Xu Hao, Lu Xiao-yan, Chen Ke-ji
National Integrative Medicine Center for Cardiovascular Diseases, China-Japan Friendship Hospital, Beijing.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007 Jan;27(1):8-13.
To investigate the correlation of blood-stasis syndrome (BSS) and its accompanied syndromes with pathological changes showed in coronary angiography and restenosis after percutaneous coronary intervention (PCI).
A total of 335 coronary heart disease patients after successful PCI were randomized into the treated group treated with Xiongshao Capsule (XC) and the control group treated with placebo for 6 months. BSS score was evaluated before and 6 months after PCI, and coronary angiography was followed up 6 months after the operation to perform the correlation analysis on BSS and its accompanied syndromes with types and complexity of coronary lesion, and the Logistic multivariate stepwise regression analysis (LMSRA) on the influencing factors of restenosis.
There were 334 cases with complete angiographic data, of which 308 cases (91.9%) finished the study, and among them 147 cases received a follow-up with angiography. Correlation analysis showed that the BSS score was significantly correlated to the maximal stenosis degree and coronary lesion score demonstrated by coronary angiography before PCI (P < 0.01), and the correlation was accentuated along with the increasing of the patients' age and the course of disease. Among the accompanied syndromes, the yang-deficiency syndrome was significantly correlated to the complexity of coronary lesions and the degree of stenosis, while the turbid- phlegm syndrome was correlated with calcification of the lesions. The difference of BSS score before and after treatment in the treated group was significantly higher than that in the control group. LMSRA showed that the recurrence of angina and BSS score were the important influencing factors on the occurrence of coronary restenosis after PCI. The incidence of restenosis was not correlated to the accompanied syndromes, and also showed no significant difference among patients with different syndrome types.
There is a certain correlation between BSS and the complexity of coronary lesions. The lesion is more severe in patients accompanied with yang-deficiency syndrome. The severity of BSS was an important influencing factor on the occurrence of restenosis after PCI, but no significant correlation was found between the occurrence and the type of accompanied syndromes.
探讨血瘀证及其兼证与冠状动脉造影所示病理改变以及经皮冠状动脉介入治疗(PCI)术后再狭窄的相关性。
将335例成功接受PCI的冠心病患者随机分为熊芍胶囊(XC)治疗组和安慰剂对照组,治疗6个月。于PCI术前及术后6个月评估血瘀证评分,并在术后6个月进行冠状动脉造影,对血瘀证及其兼证与冠状动脉病变类型和复杂程度进行相关性分析,对再狭窄的影响因素进行Logistic多因素逐步回归分析(LMSRA)。
有334例患者有完整的造影资料,其中308例(91.9%)完成研究,其中147例接受了造影随访。相关性分析显示,PCI术前血瘀证评分与冠状动脉造影所示的最大狭窄程度及冠状动脉病变积分显著相关(P<0.01),且随着患者年龄和病程的增加,相关性增强。在兼证中,阳虚证与冠状动脉病变的复杂程度和狭窄程度显著相关,而痰浊证与病变钙化相关。治疗组治疗前后血瘀证评分差值显著高于对照组。LMSRA显示,心绞痛复发和血瘀证评分是PCI术后冠状动脉再狭窄发生的重要影响因素。再狭窄的发生率与兼证无关,不同证型患者之间也无显著差异。
血瘀证与冠状动脉病变的复杂程度存在一定相关性。伴有阳虚证的患者病变更严重。血瘀证的严重程度是PCI术后再狭窄发生的重要影响因素,但与兼证类型之间未发现显著相关性。