浏览全部资源
扫码关注微信
北京中医药大学 东直门医院,北京 100700
Received:08 August 2024,
Accepted:15 November 2024,
Published Online:28 November 2024,
Published:20 July 2025
移动端阅览
牛超峰,张沛宇,李蒙等.麝香通心滴丸治疗冠状动脉慢血流的疗效及对炎症因子的影响[J].中国实验方剂学杂志,2025,31(14):114-121.
NIU Chaofeng,ZHANG Peiyu,LI Meng,et al.Efficacy of Shexiang Tongxin Dropping Pills in Treatment of Coronary Slow Flow and Its Effect on Inflammatory Factors[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(14):114-121.
牛超峰,张沛宇,李蒙等.麝香通心滴丸治疗冠状动脉慢血流的疗效及对炎症因子的影响[J].中国实验方剂学杂志,2025,31(14):114-121. DOI: 10.13422/j.cnki.syfjx.20242426.
NIU Chaofeng,ZHANG Peiyu,LI Meng,et al.Efficacy of Shexiang Tongxin Dropping Pills in Treatment of Coronary Slow Flow and Its Effect on Inflammatory Factors[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(14):114-121. DOI: 10.13422/j.cnki.syfjx.20242426.
目的
2
评价麝香通心滴丸治疗冠状动脉慢血流(CSF)的临床疗效,并观察其对炎症因子的影响。
方法
2
采用随机双盲安慰剂平行对照的试验设计,按照1∶1的比例将CSF患者随机分为观察组和对照组,观察组在常规基础治疗上加用麝香通心滴丸,对照组在常规基础治疗上加用安慰剂,共治疗12周。以心肌灌注显像静息总积分(SRS)为主要疗效指标,
西雅图心绞痛量表(SAQ)和心绞痛症状积分为次要疗效指标评估临床疗效,治疗前后检测患者血清中白细胞介素(IL)-1
α
、IL-1
β、
IL-6水平,观察其对炎症因子的影响,并对其安全性进行评价。
结果
2
该研究最终纳入64例经冠状动脉造影诊断为CSF的患者,其中观察组和对照组各32例。在临床疗效方面,与本组治疗前比较,观察组患者的SRS评分显著改善(
χ
2
=12.70,
P
<
0.05);治疗后与对照组比较,观察组患者SRS评分显著改善(
χ
2
=7.63,
P
<
0.05);与本组治疗前比较,观察组患者的心绞痛稳定状态(AS)、心绞痛发作频率(AF)、治疗满意程度(TS)、疾病的认识(DS)评分和心绞痛症状积分均有明显改善(
P
<
0.05),对照组患者DS评分有明显改善(
P
<
0.05);治疗后与对照组比较,观察组患者AS、AF、TS和心绞痛症状积分评分均有明显改善(
P
<
0.05)。在炎症因子方面,与本组治疗前比较,观察组患者IL-1
α
、IL-1
β
和IL-6水平均得到下降(
P
<
0.05)。治疗后与对照组比较,观察组患者IL-1
α
、IL-1
β
和IL-6均得到下降(
P
<
0.05)。
结论
2
麝香通心滴丸能够有效改善CSF患者的临床症状,并能够显著降低血清中炎症因子水平。
Objective
2
To evaluate the clinical efficacy of Shexiang Tongxin dropping pills in the treatment of coronary slow flow (CSF) and observe its impact on inflammatory factors.
Methods
2
A randomized, double-blind, placebo-controlled trial design was adopted. Patients with CSF were randomly divided into a test group and a control group at a 1∶1 ratio. The test group was given Shexiang Tongxin dropping pills in addition to conventional basic treatment, while the control group was given a placebo in addition to conventional basic treatment, with the treatment lasting for a total of 12 weeks. The summed rest score (SRS) of myocardial perfusion imaging was used as the primary efficacy indicator, and the Seattle Angina Questionnaire (SAQ) and angina symptom scores were used as secondary efficacy indicators to evaluate the clinical efficacy. The levels of serum interleukin-1
α
(IL-1
α
), interleukin-1
β
(IL-1
β
), and interleukin-6 (IL-6) were measured before and a
fter treatment to observe the impact of Shexiang Tongxin dropping pills on inflammatory factors, and its safety was also evaluated.
Results
2
Ultimately, 64 patients diagnosed with CSF by coronary angiography were included in this study, with 32 patients in each group. In terms of clinical efficacy, the SRS score of the patients in the test group was significantly improved after treatment compared with before treatment (
χ
2
=12.70,
P
<
0.05). After treatment, compared with the control group, the test group showed significantly improved SRS score (
χ
2
=7.63,
P
<
0.05). The scores of angina stability (AS), angina frequency (AF), treatment satisfaction (TS), and disease perception (DS) and the angina symptom score were all significantly improved in the test group after treatment compared with before treatment (
P
<
0.05). In the control group, the DS score was significantly improved (
P
<
0.05). After treatment, compared with the control group, the test group exhibited significantly improved scores of AS, AF, and TS and the angina symptom score (
P
<
0.05). In terms of inflammatory factors, the levels of IL-1
α
, IL-1
β
, and IL-6 in the test group decreased after treatment compared with before treatment (
P
<
0.05). After treatment, compared with the control group, the test group had decreased levels of IL-1
α
, IL-1
β
, and IL-6 (
P
<
0.05).
Conclusion
2
Shexiang Tongxin dropping pills can effectively improve the clinical symptoms of patients with CSF and significantly reduce the levels of inflammatory factors in serum.
胡盛寿 , 王增武 . 《中国心血管健康与疾病报告2022》概述 [J]. 中国心血管病研究 , 2023 , 21 ( 7 ): 577 - 600 .
HU S S , WANG Z W . Overview of report on cardiovascular Health and Diseases in China 2022 [J]. Chin J Cardiovascul Res , 2023 , 21 ( 7 ): 577 - 600 .
WANG X , NIE S P . The coronary slow flow phenomenon: Characteristics, mechanisms and implications [J]. Cardiovasc Diagn Ther , 2011 , 1 ( 1 ): 37 - 43 .
李燕伟 . 麝香通心滴丸对冠状动脉慢血流气虚血瘀痰浊阻滞证患者血管内皮保护作用的临床研究 [D]. 成都 : 成都中医药大学 , 2018 .
LI Y W . Clinical study on the protective effect of Shexiang Tongxin dripping pill on vascular endothelium in patients with coronary slow blood flow Qi deficiency and blood stasis phlegm stagnation syndrome [D]. Chengdu : Chengdu University of Traditional Chinese Medicine , 2018 .
徐朝 . 血管活性药物-麝香通心滴丸治疗冠状动脉慢血流的临床研究 [D]. 宁波 : 宁波大学 , 2016 .
XU Z . Vasoactive agent-clinical research on treatment of coronary slow flow phenomenon with Shexiang Tongxin dropping [D]. Ningbo : Ningbo University , 2016 .
王月 . 冠状动脉慢血流与血管内皮的相关性研究及药物干预 [D]. 沈阳 : 沈阳医学院 , 2018 .
WANG Y . The relationship between slow flow of coronary artery and vascular endothelium and drug intervention [D]. Shenyang : Shenyang Medical College , 2018 .
韩松洁 , 张晓雨 , 张立晶 , 等 . 麝香通心滴丸对PCI术后患者慢血流的临床证据评价 [J]. 世界科学技术—中医药现代化 , 2018 , 20 ( 10 ): 1772 - 1777 .
HAN S J , ZHANG X Y , ZHANG L J , et al . Clinical evidence evaluation of Shexiang Tongxin dropping pill for slow blood flow after PCI [J] . World Sci Technol Mod Tradit Chin Med Mater Med , 2018 , 20 ( 10 ): 1772 - 1777 .
李蒙 , 刘用 , 张健真 , 等 . 麝香通心滴丸预处理对大鼠心肌缺血再灌注损伤的保护作用机制 [J]. 中西医结合心脑血管病杂志 , 2024 , 22 ( 2 ): 250 - 253 .
LI M , LIU Y , ZHANG J Z , et al . Protective effect of Shexiang Tongxin dropping pill pretreatment on myocardial ischemia-reperfusion injury in rats [J]. Chin J Integr Med Cardio-Cerebrovascul Dis , 2024 , 22 ( 2 ): 250 - 253 .
LI J J , QIN X W , LI Z C , et al . Increased plasma C-reactive protein and interleukin-6 concentrations in patients with slow coronary flow [J]. Clin Chim Acta , 2007 , 385 ( 1/2 ): 43 - 47 .
YILMAZ M , KORKMAZ H , BILEN M N , et al . Could neutrophil/lymphocyte ratio be an indicator of coronary artery disease, coronary artery ectasia and coronary slow flow? [J]. J Int Med Res , 2016 , 44 ( 6 ): 1443 - 1453 .
QIU Z , JIANG Y , JIANG X , et al . Relationship between platelet to lymphocyte ratio and stable coronary artery disease: Meta-analysis of observational studies [J]. Angiology , 2020 , 71 ( 10 ): 909 - 915 .
CERQUEIRA M D , WEISSMAN N J , DILSIZIAN V , et al . Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: A statement for healthcare professionals from the cardiac imaging committee of the council on clinical cardiology of the American heart association [J]. Circulation , 2002 , 105 ( 4 ): 539 - 542 .
王阶 , 邢雁伟 . 冠心病心绞痛证候要素诊断标准 [J]. 中医杂志 , 2018 , 59 ( 6 ): 539 - 540 .
WANG J , XING Y W . Diagnostic criteria for syndrome elements of coronary heart disease and angina pectoris [J]. J Tradit Chin Med , 2018 , 59 ( 6 ): 539 - 540 .
中华医学会核医学分会 , 中华医学会心血管病学分会 . 核素心肌显像临床应用指南(2018) [J]. 中华心血管病杂志 , 2019 , 47 ( 7 ): 519 - 527 .
Chinese Society of Nuclear Medicine , Chinese Society of Cardiology . Guidelines for clinical application of radionuclide myocardial imaging (2018) [J]. Chin J Cardiol , 2019 , 47 ( 7 ): 519 - 527 .
张颖 , 牟甜甜 , 董薇 , 等 . 定量临床核心脏病学(第1部分):已明确的临床应用 [J]. 中华核医学与分子影像杂志 , 2022 , 42 ( 8 ): 504 - 512 .
ZHANG Y , MOU T T , DONG W , et al . Quantitative clinical nuclear cardiology (part 1): Established clinical applications [J]. Chin J Nucl Med Mol Imaging , 2022 , 42 ( 8 ): 504 - 512 .
李远 , 柳岩 , 肖文良 , 等 . 门控心肌灌注显像评价心可舒片治疗冠状动脉慢血流55例临床研究 [J]. 中医杂志 , 2017 , 58 ( 24 ): 2119 - 2123 .
LI Y , LIU Y , XIAO W L , et al . Clinical study on evaluation of Xinkeshu tablet (心可舒片) in treating 55 patients of coronary slow flow with gated myocardial perfusion imaging [J]. J Tradit Chin Med , 2017 , 58 ( 24 ): 2119 - 2123 .
王涛 , 张慧平 , 李远 , 等 . 99Tcm-MIBI门控心肌灌注显像评价尼可地尔对冠状动脉慢血流的疗效 [J]. 中国介入心脏病学杂志 , 2014 , 22 ( 7 ): 436 - 439 .
WANG T , ZHANG H P , LI Y , et al . Effect of nicorandil on coronary slow flow evaluated by 99Tcm-MIBI gated myocardial perfusion imaging [J]. Chin J Interventional Cardiol , 2014 , 22 ( 7 ): 436 - 439 .
GARRATT A M , HUTCHINSON A , RUSSELL I , et al . The UK version of the Seattle Angina Questionnaire (SAQ-UK): Reliability, validity and responsiveness [J]. J Clin Epidemiol , 2001 , 54 ( 9 ): 907 - 915 .
GUNES Y , TUNCER M , GUNTEKIN U , et al . Regional functions of the left ventricle in patients with coronary slow flow and the effects of nebivolol [J]. Ther Adv Cardiovasc Dis , 2009 , 3 ( 6 ): 441 - 446 .
王阶 , 李军 , 董艳 , 等 . 泛血管疾病的中医内涵及防治策略 [J]. 中国实验方剂学杂志 , 2025 , 31 ( 7 ): 1 - 14 .
WANG J , LI J , DONG Y , et al . Connotation and prevention strategies of traditional Chinese medicine for panvascular diseases [J]. Chin J Exp Tradit Med Form , 2025 , 31 ( 7 ): 1 - 14 .
MUKHOPADHYAY S , KUMAR M , YUSUF J , et al . Risk factors and angiographic profile of coronary slow flow (CSF) phenomenon in North Indian population: An observational study [J]. Indian Heart J , 2018 , 70 ( 3 ): 405 - 409 .
CHALIKIAS G , TZIAKAS D . Slow coronary flow: Pathophysiology, clinical implications, and therapeutic management [J]. Angiology , 2021 , 72 ( 9 ): 808 - 818 .
BELTRAME J F , LIMAYE S B , HOROWITZ J D . The coronary slow flow phenomenon-A new coronary microvascular disorder [J]. Cardiology , 2002 , 97 ( 4 ): 197 - 202 .
刘用 , 肖狄 , 康静璠 , 等 . 冠状动脉慢血流的发病机制及其DNA甲基化研究进展 [J]. 中国医药 , 2023 , 18 ( 6 ): 931 - 934 .
LIU Y , XIAO D , KANG J P , et al . Advances in the pathogenesis and DNA methylation of coronary slow flow [J]. China Med , 2023 , 18 ( 6 ): 931 - 934 .
古再努尔·艾尼瓦尔 , 曹桂秋 . 冠状动脉慢血流现象治疗的研究进展 [J]. 中国当代医药 , 2022 , 29 ( 23 ): 30 - 34 .
GUZAINUER A , CAO G Q . Progress in the treatment of coronary slow flow phenomenon [J]. China Moder Med , 2022 , 29 ( 23 ): 30 - 34 .
张志引 , 杨冯静 , 张明玺 . 冠状动脉慢血流中医治疗新进展 [J]. 山西中医 , 2022 , 38 ( 6 ): 68 - 70 .
ZHANG Z Y , YANG F J , ZHANG M X . New progress in traditional Chinese medicine treatment of coronary slow flow [J]. Shanxi J Tradit Chin Med , 2022 , 38 ( 6 ): 68 - 70 .
李蒙 , 李金根 , 刘佳 等 . 麝香通心滴丸改善冠状动脉慢血流的研究进展 [J]. 世界中医药 , 2022 , 17 ( 8 ): 1180 - 1183 .
LI M , LI J G , LIU J , et al . Research progress of Shexiang Tongxin drop pills in improving slow coronary blood flow of coronary artery [J]. World Chin Med , 2022 , 17 ( 8 ): 1180 - 1183 .
李冬梅 , 孟庆鑫 , 李忠娟 , 等 . 24小时动态心电图在冠状动脉慢血流中的应用分析 [J]. 中国医药科学 , 2021 , 11 ( 11 ): 198 - 200,215 .
LI D M , MENG Q X , LI Z G , et al . An analysis of the application of 24-hour dynamic electrocardiogram to coronary slow flow [J]. China Med Pharm , 2021 , 11 ( 11 ): 198 - 200,215 .
宋文慧 , 张怡然 , 王海燕 . 无创影像学技术在冠状动脉慢血流评估中的应用研究进展 [J]. 山东医药 , 2022 , 62 ( 35 ): 104 - 108 .
SONG W H , ZHANG Y R , WANG H Y . Research progress on the application of noninvasive imaging techniques in the evaluation of coronary slow flow [J]. Shandong Med J , 2022 , 62 ( 35 ): 104 - 108 .
石宇杰 , 牛丽丽 , 李俊峡 , 等 . 负荷心肌核素灌注显像联合冠状动脉CTA对冠状动脉慢血流的诊断价值 [J]. 中国循证心血管医学杂志 , 2015 , 7 ( 4 ): 527 - 529 .
SHI Y J , NIU L L , LI J X , et al . Diagnostic value of load myocardial nuclein perfusion imaging combining coronary computed tomographic angiography to coronary slow flow [J]. Chin J Evid-Based Cardiovascul Med , 2015 , 7 ( 4 ): 527 - 529 .
王苏 , 孟晶晶 , 王茜 , 等 . 心肌核素显像指导下尼可地尔治疗冠状动脉慢血流1例 [J]. 中国介入心脏病学杂志 , 2018 , 26 ( 12 ): 717 - 718 .
WANG S , MENG J J , WANG Q , et al . Nicorandil treatment of coronary slow flow under the guidance of myocardial radionuclide imaging: A case report [J]. Chin J Intervent Cardiol , 2018 , 26 ( 12 ): 717 - 718 .
王茜 , 孟晶晶 , 王苏 , 等 . 定量单光子发射型计算机断层显像心肌核素对冠状动脉慢血流的辅助诊断及尼可地尔的疗效评估-附2例病例 [J]. 心肺血管病杂志 , 2019 , 38 ( 2 ): 206 - 209 .
WANG Q , MENG J J , WANG S , et al . Auxiliary diagnosis of coronary slow flow by quantitative single photon emission computed tomography myocardial radionuclide and evaluation of the efficacy of nicorandil - two cases attached [J]. J Cardiovascul Pulm Dis , 2019 , 38 ( 2 ): 206 - 209 .
稳定性冠心病无创影像检查路径的专家共识 [J]. 中国介入心脏病学杂志 , 2017 , 25 ( 10 ): 541 - 549 .
Expert consensus on the non-invasive imaging examination pathway for stable coronary artery disease [J]. Chin J Intervent Cardiol , 2017 , 25 ( 10 ): 541 - 549 .
OZ F , CIZGICI A Y , OFLAZ H , et al . Impact of vitamin D insufficiency on the epicardial coronary flow velocity and endothelial function [J]. Coron Artery Dis , 2013 , 24 ( 5 ): 392 - 297 .
MANGIERI E , MACCHIARELLI G , CIAVOLELLA M , et al . Slow coronary flow: Clinical and histopathological features in patients with otherwise normal epicardial coronary arteries [J]. Cathet Cardiovasc Diagn , 1996 , 37 ( 4 ): 375 - 381 .
赵健 , 梁春 . 麝香通心滴丸治疗冠状动脉微循环障碍的研究进展 [J]. 中西医结合心脑血管病杂志 , 2023 , 21 ( 11 ): 2003 - 2005 .
ZHAO J , LIANG C . Research progress of Shexiang Tongxin dropping pills in the treatment of coronary microcirculation disorders [J]. Chin J Integr Tradit West Med Cardio-Cerebrovascul Dis , 2023 , 21 ( 11 ): 2003 - 2005 .
闫丹丹 , 梁如 , 邓兵 , 等 . 冠心病稳定性心绞痛痰瘀互结证西雅图心绞痛量表评价研究 [J]. 中国中医基础医学杂志 , 2019 , 25 ( 5 ): 630 - 633,651 .
YAN D D , LIANG R , DENG B , et al . Research on the evaluation of seattle angina questionnaire in coronary heart disease patients with stable angina of phlegm and blood stasis syndrome [J]. J Basic Chin Med , 2019 , 25 ( 5 ): 630 - 633,651 .
胡文标 . 炎症因子与冠心病关系的进展及分析 [J]. 中西医结合心血管病电子杂志 , 2020 , 8 ( 22 ): 21 - 22 .
HU W B . Progress and analysis of the relationship between inflammatory factors and coronary heart disease [J]. Cardiovascul Dis Electronic J Integr Tradit Chin West Med , 2020 , 8 ( 22 ): 21 - 22 .
任凤梧 , 孙玉秀 , 姜小刚 , 等 . 纳葛通脉汤治疗气虚血瘀型冠心病稳定型心绞痛的疗效观察及对血脂、IL-1 β 、IL-6的影响 [J]. 中国中医药科技 , 2023 , 30 ( 6 ): 1090 - 1092 .
REN F W , SUN Y X , JIANG X G , et al . Observation on curative effect of Nage Tongmai decoction (纳葛通脉汤) in treatment of stable angina pectoris in coronary heart disease belonging to Qi deficiency and blood stasis and influences on blood lipid, IL-1 β and IL-6 [J]. Chin J Tradit Med Sci Technol , 2023 , 30 ( 6 ): 1090 - 1092 .
程志 , 杨云霞 , 程云耀 , 等 . 麝香保心丸联合瑞舒伐他汀钙片治疗冠心病心绞痛的疗效及对血液流变学和血脂的影响 [J]. 临床合理用药 , 2024 , 17 ( 11 ): 44 - 47 .
CHENG Z , YANG Y X , CHENG Y Y , et al . Efficacy of Shexiang Baoxin pills combined with rosuvastatin calcium tablets in the treatment of coronary heart disease and angina pectoris and their effects on hemorheology and blood lipids [J]. Chin J Clin Rational Drug Use , 2024 , 17 ( 11 ): 44 - 47 .
权赫秀 , 杨小琪 , 金鹏 , 等 . 麝香及其代用品人工麝香对H 2 O 2 诱导H9c2心肌细胞损伤保护作用比较研究 [J]. 中药材 , 2018 , 41 ( 4 ): 961 - 965 .
QUAN H X , YANG X Q , JIN P , et al . Protective effect of moschus and the alternative artificial moschus on H9c2 cardiomyocytes impaired by H 2 O 2 [J]. J Chin Med Mater , 2018 , 41 ( 4 ): 961 - 965 .
黄东宇 , 杨璐铭 , 钟映琪 , 等 . 蟾酥活性成分及其药理作用的研究进展 [J]. 沈阳药科大学学报 , 2023 , 40 ( 1 ): 124 - 136 .
HUANG D Y , YANG L M , ZHONG Y Q , et al . Research progress on the active components of Bufonis Venenum and their pharmacological actions [J]. J Shenyang Pharm Univ , 2023 , 40 ( 1 ): 124 - 136 .
贡却拉姆 , 文媛媛 , 旦知才让 , 等 . 藏法合成人工牛黄促进糖尿病创伤愈合的机制研究 [J]. 华西药学杂志 , 2023 , 38 ( 6 ): 639 - 644 .
GONGQUELAMU , WEN Y Y , DANZHICAIRANG , et al . Study on the mechanism of artificial bezoar synthesized by Tibetan method promoting the diabetic wound healing [J]. West China J Pharm Sci , 2023 , 38 ( 6 ): 639 - 644 .
赵昭 , 侯倩 . 冰片对缺血性脑卒中的药理作用研究进展 [J]. 临床医学研究与实践 , 2023 , 8 ( 8 ): 174 - 177 .
ZHAO Z , HOU Q . Research progress in pharmacological effects of borneol on ischemic stroke [J]. Clin Res Pract , 2023 , 8 ( 8 ): 174 - 177 .
韩大荣 . 人参皂苷在心肌缺血及再灌注损伤保护作用方面的研究进展 [J]. 医学理论与实践 , 2011 , 24 ( 6 ): 637 - 638 .
HAN D R . Research progress on the protective effect of ginsenoside on myocardial ischemia and reperfusion injury [J]. J Med Theory Pract , 2011 , 24 ( 6 ): 637 - 638 .
朱建强 , 吴霞 , 杨丹 . 丹参素治疗心肌梗死的药理作用研究进展 [J]. 现代药物与临床 , 2024 , 39 ( 7 ): 1927 - 1931 .
ZHU J Q , WU X , YANG D . Research progress on pharmacological effects of Danshensu in treatment of myocardial infarction [J]. Drug Clin , 2024 , 39 ( 7 ): 1927 - 1931 .
何莉莉 , 刘棣文 , 崔娜 , 等 . 熊胆粉及其活性成分治疗神经系统疾病作用机制研究进展 [J]. 环球中医药 , 2024 , 17 ( 4 ): 743 - 751 .
HE L L , LIU D W , CUI N , et al . Research progress on the mechanism of bear bile powder and its active research progress on the mechanism of bear bile powder and its active [J]. Global Tradit Chin Med , 2024 , 17 ( 4 ): 743 - 751 .
0
Views
36
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution