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1.江西中医药大学,南昌 330006
2.温岭市第一人民医院,浙江 温岭 317500
3.江西中医药大学 附属医院,南昌 330006
胡芳,在读硕士,从事心血管临床与实验研究,E-mail:1746802160@qq.com
刘中勇,硕士,二级教授,从事心血管临床与实验研究,E-mail:lzyongmail@163.com
收稿日期:2019-12-01,
网络出版日期:2020-07-20,
纸质出版日期:2020-09-20
移动端阅览
胡芳,沈金峰,刘中勇.六君子汤合二陈汤加减对冠心病患者Hcy,NO,hs-CRP的影响[J].中国实验方剂学杂志,2020,26(18):24-29.
HU Fang,SHEN Jin-feng,LIU Zhong-yong.Effect of Modified Liu Junzitang and Erchentang on Hcy, NO, hs-CRP in Patients with Coronary Heart Disease[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(18):24-29.
胡芳,沈金峰,刘中勇.六君子汤合二陈汤加减对冠心病患者Hcy,NO,hs-CRP的影响[J].中国实验方剂学杂志,2020,26(18):24-29. DOI: 10.13422/j.cnki.syfjx.20201723.
HU Fang,SHEN Jin-feng,LIU Zhong-yong.Effect of Modified Liu Junzitang and Erchentang on Hcy, NO, hs-CRP in Patients with Coronary Heart Disease[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(18):24-29. DOI: 10.13422/j.cnki.syfjx.20201723.
目的
2
通过观察血清同型半胱氨酸(homocysteine,Hcy),一氧化氮(nitric oxide,NO),高敏-C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)与冠脉病变数量及程度的关系及其运用六君子汤联合二陈汤加减对冠心病(coronary heart disease,CHD)患者Hcy,NO,hs-CRP的影响,探讨六君子汤联合二陈汤加减对CHD患者的保护作用。
方法
2
选取来自江西中医药大学附属医院2016年11月至2019年4月心血管科住院CHD(痰浊内阻型)患者76例,分析Hcy,NO,hs-CRP与冠脉病变数量及程度的关系。以抽签方式,将76例患者随机分为观察组和对照组,每组各38例患者。对照组患者给予常规治疗,观察组患者在常规治疗基础上服用六君子汤合二陈汤加减,周期为3个月。评估两组服药前后中医症状评分;检测两组患者服药前后Hcy,NO,hs-CRP,甘油三酯(TG),低密度脂蛋白(LDL),高密度脂蛋白(HDL),总胆固醇(TC),载脂蛋白A1(Apo A1),载脂蛋白B(Apo B),
N
末端B型利钠肽原(NT-proBNP),左心室射血分数(LVEF)指标。
结果
2
Hcy,hs-CRP水平与冠脉病变支数及程度呈正相关。NO水平与冠脉病变支数及程度负相关关系。与本组治疗前比较,两组患者治疗后中医症状评分均有不同程度下降(
P
<
0.05);与对照组治疗后比较,观察组在降低中医症状评分更明显(
P
<
0.05)。与本组治疗前比较,两组治疗后可以降低Hcy,hs-CRP水平,提高NO水平(
P
<
0.05);与对照组治疗后比较,观察组降低Hcy,hs-CRP水平及提高NO水平更明显(
P
<
0.05)。与本组治疗前比较,两组治疗后均降低TG,LDL,TC,Apo A1,Apo B水平,提高HDL水平(
P
<
0.05);与对照组治疗后比较,观察组可降低TG,LDL,TC,Apo A1,Apo B水平,提高HDL水平(
P
<
0.05)。与本组治疗前比较,两组治疗后均可提高LVEF水平,降低NT-proBNP水平(
P
<
0.05);与对照组治疗后比较,观察组可提高LVEF水平,降低NT-proBNP水平(
P
<
0.05)。
结论
2
Hcy,hs-CRP水平与冠脉病变呈正相关关系,NO水平与冠脉病变呈负相关,六君子汤联合二陈汤加减可能是通过抑制CHD患者的Hcy,hs-CRP及提高CHD患者的NO水平,从而降低患者血脂,提高患者心功能,改善患者临床症状。
Objective
2
To observe the relationship between serum homocysteine (Hcy)
nitric oxide (NO)
high-sensitivity C-reactive protein (hs-CRP) as well as the number and degree of coronary lesions
and the effect of Liu Junzitang combined with Erchentang on Hcy
NO
hs-CRP in patients with coronary heart disease (CHD)
so as to explore the protector effect of Liu Junzitang combined with Erchentang on CHD patients.
Method
2
A total of 76 inpatients with phlegm turbidity and internal resistance (CHD) from the Cardiovascular Department of Jiangxi University of Traditional Chinese Medicine(TCM) from November 2016 to April 2019 were selected to analyze the relationship between Hcy
NO
hs-CRP as well as the number and degree of coronary lesions. By lottery
the 76 patients were randomly divided into observation group and control group
with 38 patients in each group. Patients in the control group were given conventional therapy
while patients in the observation group were given Liu Junzitang combined with Erchentang in addition to conventional therapy. The experimental period was 3 months. TCM symptom scores of the two groups before and after administration were evaluated. Hcy
NO
hs-CRP
triglyceride (TG)
low-density lipoprotein (LDL)
high-density lipoprotein (HDL)
and total cholesterol (TC)
apolipoprotein A1 (Apo A1)
apolipoprotein B (Apo B)
N
-terminal B-type natriuretic peptide (NT-proBNP)
left ventricular ejection fraction (LVEF) indicators of the two groups were measured before and after administration.
Result
2
The levels of Hcy and hs-CRP were positively correlated with the number and degree of coronary lesions. The level of NO was negatively correlated with the number and degree of coronary lesions. TCM symptom scores were different between the two groups after treatment. Compared with the control group
the TCM symptom score in the observation group was decreased more significantly (
P
<
0.05). The two groups could reduce Hcy
hs-CRP and increase in NO to a certain extent (
P
<
0.05). Compared with the control group
the observation group showed reduction in Hcy
hs-CRP and increase in NO more significantly (
P
<
0.05). After treatment in both groups
TG
LDL
TC
Apo A1
Apo B and HDL were reduced (
P
<
0.05) compared with before treatment. Compared with the control group
the observation group showed decrease in TG
LDL
TC
Apo A1
Apo B and increase in HDL more significantly (
P
<
0.05). Both groups could increase LVEF and decrease NT-proBNP after treatment (
P
<
0.05). Compared with the control group
the observation group increased LVEF and decreased NT-proBNP more significantly (
P
<
0.05).
Conclusion
2
The levels of Hcy and hs-CRP were positively correlated with coronary lesions
while the level of NO was negatively correlated with coronary lesions. Modified Liu Junzitang and Erchentang may be correlated with inhibition of Hcy
hs-CRP and CHD and increase of patient's NO level
thereby reducing the patient's blood lipids
improving the patient's heart function
and improving the patient's clinical symptoms.
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