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内风证假说对急性冠状动脉综合征影响的临床研究综述

Clinical study of the hypothesis of endogenous collateral wind on acute coronary syndrome: a review.

作者信息

Wang Xian, Zhang Cong, Yang Ran, Zhu Haiyan, Zhao Huaibing, Li Xiaoming

机构信息

Department of cardiology, Dongzhimen hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 100700, China.

Beijing University of Chinese Medicine, Beijing, 100029, China.

出版信息

Afr J Tradit Complement Altern Med. 2013 Nov 2;11(1):121-6. doi: 10.4314/ajtcam.v11i1.18. eCollection 2014.

Abstract

BACKGROUND

Acute Coronary Syndrome (ACS), is a serious threat to people's health, and life, and in recent years, the incidence has increased yearly. This study was to propose the hypothesis of "endogenous collateral wind" based on the patho-mechanism of thrombogenesis complicated by ruptured plaque on ACS, and the theory of traditional Chinese medicine.

MATERIALS AND METHODS

Through successful coronary angiography (CAG), and intravascular ultrasound (IVUS), patients with coronary artery disease were made the differential diagnosis such as blood stasis, blood stasis due to phlegm obstruction, and endogenous collateral wind. The levels of plasma inflammatory marker were measured to study on the characteristics of "endogenous collateral wind". Luo heng dripping pills with promoting blood circulation to expel wind-evil, and remove wetness were made based on the hypothesis of "endogenous collateral wind" on ACS. Patients with unstable angina were randomly divided into 3, groups based on therapeutic methods: conventional therapy group, Luo Heng dripping pills group and Tongxinluo caps. Differences among groups were compared.

RESULTS

There were great changes in number and degree of coronary arteriostenosis confirmed by CAG, the types of ACC/AHA lesion and Levin lesion confirmed by CAG, remodeling index, positive or negative remodeling percentage measured by IVUS, the plasma levels of plasma inflammatory marker measured by ELLSA in the patients with endogenous collateral wind, compared with patients with blood stasis and blood stasis due to phlegm obstruction. The total effective rate of improved angina in Luo Heng dripping pills group was significantly higher than those in other two groups. The levels of plasma inflammatory marker were significantly lower in Luo Heng dripping pills group.

CONCLUSION

There were some pathological basis which were found about the hypothesis of "endogenous collateral wind" on acute coronary syndrome. It provided evidences for patients with coronary artery disease treated by medicines with expelling evil-wind, and removing wetness.

摘要

背景

急性冠状动脉综合征(ACS)严重威胁人类健康和生命,近年来其发病率逐年上升。本研究基于ACS斑块破裂并发血栓形成的病理机制及中医理论,提出“内生络风”假说。

材料与方法

通过成功的冠状动脉造影(CAG)和血管内超声(IVUS),对冠心病患者进行血瘀、痰瘀互结和内生络风等证型的鉴别诊断。检测血浆炎症标志物水平,研究“内生络风”的特征。基于ACS“内生络风”假说研制具有活血化瘀、祛风除湿作用的洛衡滴丸。将不稳定型心绞痛患者按治疗方法随机分为3组:常规治疗组、洛衡滴丸组和通心络胶囊组,比较各组间差异。

结果

与血瘀证和痰瘀互结证患者相比,内生络风证患者CAG证实的冠状动脉狭窄数量和程度、CAG证实的ACC/AHA病变类型和Levin病变、重塑指数、IVUS测量的正负重塑百分比、ELISA检测的血浆炎症标志物水平均有较大变化。洛衡滴丸组心绞痛改善总有效率显著高于其他两组,血浆炎症标志物水平显著低于其他两组。

结论

急性冠状动脉综合征“内生络风”假说存在一定的病理基础,为冠心病患者运用祛风除湿类药物治疗提供了依据。

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