医学免费论文:活血通脉片对老年冠心病的疗效观察及机制探讨
【摘要】 目的观察活血通脉片治疗老年冠心病心绞痛的临床疗效,初步探索其作用机制。方法将80例老年冠心病心绞痛患者随机分为活血通脉片组(40例,常规西药加活血通脉片)与单纯西药治疗组(40例,单用西药治疗),观察治疗前后血浆内皮素(ET)与降钙素基因相关肽(CGRP)含量,临床症状和心电图的变化,并选择30例门诊健康体检者为正常组进行对比。结果治疗前与治疗后两组患者ET明显高于健康人(P<0.01),CGRP明显低于健康人(P<0.01),活血通脉组临床疗效总有效率及心电图疗效总有效率明显优于西药对照组(P<0.01);两组患者ET均明显降低,CGRP明显升高,但是活血通脉组优于西药对照组(P<0.01)。结论活血通脉片可抑制血浆ET过量释放,同时提高血浆CGRP浓度,具有良好的抗心肌缺血作用,对老年冠心病心绞痛有较好的疗效。
【关键词】 活血通脉片 老年冠心病 心绞痛
Effective Observation and Mechanism of HXTMT on Senile Coronary Heart Disease
JIANG Yurong, YANG Jian, LI Song, LI Ying^, LV Jianqiong
(The First College of Clinical Medical Science, China Three Gorges University&The Department of Cardiology, YiChang Central People's Hospital, Yichang, Hubei 443003, China)
Abstract:ObjectiveTo observe the curative effect of HXTMT on senile coronary heart disease(CHD) and its mechanism. MethodsEighty patients were divided into two groups randomly. Group Ⅰ(n=40) was treated by HXTMT adding up general medicine;Group Ⅱ(n=40)only by common medicine. The changes of the ET and CGRP contents before and after treatment were observed,and the symtpoms and ECG were compered with healthy people(n=30). ResultsThe ET contents of group ⅠandⅡwere both higher than healthy people before and after treatment (P<0.01).CGRP was significantly lower than the healthy people, but the group Ⅰwas higher than to the group Ⅱ in general effection and ECG change. ConclusionHXTMT can inhibit the release of serum ET and increase the serum CGRP. There is good effect on ischemis myocardiopathy in CHD.
Key words:HXTMT; Coronary artery disease; Angina
冠心病是老年人常见病。随着人口老龄化,冠心病已成为危及人类健康的主要疾病之一,所以对冠心病的有效治疗成了国内外非常关注的问题。血浆内皮素(ET)和降钙素基因相关肽(CGRP)是近年来发现的一对效应相反的血管活性物质,ET加重心肌缺血,CGRP有拮抗ET的作用,对缺血心肌有保护作用。活血通脉片具有益气活血、通经止痛之功,对冠心病心绞痛具有一定疗效,对ET和CGRP的影响已成为当今研究的热点。为了解活血通脉片治疗老年冠心病心绞痛的临床疗效和治疗机理,我们对80例老年心绞痛患者作了临床研究,并以ET和CGRP等作为判断疗效的治疗指标。现报道如下医.学.全.在.线www.lindalemus.com。
1 材料与方法
1.1 病例资料根据WHO1979年“缺血性心脏病的命名及诊断标准”[1]选择老年心绞痛患者80例及健康人30例,将心绞痛患者随机分为两组,其中活血通脉组40例,男23例,女17例,年龄55~75岁,平均(64.1±6.8)岁,病程1.0~4.6年,平均2.4年,其中稳定型心绞痛18例,不稳定型心绞痛22例;单纯西药组40例,男22例;女18例,年龄54~72岁,平均(61.4±5.1)岁,病程1.2~4.1年,平均2.1年,其中稳定型心绞痛19例,不稳定型心绞痛21例。两组病例在性别、年龄、病情等方面比较均无显著差异(P>0.05),具有可比性。另选择30例门诊健康体检者作比较,其中男16例,女14例,年龄55~65岁平均(60.5±5.8)岁。