摘要：
Objective To observe the effect of Tongbi decoctionon for the changes of the endothelial function and hemorheology in patients with coronary heart disease. Methods A total of 90 patients with angina pectoris were divided into the observation group and the control group according to the random number table method, with 45 in each group. The control group was given routine clinical treatment, and the observation group was treated with Tongbi decoction on the basis of the control group. After treated for 4 weeks, the pain severity of angina pectoris was observed before and after treatment, and the frequency and duration of angina pectoris were recorded. The levels of serum vascular endothelin (ET) and endothelin (VEGF) were measured by ELISA. The serum NO was measured by nitrate reductase method, and whole blood viscosity and plasma viscosity were measured by blood viscometer. The hematocrit was measured by hematocrit analyzer and optical density method. The erythrocyte aggregation index was measured, and the fibrinogen level was measured by heating precipitation method. And the clinical efficacy was evaluated. Results After treatment, the total effective rate was 93.3％ (42/45) in the observation group and 77.8％ (35/45) in the control group, and there was significant difference between the two groups (Z=-3.164, P=0.002). After treatment, the score of angina pain (0.62 ± 0.05 vs. 1.17 ± 0.14, t=5.733) , the frequency of angina attack (3.62 ± 0.43 times/week vs. 5.02 ± 0.64 times/week, t=5.042), the duration of angina attack (3.17 ± 0.42 minutes/time vs. 4.06 ± 0.51 minutes/time, t=4.781) in the observation group were significantly lower than those in the control group (P<0.05). After treatment, the levels of VEGF and NO in the observation group were significantly higher than those in the control group (t value was 5.892, 5.347, all Ps<0.05), and ET was significantly lower than that in the control group (t=4.926, P=0.037). After treatment, the whole blood viscosity, plasma viscosity, hematocrit, aggregation index and fibrinogen levels in the observation group were significantly lower than those in the control group (t values were 4.832, 4.233, 5.031, 4.136, 4.531, all Ps<0.05). Conclusions The application of Tongbi decoction can improve the endothelial function of patients with angina pectoris, adjust the hemorheological indexes and relieve the symptoms related to angina pectoris.%目的 观察通痹汤对冠心病心绞痛患者内皮功能及血液流变学的影响.方法 将符合入选标准的90例冠心病心绞痛患者按随机数字表法分为2组,每组45例.对照组给予常规疗法治疗,观察组在对照组基础上加服通痹汤.2组均治疗4周.分别于治疗前后观察患者心绞痛的疼痛程度,记录心绞痛发作频率及持续时间;采用ELISA法检测血清VEGF、内皮素(endothelin,ET)水平,采用硝酸还原酶法检测血清NO水平,采用SA6K自动血液流变仪检测全血黏度与血浆黏度,采用血细胞分析仪检测血细胞比容,采用光密度法测量红细胞聚集指数,采用加热沉淀法测定纤维蛋白原水平;评价临床疗效.结果 观察组总有效率为93.3％(42/45)、对照组为77.8％(35/45),2组比较差异有统计学意义(Z=-3.164,P=0.002).治疗后,观察组心绞痛疼痛积分[(0.62±0.05)分比(1.17±0.14)分,t=5.733]低于对照组(P<0.05),心绞痛发作频率[(3.62±0.43)次/周比(5.02±0.64)次/周,t=5.042]、持续时间[(3.17±0.42)min/次比(4.06±0.51)min/次,t=4.781]均低于对照组(P<0.05).治疗后,观察组血清VEGF、NO水平均高于对照组(t值分别为5.892、5.347,P值均<0.05)、ET低于对照组(t=4.926,P=0.037);观察组全血黏度、血浆黏度、血细胞比容、红细胞聚集指数、纤维蛋白原水平均低于对照组(t值分别为4.832、4.233、5.031、4.136、4.531,P值均<0.05).结论 通痹汤可改善冠心病心绞痛患者内皮功能,调节血液流变学指标,缓解心绞痛.
