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目的:在中药通脉愈心浓缩丸预防冠脉内支架置入术后再狭窄疗效观察的基础上,研究通脉愈心浓缩丸防治再狭窄的作用及其机制,为临床运用提供依据。方法:将符合入选标准的121例冠脉内支架置入术成功的冠心病患者随机分为西药常规治疗加通脉愈心浓缩丸组(治疗组,61例)和西药常规治疗组(对照组,60例)。疗程均为6个月,追踪观察患者有无心绞痛复发、心电图异常,并通过心电图活动平板运动试验及冠状动脉造影复查评价再狭窄的发生。并对观察病例观察其治疗前后血清一氧化氮(NO)及血浆内皮素(ET)的变化。结果:治疗组心绞痛复发率显著低于对照组。治疗组再狭窄率为9.8%,对照组再狭窄率为23.3%,治疗组显著低于对照组(P<0.01)。治疗组在治疗结束时血清NO高于对照组,而血浆ET低于对照组。结论:具有化痰祛浊、活血通脉功效的通脉愈心浓缩丸对预防冠脉内支架置入术后再狭窄有较好的疗效,其作用机制可能与降低ET、升高NO、改善内皮功能障碍有关。
Objective: To study the effect and mechanism of Tongmai Yuxin Concentrated Pills in preventing and treating restenosis on the basis of observing the curative effect of restenosis after coronary artery stent implantation. Methods: A total of 121 patients with coronary artery disease who met the inclusion criteria were randomly divided into routine treatment of traditional Chinese medicine plus Tongmai Yuxiannian Pill group (treatment group, 61 cases) and western medicine conventional treatment group (control group , 60 cases). The course of treatment was 6 months. The patients were followed up for angina recurrence and electrocardiogram abnormalities. Restenosis was evaluated by electrocardiogram treadmill exercise test and coronary angiography. The changes of serum nitric oxide (NO) and plasma endothelin (ET) before and after treatment were observed. Results: The recurrence rate of angina in treatment group was significantly lower than that in control group. The restenosis rate was 9.8% in the treatment group and 23.3% in the control group, which was significantly lower in the treatment group than in the control group (P <0.01). Serum NO was higher in the treatment group than in the control group at the end of treatment, while plasma ET was lower than that in the control group. Conclusion: Tongmai Yuxin Concentrated Pill with the effect of eliminating phlegm and removing blood stasis, promoting blood circulation and promoting blood circulation has a good curative effect in preventing restenosis after coronary stenting, and its mechanism may be related to reducing ET, increasing NO, improving Endothelial dysfunction.