张恒勋 李海龙 刘小锋

摘要 目的：探究瓜蔞薤白桂枝汤对老年冠心病患者血脂及NT-proBNP、hs-CRP、Fib水平影响。方法：选取2014年4月至2018年4月西藏民族大学附属医院收治的老年冠心病患者78例作为研究对象，根据就诊顺序编号，按照随机数字表法随机分为对照组和观察组，每组39例。对照组常规西医治疗，观察组在对照组基础上加用瓜蒌薤白桂枝汤治疗，同时治疗4周。观察2组治疗前、完成治疗后血脂、NT-pro BNP、hs-CRP、Fib、WBC、HCY、血流流变学、心脏功能水平变化并比较;完成治疗后进行疗效评价。结果：观察组患者治疗后TC、TG、HDL-C、NT-proBNP、hs-CRP、Fib、WBC、HCY、全血高切黏度、全血低切黏度、血浆黏度、红细胞聚集指数下降较对照组患者幅度更低，LDL-C、EDD、NEDD、LVEF、LVPFR上升幅度及治疗后临床总有效率较对照组更高（P<0.05）。结论：瓜蒌薤白桂枝汤能降低老年冠心病患者血脂水平，抑制炎性反应，改善冠状动脉血循环，从而提高疗效，改善心功能。

关键词  瓜蒌薤白桂枝汤;冠心病;血脂;N端前脑钠肽;超敏C-反应蛋白;纤维蛋白原;血液流变学;心功能;疗效

Effects of Gualou Xiebai Guizhi Decoction on Elderly Patients with Coronary Heart Disease

ZHANG Hengxun¹，LI Hailong²，LIU Xiaofeng³

（1 Department of Internal Three，Affiliated Hospital of Tibet University for Nationalities，Xizang 712082，China; 2 Geriatrics Department，Xi′an Ninth Hospital，Xi′an710054，China; 3 Internal Medicine Department，Xianyang West Oak Hospital，Xianyang 712000，China）

Abstract Objective：To explore the effects of Gualou Xiebai Guizhi Decoction on blood lipid，NT-proBNP，hs-CRP and FiB levels in elderly patients with coronary heart disease.Methods：A total of 78 elderly patients with coronary heart disease were selected in Affiliated Hospital of Tibet University for Nationalities were randomly divided into a control group（39 cases）and a study group（39 cases）.The control group was treated with Western medicine，and the study group was treated with Gualou Xiebai Guizhi Decoction on the basis of the control group for 4 weeks.The changes of blood lipid，NT Pro BNP，hs CRP，FiB，WBC，Hcy，hemorheology and cardiac function were observed and compared before treatment in the 2 groups.After the treatment was completed，the effect evaluation was performed.Results：After treatment，TC，TG，HDL-C，NT-proBNP，hs-CRP，FIB，WBC，HCY，whole blood high shear viscosity，whole blood low shear viscosity，plasma viscosity，red blood cell aggregation index in the study group were lower than those in the control group，and LDL-C，EDD，NEDD，LVEF，lVPFR were higher than those in the control group（P<0.05）.Conclusion：Gualou Xiebai Guizhi Decoction can reduce the level of blood lipid，inhibit the inflammatory reaction，improve the blood circulation of coronary artery，so as to improve the curative effects and heart function.

Keywords Gualou Xiebai Guizhi Decoction; Coronary heart disease; Blood lipid; N-terminal pro-brain natriuretic peptide; Hypersensitive C-reactive protein; Fibrinogen; Hemorheology; Heart function; Therapeutic effects

中图分类号：R259;R541.4 文献标识码：A doi：10.3969/j.issn.1673-7202.2020.08.013

冠心病是指由于供血不足引起心肌细胞缺血、缺氧甚至坏死而引起的心脏病变，其根源于冠状动脉因粥样硬化而出现冠状动脉血管管腔狭窄，甚至阻塞，其确切病因不清楚，多数学者认为和高血压、高脂血症、糖尿病等有关[1]。患者表现为胸腔中央出现压榨性疼痛，迁延至颈部、手臂、后背和胃部，伴有气促、出汗、寒颤、眩晕等症状，严重者会因心力衰竭而导致死亡。在治疗上有药物、支架和手术等方式，但费用大、创伤大、风险大、对有些患者疗效不稳定。而中医在改善冠心病临床症状、提高疗效上有明显优势性，且不良反应相对低，安全性高。……