温通煎能预防冠心病患者介入治疗后再狭窄

目的就如何利用中西医两种医学防治心血管病的优势,进一步提高临床疗效。从辨证与辨病、整体观念与综合调控治疗、传统中医理论和现代药理研究相结合等方面,寻找提高中医药防治临床心血管病疗效的具体方法和有效途径。方法500例冠心病介入性治疗后随机分为温通煎组250例,选用由制附子、山楂、决明子、丹参、水蛭、黄芪、麦门冬等组成的温通煎口服与常规温通煎组250例作对照,6个月后观察总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、体质指数、运动平板实验后心电图的变化,临床表现及是否有再狭窄或再堵塞。结果温通煎组与常规用药组血压、总胆固醇和甘油三酯无差异(P>0.05)。高密度和低密度脂蛋白胆固醇、体质指数和空腹血糖有差异(P<0.05)。温通煎组有13例未完成6个月的治疗;常规用药组有14例中途改用中药治疗,另有6例死亡。温通煎组运动平板试验5 min后感心前区不适(心前区闷痛)者11例,但心电图无病理性改变;常规用药组运动平板试验5 min后感心前区不适者46例,心电图S-T段水平压低者29例,斜下压低者12例,5例心电图未改变。经冠状动脉造影证实冠状动脉狭窄与上次比较加重20%以上者16例。温通煎组无再狭窄或再堵塞病例,明显优于常规用药组(P<0.05)。结论温通煎可以预防冠心病介入性治疗后再狭窄及再堵塞。并能调节冠心病人的脂质代谢紊乱,改善冠心病人介入治疗后的生活质量。

Wentongjian in Prevented Coronary Restenosis of Percutaneous Coronary Intervention

Aim To study how to take advantages of Chinese medicine and western medicine on preventing and cure coronary heart disease;to find an effective way to prevent and cure clinical heart disease with Chinese medicine;Dialectics,entity concept and sythesise adjust and control,traditional Chinese medicine theory combined mordern parmaceutic study and so on are throngh the study. Methods 500 patients after coronary intervention were randomly divided into two groups.One group(n=250) to receive wentongjian which were made from Zhifuzi, shanzha,juemingzi,danshen,shuizhi,huangqi and maimendong.The other group(control group,n=250) to receive routine medical treatment.Changes were observed six months later on total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),low density lipoprotein(LDL),body mass index(BMI), electrocardiogram(ECG),after the exercise treadmill test(ETT),clinical sympton and whether there was a coronary restenosis or reblocked. Results The blood pressure,TC and TG had no difference(P>0.05) in two groups.HDL,LDL,BMI,fasting blood glucose(FBG) had difference(P<0.05).13 cases in Wentongjian group didn't persist with the 6 months,treatment,14 cases changed into the treatment of traditional Chinese Medicine and 6 cases died in the control group.In Wentongjian group,11 cases feeled nucomfortable after 5 min during treadmill test,but there no changes on electrocardiogram.In control group,46 cases feeled uncomfortable after 5 min during treadmill test,29 cases's S-T sections were evenly lowered and 12 cases S-T sections lowered like slope,five cases have no changes,there were more than 20% restenosis in 16 cases.These were no restenosis or reblocked cases in Wentongjian group.They are significantly better than those in the control group. Conclusions Wentongjian could prevent coronary restenosis and reblocked after percutaneous coronary implantation,adjust the serum lipids metabolism out of disorder.