三七总苷联合葛根黄酮治疗不稳定型心绞痛的机制探讨

目的观察三七总苷联合葛根黄酮对不稳定型心绞痛的治疗效果,并进一步探讨其可能的治疗机制。方法随机将64例不稳定型心绞痛患者分为2组,分别给予常规抗不稳定型心绞痛治疗（A组）及在常规治疗基础上添加三七总苷注射液静脉滴注及口服葛酮通络胶囊（B组）,治疗2周。观察2组临床疗效以及治疗前后血浆中纤溶酶原激活物（t-PA）及抑制物（PAI）、可溶性细胞间黏附分子-1（sICAM-1）、C反应蛋白（CRP）、基质金属蛋白酶-9、氧化型低密度脂蛋白（ox-LDL）的水平及超氧化物歧化酶（SOD）的活力变化并进行对比分析。结果 B组的临床疗效显著高于A组;B组的t-PA水平治疗后明显升高、PAI水平明显降低（P均〈0.05）,而A组t-PA、PAI治疗前后均无明显变化（P均〉0.05）;2组的SICAM-1、CRP及MMP-9水平治疗后均明显降低（P均〈0.05）,B组降低的幅度较A组更显著（P均〈0.05）;A组的ox-LDL治疗前后无明显变化,而B组治疗后水平明显降低（P〈0.05）;2组的SOD活力在治疗后均升高（P均〈0.05）,B组的升高幅度较A组更显著（P〈0.05）。结论三七总苷联合葛根黄酮治疗不稳定型心绞痛临床疗效肯定,其通过调节血脂、改善纤溶活性、减轻炎症反应及抗氧化等,从而降低冠状动脉事件的再发生率。

Study of the mechanism of Total Saponin of Panax Pseudoginseng combined with Puerariae Flavones on unstable angina pectoris

Objective It is to observe the effects of Total Saponin of Panax Pseudoginseng combined with Puerariae Flavones on unstable angina pectoris（UAP） and further discuss its probable mechanism.Methods 64 UAP patients were randomly divided into two groups,group A were given routine anti-UAP treatment,and group B was added with Total Saponin of Panax Pseudoginseng injection combined with Puerariae Flavones Capsules on the basis of treatment above.Both the treatment lasted for 2 weeks.The clinical effiects,and the serum levels of plasminogen activator（PAI）,soluble intercellular adhension molecule-1（SICAM-1）,C-reactive protein（CRP）,matrix metalloproteinase-9（MMP-9）,oxidative-LDL and superoxide dismutase（SOD） were observed and compared between the two groups.Results The total clinical effective rate of group B was significantly higher than that of group A.The level of t-PA and PAI in group A showed no changes before and after treatment（P both0.05）,while that in group B obviously increased and decreased respectively（P both0.05）;The level of SICAM-1,CRP and MMP-9 in both groups decreased significantly（P both0.05）,but the decreased degree in group B were greater than thatof group A（P both0.05）;The level of ox-LDL in group B reduced significantly after treatment（P0.05）,but no change happened in group A（P0.05）;The level of SOD in both groups increased significantly（P both0.05）,but the increased degree in group B were greater than that in group A（P0.05）.Conclusion Total Saponin of Panax Pseudoginseng combined with Puerariae Flavones has a confirmed effect on UAP,it can low down the recurrence rat of coronary artery occurrence by obviously improving blood fat and fibrinolytic activity,anti-oxidation and relieving inflammatory reaction.