加味瓜蒌薤白半夏汤联合针刺治疗冠心病心绞痛的疗效和对血清HMGB1、CGRP、GM-CSF的影响

目的:探讨加味瓜蒌薤白半夏汤联合针刺治疗冠心病心绞痛的疗效和对血清指标的影响。方法:81例慢性稳定型心绞痛(CSAP)患者按照随机数字表法分为观察组41例和对照组40例。对照组采用西药对症治疗,观察组在对照组基础上采用加味瓜蒌薤白半夏汤联合循经取穴针刺治疗。比较两组疗效和安全性,并观察其对血清指标及血脂、血液流变学水平的影响。结果:组内比较,对比治疗前,两组心绞痛发作次数减少,视觉模拟评分法(VAS)评分和中医证候积分降低,血清高迁移率族蛋白B1(HMGB1)、粒细胞和巨噬细胞集落刺激因子(GM-CSF)、C-反应蛋白(CRP)、利钠肽(BNP)含量降低,血清降钙素基因相关肽(CGRP)含量升高,血脂情况改善,总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平均降低,血液流变学情况改善,全血黏度、血浆黏度、红细胞比容、血小板聚集率均降低,差异具有统计学意义(P<0.05)。治疗后组间比较,观察组心绞痛发作次数、VAS评分、中医证候积分、血清HMGB1、GM-CSF、CGRP、血脂(TC、TG、LDL-C)和血液流变学(全血黏度、血浆黏度、红细胞比容、血小板聚集率)与对照组比较差异具有统计学意义(P<0.05),观察组疗效优于对照组。治疗有效性和安全性比较,观察组疗效优于对照组(P<0.05)。结论:加味瓜蒌薤白半夏汤联合针刺对冠心病心绞痛痰浊闭阻证患者具有良好疗效,效果优于单纯西医对症治疗,能够显著缓解心绞痛症状,改善血脂和血液流变学水平,且无明显不良反应,推测可能与调节血清HMGB1、CGRP、GM-CSF有关。

Curative Efficacy of Modified Gualou Xiebai Banxia Decoction(加味瓜蒌薤白半夏汤)Combined with Acupuncture on Angina Pectoris in Coronary Heart Disease and Its Effect on Serum HMGB1,CGRP and GM-CSF

Objective:To investigate the curative efficacy of Modified Gualou Xiebai Banxia Decoction(加味瓜蒌薤白半夏汤)combined with acupuncture on angina pectoris in coronary heart disease and its effect on serum indexes.Methods:A total of 81 patients with chronic stable angina pectoris(CSAP)were randomly divided into the observation group(n=41)and the control group(n=40).The control group was given symptomatic treatment with western medicine.The observation group was treated with Modified Gualou Xiebai Banxia Decoction combined with acupuncture at acupoints selected along the meridians.The efficacy and safety of the two groups were compared,and the effects on serum indexes,blood lipid and hemorheology were observed.Results:Compared with those before treatment,the angina pectoris attack times,visual analogue scale(VAS)score and traditional Chinese medicine(TCM)syndrome score of the two groups were decreased,the contents of high-mobility group box 1 protein(HMGB1),granulocyte-macrophage colon y stimulating factor(GM-CSF),C-reactive protein(CRP)and Brain natriuretic peptide(BNP)in serum were decreased,and the content of serum calcitonin gene-related peptide(CGRP)was increased,blood lipids were improved,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)levels were decreased,hemorheology was improved,whole blood viscosity,plasma viscosity,hematocrit,platelet aggregation rate were decreased,the difference was statistically significant(P<0.05).After treatment,the angina pectoris attack times,VAS score,TCM syndrome score,serum HMGB1,GM-CSF,CGRP,blood lipids(TC,TG,LDL-C)and hemorheology(whole blood viscosity,plasma viscosity,hematocrit,platelet aggregation rate)in the observation group were significantly different from those in the control group(P<0.05),and the curative efficacy of the observation group was better than that of the control group.The efficacy and safety of the observation group were better than those of the control group(P<0.05).Conclusions:Modified Gualou Xiebai Banxia Decoction combined with acupuncture has good curative efficacy on patients with angina pectoris in coronary heart disease with phlegm turbidity blocking syndrome.The effect is better than western medicine symptomatic treatment.It can significantly relieve the symptoms of angina pectoris,improve blood lipid and hemorheology,and has no obvious adverse reactions.It is speculated that it may be related to the regulation of serum HMGB1,CGRP and GM-CSF.