小陷胸汤加味治疗不稳定性心绞痛痰热互结证的临床疗效及对血管内皮功能的影响

摘要

Objective To observe the curative efficacy of modified Xiaoxianxiong decoction on treatment of unstable angina with intermingled phlegm-heat syndrome and its effects on vascular endothelial function.Methods 56 unstable angina patients with intermingled phlegm-heat syndrome were randomly divided into two groups.28 cases in control group were treated by western routine therapy,and 28 cases in treatment group were treated by modified Xiaoxianxiong decoction on the basis of the control group.The treatment course was 30 d in two groups.The changes of vascular endothelial function including serum nitric oxide(NO) and endothelin(ET) before and after treatment were observed in two groups.The curative efficacy of angina,electrocardiogram and traditional Chinese medicine (TCM) syndrome were compared in two groups.Results The total effective rate of angina in treatment group (92.86％) was superior to that in control group(89.28％),with statistical differences (P ＜ 0.05).The total effective rate of electrocardiogram in treatment group (92.86％)was higher than that in control group(85.71％)with no significant difference (P ＞ 0.05).The total effective rate of TCM syndrome in treatment group (96.43 ％) was superior to that in control group (78.57 ％),with statistical differences (P ＜ 0.05).The NO after treatment increased in two groups (P ＜ 0.05),and the ET reduced (P ＜ 0.05).The NO after treatment in treatment group was higher than that in control groups (P ＜0.05),and ET was lower (P ＜ 0.05).Conclusion Modified Xiaoxianxiong decoction combined with western routine therapy can effectively improve the clinical symptoms and vascular endothelial function of unstable angina patients with intermingled phlegm-heat syndrome.%目的 观察小陷胸汤加味治疗不稳定性心绞痛痰热互结证的临床疗效及对血管内皮功能的影响.方法 将56例不稳定性心绞痛痰热互结证患者随机分为2组,对照组28例予西医常规治疗,治疗组28例在对照组治疗基础上加小陷胸汤加味治疗,2组疗程均为30 d.观察2组治疗前后血管内皮功能[血清一氧化氮(N0)、内皮素(ET)]变化,比较2组心绞痛疗效、心电图疗效及中医证候疗效.结果 治疗组心绞痛总有效率92.86％,对照组心绞痛总有效率89.28％,2组心绞痛总有效率比较差异有统计学意义(P＜0.05),治疗组心绞痛疗效优于对照组.治疗组心电图总有效率92.86％,对照组心电图总有效率85.71％,2组心电图总有效率比较差异无统计学意义(P＞0.05),2组心电图疗效相当.治疗组中医证候总有效率96.43％,对照组中医证候总有效率78.57％,2组中医证候总有效率比较差异有统计学意义(P＜0.05),治疗组中医证候疗效优于对照组.2组治疗后NO水平均较本组治疗前升高(P＜0.05),ET水平降低(P＜0.05).治疗组治疗后NO水平高于对照组(P＜0.05),ET水平低于对照组(P＜0.05).结论 小陷胸汤加味联合西医常规治疗能有效改善不稳定性心绞痛痰热互结证患者临床症状和血管内皮功能.