益气舒心丸对急性冠脉综合征患者冠状动脉造影术中冠脉血流储备的影响

摘要

Objective To observe the effects ofYiqi Shuxin Pills on the coronary flow reserve (CFR) of patients with acute coronary syndrome (ACS) in the coronary angiography (CAG); To discuss its relevant mechanism of action.Methods Totally 101 patients with ACS were divided into control group (49 cases) and treatment group (52 cases). Patients in the treatment group were treated with western therapy andYiqi Shuxin Pills, while patients in the control group were treated with western therapy only. After treated for 6 months, CAG was reviewed to compare the CFR in both groups before and after the treatment. The blood-stasis syndrome and qi-deficiency syndrome scores and the level of NO, ET-1, hs-CRP, sVCAM-1, P-selectin in blood of both groups before and after the treatment were observed.Results The blood-stasis syndrome and qi-deficiency syndrome scores in the treatment group were significantly lower than those in the control group (P<0.01); The levels of ET-1, hs-CRP, sVCAM-1, P-selectin were obviously reduced and NO obviously increased in treatment group than those of control group (P<0.05). The CFR in the treatment group was significantly better than that of control group, with statistical significance (P<0.05). ConclusionYiqi Shuxin Pills can improve the state of blood-stasis syndrome and qi-deficiency syndrome, improve vascular endothelial function, relieve inflammatory reaction, lower the expression of platelet, stabilize atherosclerotic plaque of coronary artery, and then improve the CFR of ACS patients in CAG.%目的：观察益气舒心丸对急性冠脉综合征（ACS）患者冠状动脉造影（CAG）术中冠脉血流储备（CFR）的影响，探讨相关机制。方法将101例ACS患者随机分为对照组49例和治疗组52例。对照组予西医常规治疗，不加用任何具有益气或活血作用的中药或中成药；治疗组在西医常规治疗基础上，加服益气舒心丸。治疗6个月后复查CAG，观察治疗前后气虚证、血瘀证积分和一氧化氮（NO）、内皮素-1（ET-1）、高敏C反应蛋白（hs-CRP）、可溶性血管细胞黏附分子1（sVCAM-1）、P-选择素（P-selectin）及CFR各指标的变化。结果治疗后，治疗组气虚证、血瘀证积分较治疗前明显降低，优于对照组（P＜0.01）；治疗组ET-1、hs-CRP、sVCAM-1、P-selectin 较治疗前明显降低，NO 较治疗前明显升高，均优于对照组（P＜0.05）；治疗组CFR较对照组明显升高，差异有统计学意义（P＜0.05）。结论益气舒心丸可改善ACS患者的气虚血瘀状态，改善血管内皮功能，减轻炎症反应，抑制血小板活化，从而稳定冠状动脉粥样硬化斑块，增加CFR。