润肺解毒汤加减对冠心病心绞痛气滞血瘀证病人血清PAPP-A及VASP的影响

目的观察润肺解毒汤加减对冠心病心绞痛气滞血瘀证病人血清妊娠相关血浆蛋白A(PAPP-A)及血管扩张刺激磷蛋白(VASP)的影响。方法选取2019年6月—2019年12月我院收治的120例冠心病心绞痛气滞血瘀证病人,采用随机数字表法分为对照组和观察组,各60例。对照组给予常规西医治疗,观察组在对照组基础上给予润肺解毒汤治疗,治疗1个月后评价两组临床疗效。比较治疗前后两组中医主症积分、血液流变学指标、心电图、血清PAPP-A、VASP表达水平变化,同时观察两组治疗期间不良反应发生情况。结果对照组总有效率为78.33%,观察组为91.67%,两组比较差异有统计学意义(χ²=4.183,P=0.041)。治疗后,两组胸闷、胸痛评分、全血高切黏度、全血低切黏度、血小板聚集率和红细胞聚集指数、PAPP-A表达均降低,VASP表达均升高,且观察组优于对照组,差异有统计学意义(P<0.05或P<0.01)。治疗后,两组V1导联P波双向的负向波振幅及宽度乘积(PTF-V1)≤-0.04 mm·s和ST段异常比例均降低,且观察组低于对照组,差异有统计学意义(P<0.05或P<0.01)。结论润肺解毒汤加减辅助常规西医治疗可有效提高冠心病心绞痛气滞血瘀证病人临床疗效,改善胸痛、胸闷、血液流变学及心电图指标,降低血清PAPP-A水平,升高VASP表达水平,起稳定动脉粥样硬化斑块、抑制血小板聚集的作用。

Effects of Modified Runfei Jiedu Decoction on Serum PAPP-A and VASP in Patients with Coronary Heart Disease and Angina Pectoris of Qi Stagnation and Blood Stasis Syndrome

Objective To investigate the effects of Modified Runfei Jiedu Decoction on serum pregnancy associated plasma protein-A(PAPP-A)and vasodilator stimulated phosphoprotein(VASP)in patients with coronary heart disease and angina pectoris of Qi stagnation and blood stasis syndrome.Methods One hundred and twenty patients with coronary heart disease and angina pectoris of Qi stagnation and blood stasis syndrome were randomly divided into the control group and observation group,with 60 casesin each group.The patients in the control group were treated with conventional western medicine for 1 month,and the patients in the observation group were treated with Modified Runfei Jiedu Decoction on the basis of the control group for 1 month.The clinical efficacy,scores of traditional Chinese medicine main symptoms,hemorheology indexes,electrocardiogram,and the expressions of PAPP-A and VASP were compared between two groups before and after treatment.The adverse reactions of two groups were observed during treatment.Results The clinical efficacy was 78.33%in the control group and that was 91.67%in the observation group,the difference was statistically significant(χ²=4.183,P=0.041).After treatment,the scores of chest tightness,chest pain,high shear viscosity of whole blood,low shear viscosity of whole blood,platelet aggregation rate and red blood cell aggregation index,PAPP-A were decreased in both groups,while VASP was increased,and those in the observation group were better than those in the control group,the difference was statistically significant(P<0.05 or P<0.01).After treatment,the proportion of P-wave terminal force in lead V1(PTF-V1)≤-0.04 mm·s and the proportion of abnormal ST segment in both groups were decreased(P<0.01),and those in the observation group were lower than those in the control group(P<0.05),the difference was statistically significant.Conclusion Modified Runfei Jiedu Decoction combined with conventional western medicine could effectively improve the clinical efficacy of coronary heart disease with angina pectoris syndrome of Qi stagnation and blood stasis syndrome,improve chest pain,chest tightness,hemorheology,and electrocardiogram indicators,reduce serum PAPP-A,increase VASP,stabilize atherosclerotic plaque,and inhibit platelet aggregation.