inhibit the progress of the disease.
NETL
NSTL
维普
万方数据