目的:观察通痹汤对冠状动脉粥样硬化性心脏病(简称冠心病)稳定型心绞痛气虚血瘀证患者白细胞分化抗原40(Cluster of Differentiation 40,CD40)、白细胞分化抗原 154(Cluster of Differentiation 154,CD154)、血管性血友病因子(von Willebrand Factor,vWF)的影响.方法:将90例气虚血瘀型冠心病心绞痛患者随机分为试验组和对照组,每组45例.对照组给予常规临床治疗(包括抗血小板聚集、降低血脂稳定斑块、抑制心室重构、营养心肌、扩张动脉、减少心肌耗氧等治疗),试验组在对照组基础上加用通痹汤口服治疗.一个疗程为2周,2个疗程后评估患者的心绞痛症状、6 min步行距离(6-minute Walking Distance,6MWD)、血浆D-二聚体、CD40、CD154、vWF变化.结果:试验组总有效率为82.2％(37/45),对照组为46.7％(21/45),差异有统计学意义(P＜0.01).治疗后,试验组心绞痛发作次数少于对照组[(3.54±0.51)(次/周)VS.(4.94±0.59)(次/周),P＜0.05)]、6MWD 大于对照组[(544.17±51.54)mVS.(516.79±36.28)m,P＜0.05].治疗后,试验组硝酸甘油停减率为 66.7％(30/45),对照组硝酸甘油停减率为26.7％(12/45),差异有统计学意义(P＜0.01).治疗后,试验组CD40[(146.69±40.23)ng/L VS.(223.60±91.34)ng/L,P＜0.01]、CD154[(10.62±7.17)ng/LVS.(14.20±6.73)ng/L,P＜0.01]、vWF 因子[(427.29±91.79)U/L VS.(513.63±101.81)U/L,P＜0.01]、血浆 D-二聚体[(1.06±0.73)ng/L VS.(1.63±0.83)ng/L,P＜0.01]水平均低于对照组.结论:通痹汤能够改善冠心病患者心绞痛发作次数,增加6MWD,降低CD40、CD154、vWF因子、D-二聚体水平.
The influence of the Tongbi decoction on the expressions of CD40,CD 154 and von willebrand factor in stable angina pectoris patients
Objective:To observe the effect of the Tongbi decoction(通痹汤)on the expressions of cluster of differentiation 40(CD40),cluster of differentiation 154(CD 154)and von willebrand factor(vWF)in stable angina pectoris in coronary heart disease patients with Qi(气)deficiency and blood stasis.Methods:Ninety stable angina pectoris patients with Qi deficiency and blood stasis were selected and randomly grouped into the test group and the control group,with 45 patients in each group.The control group was given conventional treatment,including antiplatelet aggregation,reduction of blood lipid stable plaques,inhibition of ventricular remodeling,myocardial nutrition,arterial dilation,reduction of myocardial oxygen consumption,etc..The treatment group was given the Tongbi decoction orally on the basis of conventional treatment.One course was lasted for 2 weeks.Angina symptoms,6MWD,plasma D dimer,CD40,CD154 and vWF were assessed after 2 courses of treatment.Results:The total efficiency was 82.2％(37/45)in the test group and 46.7％(21/45)in the control group,and the difference was statistically significant(P＜0.01).After treatment,the frequency of angina pectoris attack in the test group was less than the control group(P＜0.05),and the 6-minute walking distance(6MWD)was greater than the control group(P＜0.05).After treatment,the rate of nitroglycerin stopping reduction in the test group[66.7％(30/45)]was significantly higher than that in the control groups[26.7％(12/45)],and the difference was statistically significant(P＜0.01).The expression levels of CD40(P＜0.01),CD154(P＜0.01),vWF(P＜0.01)and plasma D-dimer(P＜0.01)in the test group were significantly lower than those in the control group.Conclusion:The Tongbi decoction can improve the incidence of angina pectoris in patients with coronary heart disease,increase 6MWD,and reduce the expression levels of CD40,CD 154,vWF and plasma D-dimer.
Stable angina pectoris in coronary heart diseaseQi deficiency and blood stasis syndromeThe Tongbi decoctionCluster of differentiation 40Von Willebrand factor
万方数据
维普
