Liu Yun Fang, Yu Hui Ming, Zhang Cheng, Yang Rui Xue, Yan Fang Fang, Liu Yan, Zhang Yun, Zhao Yu Xia
Department of Integrated Traditional Chinese and Western Medicine, Shandong University Qilu Hospital, Jinan, Shandong, China.
J Altern Complement Med. 2007 Apr;13(3):369-74. doi: 10.1089/acm.2006.6226.
To investigate the effects of the Traditional Chinese Medicine (TCM) Quyu Xiaoban capsules (QYXB) on clinical outcomes and platelet activation and aggregation in patients with unstable angina pectoris (UAP) and phlegm and blood stasis syndrome.
Ninety patients with UAP were randomly divided into two groups: a control group that received a loading dose of 300 mg aspirin and a maintenance dose of 100 mg of aspirin plus baseline therapy for 4 weeks, and a trial group that received the same doses of aspirin and baseline therapy plus QYXB for 4 weeks. The severity of anginal attacks, alterations of TCM symptoms and signs, and electrocardiographic (ECG) changes were assessed in all patients before and after treatment. The plasma platelet aggregation (PAG) rate and P-selectin level were measured in all patients at baseline and at the end of the fourth week of treatment.
After treatment for 4 weeks, both group of patients showed improvement in the severity of angina pectoris and TCM symptoms and signs, but there was a significant difference in the two groups' rates of clinical improvement, whereas the rate of ECG improvement of the two groups showed no difference. As compared with the baseline value, the PAG rate in both groups decreased significantly at the end of the fourth week (63.74 +/- 11.18% vs. 55.69 +/- 10.40% in the control group, and 63.83 +/- 12.70% vs. 50.04 +/- 8.91% in the trial group). Similar changes in P-selectin levels were observed in the two groups (9.40 +/- 1.25 ng/mL vs. 8.90 +/- 1.34 ng/mL in the control group, and 9.56 +/- 1.16 ng/mL vs. 7.80 +/- 0.98 ng/mL in the trial group). However, both the PAG rate and P-selectin level decreased to a greater extent in the trial group than in the control group after treatment, and the difference between the two groups was significant (both p < 0.05). Nevertheless, these biochemical changes were too small to fully explain the beneficial clinical outcomes achieved with QYXB capsules.
In comparison with both the respective baseline values and with aspirin therapy, QYXB capsules significantly attenuated anginal attacks and improved TCM symptoms and signs in patients with UAP. The exact mechanisms underlying these therapeutic effects remain to be explored.
探讨中药祛瘀消斑胶囊（QYXB）对不稳定型心绞痛（UAP）痰瘀互结证患者临床疗效及血小板活化和聚集的影响。
将90例UAP患者随机分为两组：对照组给予负荷剂量300mg阿司匹林及维持剂量100mg阿司匹林加基础治疗4周；试验组给予相同剂量阿司匹林及基础治疗加QYXB治疗4周。评估所有患者治疗前后心绞痛发作的严重程度、中医症状和体征的变化以及心电图（ECG）变化。在基线和治疗第4周结束时测量所有患者的血浆血小板聚集（PAG）率和P-选择素水平。
治疗4周后，两组患者心绞痛严重程度及中医症状和体征均有改善，但两组临床改善率有显著差异，而两组心电图改善率无差异。与基线值相比，两组在第4周结束时PAG率均显著降低（对照组：63.74±11.18% vs. 55.69±10.40%；试验组：63.83±12.70% vs. 50.04±8.91%）。两组P-选择素水平也有类似变化（对照组：9.40±1.25ng/mL vs. 8.90±1.34ng/mL；试验组：9.56±1.16ng/mL vs. 7.80±0.98ng/mL）。然而，治疗后试验组PAG率和P-选择素水平下降幅度均大于对照组，两组差异有统计学意义（均p<0.05）。尽管如此，这些生化变化太小，无法完全解释QYXB胶囊所取得的有益临床疗效。
与各自的基线值及阿司匹林治疗相比，QYXB胶囊显著减轻了UAP患者的心绞痛发作，改善了中医症状和体征。这些治疗效果的确切机制仍有待探索。
