| 引用本文:荣鸽璇1，李昕玲2，谭弘3，陈建荣4.大柴胡汤加减对冠心病不稳定型绞痛的多中心、随机、双盲对照临床研究[J].世界中医药,2019,(04):. |
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| 大柴胡汤加减对冠心病不稳定型绞痛的多中心、随机、双盲对照临床研究 |
| A Multicenter，Randomized，Double-Blind，Controlled Clinical Trial of Dachaihu Decoction for Unstable Angina Pectoris |
| 投稿时间：2018-11-09 |
| DOI：10.3969/j.issn.1673-7202.2019.04.018 |
| 中文关键词: 冠心病 不稳定性心绞痛 大柴胡汤 心功能 血管内皮 氧化应激 |
| English Keywords:Coronary heart disease Unstable angina pectoris Dachaihu Decoction Cardiac function Vascular endothelium Oxidative stress |
| 基金项目:国家自然科学基金项目(81274036) |
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| 中文摘要: |
| 目的:探究大柴胡汤加减对冠心病不稳定性心绞痛临床效果,以期选择最佳方法治疗,提高疗效。方法:选取2017年1月至2018年1月辽宁中医药大学附属医院收治的符合纳入条件冠心病不稳定性心绞痛患者216例作为研究对象,按照就诊顺序编号随机分为对照组和观察组,每组108例。对照组予常规西医治疗,观察组加用大柴胡汤治疗,均治疗4周。观察2组治疗前、完成治疗后心绞痛发作频率、持续时间变化情况并比较;观察治疗前、完成治疗后心功能指标左室舒张末径(LVEDD)、左心室射血分数(LVEF)、左房室舒张早期血流峰值与舒张晚期血流峰值比值(E/A)变化并比较;观察治疗前、完成治疗后血管内皮功能一氧化氮(NO)、内皮素(ET-1)变化并比较;观察治疗前、完成治疗后氧化应激指标血清超氧化物歧化酶(SOD)、脂质过氧化物(LPO)、丙二醛(MDA)、总抗氧化能力(TAC)变化并比较;观察治疗过程中是否出现腹胀、恶心呕吐、头痛头晕等不良反应。结果:1)2组患者治疗前心绞痛发作频率、持续时间比较，差异无统计学意义(P>0.05),完成治疗后以上指标2组较治疗前均显著下降(P<0.05),完成治疗后观察组患者以上指标显著低于对照组(P<0.05)。2)2组患者治疗前SV、LVEDD、LVEF、E/A比较，差异无统计学意义(P>0.05),完成治疗后SV、LVEF、E/A2组较治疗前均显著升高,LVEDD较治疗前均显著下降(P<0.05),完成治疗后观察组患者以上指标显著优于对照组(P<0.05)。3)2组患者治疗前NO、ET-1比较，差异无统计学意义(P>0.05),完成治疗后NO 2组较治疗前均显著升高,ET-1较治疗前均显著下降(P<0.05),完成治疗后观察组患者以上指标显著优于对照组(P<0.05)。4)2组患者治疗前SOD、LPO、MDA、TAC比较，差异无统计学意义(P>0.05),完成治疗后SOD、TAC 2组较治疗前均显著升高,LPO、MDA较治疗前均显著下降(P<0.05),完成治疗后观察组患者以上指标显著优于对照组(P<0.05)。5)2组腹胀、恶心呕吐、头痛头晕不良反应率比较，差异无统计学意义(P>0.05)。结论:大柴胡汤对冠心病不稳定性心绞痛能改善心功能,抑制氧化应激,促进血管内皮功能恢复,疗效显著。 |
| English Summary: |
| To explore the clinical effects of modified Dachaihu Decoction on unstable angina pectoris of coronary heart disease (CHD)，so as to select the best treatment method and improve the curative effect.Methods:A total of 216 eligible patients with unstable angina pectoris in Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from January 2017 to January 2018 were randomly divided into the control group (108 cases) and the observation group (108 cases) according to the order of treatment.The control group was treated with conventional western medicine，and the observation group was treated with Dachaihu Decoction for 4 weeks.The frequency and duration of angina pectoris before and after treatment were observed and compared between the 2 groups，and the left ventricular end diastolic diameter (LVEDD)，left ventricular ejection fraction (LVEF)，left atrial early diastolic peak blood flow and late diastolic peak blood flow ratio (E/A) were observed before and after treatment.The changes of nitric oxide (NO) and endothelin (ET-1) in vascular endothelial function before and after treatment were observed and compared，and the changes of serum superoxide dismutase (SOD)，lipid peroxide (LPO)，malondialdehyde (MDA) and total antioxidant capacity (TAC) before and after treatment were observed.The adverse reactions of abdominal distension，nausea and vomiting，headache and dizziness were observed.Results:1）There was no significant difference in the frequency and duration of angina pectoris between the 2 groups before treatment (P>0.05).After treatment，the above indexes in both groups were significantly decreased than those before treatment (P<0.05).After treatment，the above indexes in the observation group were significantly lower than those in the control group (P<0.05).2) There was no significant difference in SV，LVEDD，LVEF and E/A between the two groups before treatment (P>0.05).After treatment，the levels of SV，LVEF and E/A in the 2 groups were significantly higher than those before treatment，and the levels of LVEDD were significantly decreased than those before treatment (P<0.05).The above index of the observation group was significantly better than the control group after treatment (P<0.05).3) There was no significant difference in NO and ET-1 between the 2 groups before treatment (P>0.05).After treatment，NO increased significantly in both groups，ET-1 decreased significantly (P<0.05).After treatment，the above indexes in the observation group were significantly better than those in the control group (P<0.05).4) There was no significant difference in SOD，LPO，MDA and TAC between the 2 groups before treatment (P>0.05).After treatment，SOD and TAC increased significantly，and LPO and MDA decreased significantly (P<0.05).After treatment，the above indexes in the observation group were significantly better than those in the control group (P<0.05).There was no significant difference in the rates of abdominal distention，nausea and vomiting，headache and dizziness between the 2 groups (P>0.05).Conclusion:Dachaihu Decoction can improve cardiac function，inhibit oxidative stress and promote vascular endothelial function recovery in patients with unstable angina pectoris of coronary heart disease. |
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