通脉愈心浓缩丸防治冠脉内支架置入术后再狭窄的临床研究(1)
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[摘要] 目的：在中药通脉愈心浓缩丸预防冠脉内支架置入术后再狭窄疗效观察的基础上，研究通脉愈心浓缩丸防治再狭窄的作用及其机制，为临床运用提供依据。方法：将符合入选标准的121例冠脉内支架置入术成功的冠心病患者随机分为西药常规治疗加通脉愈心浓缩丸组(治疗组，61例)和西药常规治疗组(对照组，60例)。疗程均为6个月，追踪观察患者有无心绞痛复发、心电图异常，并通过心电图活动平板运动试验及冠状动脉造影复查评价再狭窄的发生。并对观察病例观察其治疗前后血清一氧化氮(NO)及血浆内皮素(ET)的变化。结果：治疗组心绞痛复发率显著低于对照组。治疗组再狭窄率为9.8%，对照组再狭窄率为23.3%，治疗组显著低于对照组(P<0.01)。治疗组在治疗结束时血清NO高于对照组，而血浆ET低于对照组。结论：具有化痰祛浊、活血通脉功效的通脉愈心浓缩丸对预防冠脉内支架置入术后再狭窄有较好的疗效，其作用机制可能与降低ET、升高NO、改善内皮功能障碍有关。
[关键词] 冠心病；冠脉内支架置入术；再狭窄；通脉愈心浓缩丸
[中图分类号] R541.4 [文献标识码]A [文章编号]1673-7210(2008)11(b)-006-03
Clinical study on Tongmaiyuxin Concentrated Pill to prevent restenosis after intracoronary stenting
LI Qing-hai1, LI Xiao-bing 2, LI Qing-yu2, LI Xiao-hai2, LI Yan-ping2, MENG Qing-li2, ZHANG Ke-qing2, WU Ya-feng1
(1.The Third Affiliated Hospital of Henan College of TCM, Zhengzhou450008, China; 2.The Affiliated Chinese Medicine Hospital of Anyang City of Henan College of TCM, Anyang 455000, China)
[Abstract] Objective: To evaluate the effect and the mechanism of Tongmaiyuxin Concentrated Pill on the prevention of restenosis, and provide a basic foundation for the clinical application. Methods: 121 patients who were selected were randomly divided into treatment group (61 cases) and control group (60 cases). The conventional western medical therapy was given to both groups. Meanwhile, the treatment group received Tongmaiyuxin Concentrated Pill. 6 months later, the relapse rate of cardiac angina and ECG were observed, and the relapse rate of restenosis was evaluated through active plate movement test and coronary arteriongraphy. The change of serum ET and NO before and after the treatment were observed. Results:The relapse rate of cardiac angina in treatment group was considerably lower than that in control group, and a significant difference of restenosis rate was shown between the treatment group (9.8%) and control group (23.3%) (P<0.01). After finishing the study, treatment group was higher than control group in serum concentration of NO but lower in ET. Conclusion:Tongmaiyuxin Concentrated Pill which has the function of dissolving sputum and running blood has better effect to prevent restenosis after intracoronary stenting, and the mechanism may be related to the increased NO and reduced ET ......
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