山楂消脂胶囊对非急性期冠心病痰瘀证患者斑块稳定性的干预研究

目的观察山楂消脂胶囊对非急性期冠心病痰瘀证患者动脉粥样硬化斑块稳定性的影响。方法将符合诊断标准的120例非急性期冠心病痰瘀症患者随机分为两组。对照组60例予基础治疗加血脂康,治疗组60例予基础治疗加山楂消脂胶囊。两组均不用他汀类调脂药,疗程6个月。观察急性心血管事件(MACE)发生率,同时,测定治疗前后超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)、血清基质金属蛋白酶2(MMP-2)、血清基质金属蛋白酶9(MMP-9)等,痰浊证、血瘀证积分以及MACE发生后各指标的变化。结果治疗6个月后治疗组血瘀证、痰浊证计分(26.53分±6.18分、22.0分±7.35分)较治疗前明显降低,且优于对照组(32.45分±6.12分,33.52分±8.22分,P<0.01)。MACE发生率与对照组比较,无统计学意义(P>0.05)。治疗组可明显降低hs-CRP、Hcy、MMP-2、MMP-9,与治疗前比有统计学意义(P<0.01)。结论山楂消脂胶囊可通过改善冠心病患者的痰浊血瘀状态,抗炎症反应,降低细胞外MMP-2、MMP-9水平的表达,稳定冠状动脉粥样硬化斑块,减少非急性期冠心病痰瘀症患者MACE的发生。

Effect of Shanzha Xiaozhi Capsule on Stability of Atherosclerosis Plaque in Non-acute Phase Coronary Heart Disease with Phlegm-stasis Syndrome

Objective To investigate the effect of Shanzha Xiaozhi capsule(SXC) on stability of atherosclerosis plaque in patient(pts) with non-acute phase coronary heart disease(CHD) and phlegm-stasis syndrome.Methods One hundred and twenty pts with non-acute phase CHD and phlegm-stasis syndrome were randomly divided into 2 groups:Treatment group(n=60) treated with baseline therapy and SXC and control group(n=60) treated with baseline therapy and Xuezhikang capsule.Major adverse cardiovascular events(MACE),high sensitive c-reactive protein(hs-CRP),homocysteine(Hcy),matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9),scores of blood-stasis syndrome and phlegm syndrome were measured before and after treatment.Results The scores of blood-stasis syndrome and phlegm syndrome in treatment group were decreased significantly compared with that in control group(P<0.01).There was no significant differences of MACE in two groups(P>0.05).After treatment,the levels of serum hs-CRP,Hcy,MMP-2,and MMP-9 in treatment group were all decreased significantly compared with that before treatment(P<0.01).Conclusion SXC could improve the state of phlegm and blood stasis,relieve inflammatory reaction,lower the expression of extracellular matrix MMP-2 and MMP-9,stabilize atherosclerotic plaque,and reduce MACE.