畅心饮治疗冠心病心绞痛痰瘀搏结证临床研究
A Clinical Study of Changxin Decoction for Treatment of Angina Pectoris with Interaction of Phlegm and Blood Stasis
  
DOI:
中文关键词:  畅心饮  冠心病  糖尿病  血脂  血糖  超敏C反应蛋白  PCSK9
英文关键词:Changxin Decoction  Coronary heart disease  Diabetes  Blood lipids  Plasma glucose  High-sensitivity C-reactive protein  Proprotein convertase subtilisin/kexin type 9
基金项目:国家自然科学基金项目(81774088)
作者单位
郭 炜,王肖龙,黄 宇,薛金贵 上海中医药大学附属曙光医院心内科上海 200021 
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中文摘要:
      目的 观察畅心饮治疗冠心病心绞痛的疗效及其可能的机制。方法 将冠心病心绞痛符合痰瘀搏结证患者随机分为对照组和治疗组,每组40例,对照组按标准西医治疗,治疗组在其基础上加服畅心饮。观察两组心绞痛和中医证候疗效,以及治疗前后总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、脂蛋白a\[(lipoprotein (a),Lp(a)\]、超敏C反应蛋白(high-sensitive reactive protein,hs-CRP)、空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白A1c(glycosylated haemoglobin A1c,HbA1c)、血前蛋白转化酶枯草杆菌蛋白酶9(proprotein convertase subtilisin kexin type 9,PCSK9)水平。结果 治疗组心绞痛和中医证候疗效均优于对照组(P<0.05)。与治疗前比较,对照组治疗后hs-CRP、TC、LDL-C、HDL-C、Lp(a)、FPG、HbA1c、PCSK9水平均无明显变化(P>0.05),治疗组治疗后hs-CRP、TC、LDL-C、Lp(a)、PCSK9水平显著降低(P<0.05);治疗组治疗前后hs-CRP、TC、LDL-C、PCSK9降低值显著大于对照组(P<0.05)。结论 畅心饮治疗冠心病心绞痛痰瘀博结证的机制可能是通过降低血PCSK9水平以降低血脂水平与炎症反应以改善动脉粥样硬化。
英文摘要:
      Objective To investigate the efficacy of Changxin Decoction in the treatment of angina pectoris and the potential mechanism. Methods Angina pectoris patients with interaction of phlegm and blood stasis were randomly divided into control group and treatment group, with 40 cases in each group. The control group received standard Western medicine treatment, while the treatment group was given Changxin Decoction in addition to standard Western medicine treatment. The two groups were evaluated for the outcomes of angina pectoris and traditional Chinese medicine (TCM) syndrome, as well as the changes in the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), lipoprotein (a) [Lp (a)], high-sensitivity C-reactive protein (hs-CRP), fasting plasma glucose (FPG), glycosylated hemoglobin A1c (HbA1c), and proprotein convertase subtilisin/kexin type 9 (PCSK9), after treatment. Results The treatment group had significantly better outcomes of angina pectoris and TCM syndrome than the control group (P<0.05). After treatment, the control group showed no significant changes in the levels of hs-CRP, TC, LDL-C, HDL-C, Lp (a), FPG, HbA1c, and PCSK9 (P>0.05), while the treatment group showed significant reductions in the levels of hs-CRP, TC, LDL-C, Lp (a), and PCSK-9 (P<0.05); the treatment group had significantly greater reductions in the levels of hs-CRP, TC, LDL-C, and PCSK-9 (P<0.05). Conclusion In the treatment of angina pectoris with interaction of phlegm and blood stasis, Changxin Decoction can decrease blood PCSK9 level to reduce blood lipids and inflammatory response, thus improving atherosclerosis.
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