血府逐瘀汤联合越鞠丸加减治疗稳定性心绞痛43例

目的： 探讨血府逐瘀汤联合越鞠丸加减治疗稳定性心绞痛临床疗效及对血脂的影响。方法： 将86例患者随机按数字法分为对照组和观察组各43例。两组给予西医常规治疗，辛伐他汀片，20 mg/次，1次/d。观察组在对照组基础上采用血府逐瘀汤合越鞠丸加减治疗，1剂/d。疗程均为12周。记录心绞痛发作次数，程度及持续时间，记录痰浊血瘀证证候积分，检测治疗前后血清脂联素（APN）、血管性血友病因子（vWF）和超敏C反应蛋白（hs-CRP）水平，检测治疗前后血清甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）及低密度脂蛋白胆固醇（LDL-C）水平，每周监测心电图。结果： 观察组心电图疗效总有效率93.0%，优于对照组的76.7%（P<0.05）；观察组降脂疗效总有效率95.3%，优于对照组的79.1%（P<0.05）；两组治疗后血脂（TC，TG，LDL-C，HDL-C）均明显改善，观察组TC，TG的改善优于对照组（P<0.01）；治疗后观察组心绞痛发作次数及持续时间均少于对照组（P<0.01）；治疗后第8，12周，观察组痰浊血瘀证评分低于对照组（P<0.01）；治疗后两组血清APN水平均升高，观察组高于对照组（P<0.01）；治疗后两组血清vWF，hs-CRP均下降，观察组低于对照组（P<0.01）。结论： 血府逐瘀汤联合越鞠丸加减能减少SAP患者心绞痛发作次数及持续时间，降低痰浊血瘀证积分，调节脂代谢，改善心电图，其作用机制可能与调节体内APN，vWF，hs-CRP水平以减轻炎症反应、改善血管内皮功能有关。

Xuefu Zhuyu Decoction Combined Yueju Pill with of Stable Angina Pectoris of 43 Cases

Objective: Xuefu Zhuyu decoction combined Yueju pill to study the clinical curative effect of add and subtract treatment on stable angina pectoris and its influence on blood lipids. Method: Eighty-six cases of patients were divided into control group (43 cases) and observation group (43 cases) according to the digital method randomly. Patients in both groups took conventional western medicine treatment, simvastatin tablets, 20 mg/time, 1 time/day. Based on the treatment of control group, patients in the observation group took add and subtract treatment of Xuefu Zhuyu decoction combined Yueju pill, 1 dose/day, treatment course 12 weeks. Attack frequency, degree and last time of angina pectoris and the phlegm turbidity syndrome of blood stasis syndrome integral were recorded. Before and after treatment, levels of serum adiponectin (APN), von willebrand factor (vWF), hypersensitive c-reactive protein (hs-CRP) were detected. Levels of serum triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL-C) and low density lipoprotein (LDL-C) were also detected. The electrocardiogram of patients was monitored every week. Result: The total effect of electrocardiogram curative effect in observation group (93.0%)was better than control group (76.7%) (P<0.05). The total effect of lipid-lowering effect in observation group (95.3%) was better than control group (79.1%) (P<0.05). After treatment, the levels of blood lipids (TC, TG, LDL-C, HDL-C) of two groups were significantly improved, the improvement of TC and TG in the observation group is better than that of control group (P<0.01). The attack time and duration of angina in observation group were less than the control group (P<0.01).At the eighth and twelfth week after treatment, the phlegm turbidity syndrome score in observation group was lower than the control group (P<0.01). The two groups' level of serum APN were raised, while the observation group was higher than control group (P<0.01). The serum vWF and hs-CRP in both group decreased, the observation group was lower than the control group (P<0.01). Conclusion: Add and subtract treatment of Xuefu Zhuyu decoction combined with Yueju pill can reduce the attack time and duration of stable angina patients, relieving the phlegm turbidity syndrome score. It can also regulate lipid metabolism and improve the electrocardiogram. Its mechanism may be related to regulating APN, vWF, hs-CRP levels in order to reduce inflammation, improving endothelial function.