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复方稳斑汤联合体外反搏治疗对冠心病不稳定型心绞痛病人临床疗效及对血清一氧化氮和血管内皮素-1的影响

赵亮1，宫丽鸿2

目的观察复方稳斑汤联合体外反搏治疗对冠心病不稳定型心绞痛病人的临床疗效及其对血清一氧化氮(NO)和血管内皮素-1(ET-1)水平的影响。方法收集120例确诊冠心病不稳定型心绞痛病人，随机分为两组，对照组(60例)和试验组(60例)。对照组采用复方稳斑汤加常规西药治疗；试验组在对照组基础上联合体外反搏治疗，治疗时间均为4周，比较两组心绞痛症状、中医证候、NO及ET-1等指标。结果治疗后试验组的心绞痛症状疗效、中医证候疗效均显著优于对照组(P<0.05)。治疗后两组中医证候积分均显著下降(P<0.05)，且试验组优于对照组(P<0.05)。治疗后试验组和对照组NO及ET-1均有显著改善，且试验组优于对照组(P<0.05)。结论复方稳斑汤联合体外反搏治疗可以改善冠心病不稳定型心绞痛病人的心绞痛症状及中医证候，调节NO及ET-1水平。

冠心病；不稳定型心绞痛；体外反搏；一氧化氮；血管内皮素-1

Abstract：ObjectiveTo observe the effects of compound Wenban decoction (CWD) and enhanced external counterpulsation (EECP) on the levels of serum nitric oxide (NO) and endothelin-1 (ET-1) in patients with unstable angina pectoris (UAP).MethodsOne hundred and twenty patients with UAP were collected and randomly divided into two groups：control group (n=60) treated with routine treatment plus CWD，and treatment group (n=60) treated with routine treatment plus CWD and EECP for 4 weeks.The changes of angina pectoris symptoms，Chinese medical syndrome and the levels of serum NO and ET-1 were observed.ResultsAfter treatment， the curative effects of angina pectoris symptom，and Chinese medical syndrome in treatment group were obviously better than that in control group (P<0.05)．The scores of Chinese medical syndrome declined obviously in two groups，which was obviously better in treatment group than that in control group (P<0.05).After treatment，the levels of serum NO and ET-1 improved obviously in two groups，which was obviously better in treatment group than that in control group (P<0.05).ConclusionCWD and EECP can improve the symptoms of angina pectoris and Chinese medical syndrome in patients with UAP and regulate the levels of serum NO and ET-1.

Keywords：coronary heart disease;unstable angina pectoris；enhanced external counterpulsation；nitric oxide；endothelin -1

冠状动脉粥样硬化性心脏病(CHD)是临床上常见病、高发病，其发病机制是由于发生冠状动脉粥样硬化，造成血管狭窄、阻塞或由于发生冠状动脉功能性改变导致发生心肌缺血、缺氧以及坏死而引发的心脏病[1]。冠心病不稳定型心绞痛是临床常见的急性心血管事件的不良信号，而痰瘀互结证在临床中最常见。近年来，随着对冠心病研究的不断深入，发现中药治疗本病疗效确切。体外反搏作为一种无创的体外循环辅助装置，已在冠心病治疗中应用多年并取得确切疗效[2]。研究表明，其主要机制是通过改善血管内皮功能以缓解心绞痛症状[3]。本研究采用复方稳斑汤联合体外反搏治疗冠心病不稳定型心绞痛，旨在通过比较复方稳斑汤联合体外反搏疗法与复方稳斑汤治疗心绞痛疗效、中医证候改善以及分子生物学指标，探讨其临床疗效及可能机制。……