血府逐瘀胶囊治疗不稳定性心绞痛的临床疗效观察及机制探讨

目的 观察血府逐瘀胶囊治疗不稳定性心绞痛(unstable angina pectoris，UAP)的临床疗效，并探讨其对血管内皮的保护机制。 方法 将60例UAP患者按随机数字表法分为西药治疗组（对照组）和在此基础上合用血府逐瘀胶囊组（治疗组）,每组30例。2个月的疗程结束后，观察患者心绞痛发作频率、持续时间、硝酸甘油用量及心电图改善情况，比较治疗前后血浆内皮素（endothelin, ET）、一氧化氮（nitric oxide, NO）、血管假性血友病因子（von Willebrand factor，vWF)、可溶性血管细胞黏附分子-1（soluble vascular cell adhesion molecule-1，sVCAM-1) 及可溶性细胞间黏附分子 1（soluble intercellular adhesion molecule-1，sICAM-1)水平的变化。 结果 (1)治疗组患者治疗后较治疗前心绞痛的发作频率、持续时间等临床症状明显好转（P<0.01），硝酸甘油用量减少（P<0.01），与对照组治疗后比较，差异有统计学意义（P<0.05）； (2)治疗组心绞痛的症状和心电图明显改善，有效率分别为86.7 %和76.7 %，优于对照组的70.0 %和63.3 % (P<0.05)；(3) 对照组仅vWF和ET降低（P<0.05），NO升高(P<0.5)；治疗组治疗后vWF、ET、sVCAM-1和sICAM-1均显著降低且低于对照组(均P<0.01)，NO明显升高且高于对照组(P<0.01)。 结论 血府逐瘀胶囊是一种有效的治疗UAP的中成药，降低血浆ET、vWF、sVCAM-1、sICAM-1和升高血浆NO，是其发挥保护血管内皮和抗心绞痛的部分作用机制。

Clinical Effect and Mechanism of Xuefu Zhuyu Capsule in Treating Unstable Angina Pectoris

Objective To observe the clinical effect of Xuefu Zhuyu Capsule （XFZYC） in treating unstable angina pectoris （UAP） and to investigate its mechanism of protection on vascular endothelia. Methods Sixty UAP patients were randomly assigned to two groups, the 30 in the treated group were treated by conventional therapy plus XFZYC, and the 30 in the control group treated by conventional therapy alone. The frequency and persistent time of angina pectois, dosage of nitroglycerin used, changes of electrocardiogram （ECG） were ob- served, and the plasma levels of endothelin （ET）, nitric oxide （NO）, von Willebrand factor （vWF）, soluble vascular cell adhesion molecule-1 （sVCAM-1） and soluble intercellular adhesion molecule-1 （ slCAM-1 ） were tested before and after the two-month therapeutic course. Results （1） The c~inical symptoms as frequency and persistent time of angina pectoris in the treated group were bettered significantly after treatment and the dosage of nitroglycerin used decreased （ all P 〈0.01 ）, showing significant difference when compared with those in the con- trol group （P〈0.05）. （2） The effective rates on UAP symptoms and ECG in the treated group were 86.7% and 76.7% respectively, which were significantly higher than those in the control group （70.0% and 63.3%, P 〈 0.05）. （3） Laboratory examination showed in the control group, changes only displayed in the decrease of vWF and ET and increase of NO （all P〈0.05）, while in the treated group, plasma levels of vWF, ET, sVCAM-1 and slCAM-1 after treatment significantly decreased and were lower than those in the control group （ P 〈 0.01 ）, but NO elevated significantly and was higher than that in the control group （ P 〈 0.01 ）. Cenclusiens XFZYC is an effective Chinese patent medicine for treatment of UAP. It displays its effect on protecting vascular endothelia and anti-angina pectoris partially by decreasing the plasma levels of ET, vWF, sVCAM-1 and slCAM-1 and elevating the level of NO.