CAJ | 학술논문

目的：分析超敏 C 反应蛋白（hs - CRP）在活血解毒中药治疗不稳定型心绞痛中的临床意义，并对其辅助评价指标进行初步探索。方法选取2008年3-9月于首都医科大学附属北京安贞医院心内科及首都医科大学附属同仁医院心内科住院的经冠状动脉造影确诊的不稳定型心绞痛患者65例，并按照随机数字表法将其分为活血组和活血解毒组，剔除不符合标准的患者后，最终活血组31例，活血解毒组30例。在西医标准化治疗的基础上，活血组加用芎芍胶囊治疗，活血解毒组加用芎芍胶囊和黄连胶囊治疗，两组疗程均为1个月。比较治疗前后血清hs - CRP水平、心绞痛计分、血瘀证计分、中医主症计分、血脂指标的变化。结果治疗前、后活血解毒组血清hs - CRP水平均低于活血组（P ﹤0.05）；活血组治疗前后血清hs - CRP水平比较，差异无统计学意义（P ﹥0.05）；活血解毒组治疗后血清hs - CRP水平低于治疗前（P ﹤0.05）。治疗前两组心绞痛计分比较，差异无统计学意义（P ﹥0.05）；治疗后活血解毒组心绞痛计分低于活血组（P ﹤0.05）；活血组和活血解毒组患者治疗后的心绞痛计分均低于治疗前（P ﹤0.05）。治疗前、后两组血瘀证计分、中医主症计分比较，差异均无统计学意义（P ﹥0.05）；两组治疗后血瘀证计分、中医主症计分均低于治疗前（P ﹤0.05）。治疗前、后两组总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL - C）及高密度脂蛋白胆固醇（HDL - C）比较，差异均无统计学意义（P ﹥0.05）；两组治疗后的 TC、LDL - C均低于治疗前（P ﹤0.05）。结论与活血组相比，血清hs - CRP水平在评价活血解毒中药治疗不稳定型心绞痛患者的临床疗效中意义更加明显；心绞痛计分可能可以作为hs - CRP的辅助指标综合评价治疗不稳定型心绞痛药物的临床疗效。目的：分析超敏 C 反應蛋白（hs - CRP）在活血解毒中藥治療不穩定型心絞痛中的臨床意義，併對其輔助評價指標進行初步探索。方法選取2008年3-9月于首都醫科大學附屬北京安貞醫院心內科及首都醫科大學附屬同仁醫院心內科住院的經冠狀動脈造影確診的不穩定型心絞痛患者65例，併按照隨機數字錶法將其分為活血組和活血解毒組，剔除不符閤標準的患者後，最終活血組31例，活血解毒組30例。在西醫標準化治療的基礎上，活血組加用芎芍膠囊治療，活血解毒組加用芎芍膠囊和黃連膠囊治療，兩組療程均為1箇月。比較治療前後血清hs - CRP水平、心絞痛計分、血瘀證計分、中醫主癥計分、血脂指標的變化。結果治療前、後活血解毒組血清hs - CRP水平均低于活血組（P ﹤0.05）；活血組治療前後血清hs - CRP水平比較，差異無統計學意義（P ﹥0.05）；活血解毒組治療後血清hs - CRP水平低于治療前（P ﹤0.05）。治療前兩組心絞痛計分比較，差異無統計學意義（P ﹥0.05）；治療後活血解毒組心絞痛計分低于活血組（P ﹤0.05）；活血組和活血解毒組患者治療後的心絞痛計分均低于治療前（P ﹤0.05）。治療前、後兩組血瘀證計分、中醫主癥計分比較，差異均無統計學意義（P ﹥0.05）；兩組治療後血瘀證計分、中醫主癥計分均低于治療前（P ﹤0.05）。治療前、後兩組總膽固醇（TC）、三酰甘油（TG）、低密度脂蛋白膽固醇（LDL - C）及高密度脂蛋白膽固醇（HDL - C）比較，差異均無統計學意義（P ﹥0.05）；兩組治療後的 TC、LDL - C均低于治療前（P ﹤0.05）。結論與活血組相比，血清hs - CRP水平在評價活血解毒中藥治療不穩定型心絞痛患者的臨床療效中意義更加明顯；心絞痛計分可能可以作為hs - CRP的輔助指標綜閤評價治療不穩定型心絞痛藥物的臨床療效。
목적：분석초민 C 반응단백（hs - CRP）재활혈해독중약치료불은정형심교통중적림상의의，병대기보조평개지표진행초보탐색。방법선취2008년3-9월우수도의과대학부속북경안정의원심내과급수도의과대학부속동인의원심내과주원적경관상동맥조영학진적불은정형심교통환자65례，병안조수궤수자표법장기분위활혈조화활혈해독조，척제불부합표준적환자후，최종활혈조31례，활혈해독조30례。재서의표준화치료적기출상，활혈조가용궁작효낭치료，활혈해독조가용궁작효낭화황련효낭치료，량조료정균위1개월。비교치료전후혈청hs - CRP수평、심교통계분、혈어증계분、중의주증계분、혈지지표적변화。결과치료전、후활혈해독조혈청hs - CRP수평균저우활혈조（P ﹤0.05）；활혈조치료전후혈청hs - CRP수평비교，차이무통계학의의（P ﹥0.05）；활혈해독조치료후혈청hs - CRP수평저우치료전（P ﹤0.05）。치료전량조심교통계분비교，차이무통계학의의（P ﹥0.05）；치료후활혈해독조심교통계분저우활혈조（P ﹤0.05）；활혈조화활혈해독조환자치료후적심교통계분균저우치료전（P ﹤0.05）。치료전、후량조혈어증계분、중의주증계분비교，차이균무통계학의의（P ﹥0.05）；량조치료후혈어증계분、중의주증계분균저우치료전（P ﹤0.05）。치료전、후량조총담고순（TC）、삼선감유（TG）、저밀도지단백담고순（LDL - C）급고밀도지단백담고순（HDL - C）비교，차이균무통계학의의（P ﹥0.05）；량조치료후적 TC、LDL - C균저우치료전（P ﹤0.05）。결론여활혈조상비，혈청hs - CRP수평재평개활혈해독중약치료불은정형심교통환자적림상료효중의의경가명현；심교통계분가능가이작위hs - CRP적보조지표종합평개치료불은정형심교통약물적림상료효。
Objective To analyze the clinical significance of high - sensitivity C - reactive protein( hs - CRP)in blood - activating and toxin - resolving medicine for unstable angina(USA)patients,and a preliminary exploration of its sec-ondary index. Methods Sixty - five USA patients hospitalized in department of cardiology,Anzhen Hospital Affiliated to Cap-ital Medical University from March to September 2008 were randomly assigned into groups A( blood - activating group),B (blood - activating and toxin - resolving group). Excluding the patient does not meet the standards ,and ultimately group were 31 cases,30 cases of group B. Based on standard treatment of Western Medicine,group A were given Xiongshao capsules, group B given capsules of Xiongshao and Huanglian. The treatment lasted 1 month. Serum hs - CRP level,scores of angina, stagnation of blood and TCM main symptoms,changes of lipid parameters were compared between 2 groups before treatments and after. Results The level of serum hs - CRP was lower in group B than in group A before and after treatment( P ﹤ 0. 05). There was no significant difference in hs - CRP between pre - and post - treatments in group A(P ﹥ 0. 05). The level of hs -CRP was lower after treatment than before in group B(P ﹤ 0. 05). There was no difference in score of angina between 2 groups before treatment(P ﹥ 0. 05),and was lower in group B than in group A after treatment(P ﹤ 0. 05),and was lower after treat-ment than before between 2 groups(P ﹤ 0. 05). There was no difference in scores of stagnation of blood and TCM main symptoms between 2 groups(P ﹥ 0. 05),and lower after treatment than before treatment between 2 groups(P ﹤ 0. 05). There was no difference in TC,TG,LDL - C,HDL - C between 2 groups before and after treatment(P ﹥ 0. 05),TC,LDL - C lower after treatment than before between 2 groups(P ﹤ 0. 05). Conclusion Compared with group A,serum hs - CRP level was more sig-nificant in evaluating the clinical effects of blood - activating and toxin - resolving medicine on USA. Score of angina may be used as an auxiliary index assessing the clinical curative effects of medicines for USA.