Department of Cardiovascular Diseases,The National Hospital of Enshi Hubei 445000 China.
Cell Mol Biol (Noisy-le-grand). 2022 Jan 2;67(4):121-129. doi: 10.14715/cmb/2021.67.4.14.
The pathological basis of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) is severe coronary stenosis, unstable plaque erosion, and rupture, resulting in coronary blood flow reduction and myocardial ischemia, leading to acute thrombosis cardiovascular disease events. This subject intends to study the treatment of NSTE-ACS patients with blood stasis and toxin syndrome by Qingre Jiedu Huoxue Huayu Decoction, observe its clinical efficacy, and explore the effects of serum lipoprotein phospholipase A2 (Lp-PLA2) and tumor necrosis factor- α (TNF- α), the effect of placental growth factor (PIGF) expression. In this study, 100 patients with blood stasis and toxin syndrome of NSTE-ACS treated in the cardiovascular department of Enshi National Hospital from August 2020 to August 2021 were selected as the research object. They were randomly divided into traditional Chinese medicine comprehensive treatment groups and conventional western medicine control groups, with 50 cases. The conventional western medicine control group was treated with hydroclopidogrel tablets orally, and the comprehensive treatment group of traditional Chinese medicine combined with Qingre Jiedu Huoxue Huayu formula orally. The patients in both groups were treated for four weeks. The results showed that after treatment, the practical clinical rate of the comprehensive treatment group was significantly higher than that of the conventional western medicine control group. After treatment, the TCM syndrome score, angina pectoris attack duration, and angina pectoris attack frequency, myocardial zymogram index level, serum Lp-PLA2 and TNF of the two groups were measured- α. The levels of PIGF were significantly lower than those before treatment. The decline of the above indexes in the comprehensive treatment group of traditional Chinese medicine was significantly better than that in the control group of conventional Western Medicine (P<0.05). The incidence of MACE events in the TCM Comprehensive treatment group was significantly lower than that in the conventional western medicine control group (P <0.05).
非 ST 段抬高型急性冠状动脉综合征（NSTE-ACS）的病理基础是严重的冠状动脉狭窄、不稳定斑块侵蚀和破裂，导致冠状动脉血流减少和心肌缺血，从而导致急性血栓心血管疾病事件。本课题旨在研究清热解毒活血化瘀汤治疗 NSTE-ACS 血瘀毒证患者的疗效，观察其临床疗效，并探讨血清脂蛋白磷脂酶 A2（Lp-PLA2）和肿瘤坏死因子-α（TNF-α）、胎盘生长因子（PIGF）表达的影响。
本研究选取 2020 年 8 月至 2021 年 8 月在恩施州中心医院心血管内科治疗的 NSTE-ACS 血瘀毒证患者 100 例为研究对象，随机分为中药综合治疗组和常规西药对照组，每组 50 例。常规西药对照组给予盐酸氯吡格雷片口服治疗，中药综合治疗组给予口服清热解毒活血化瘀汤。两组患者均治疗 4 周。结果显示，治疗后，中药综合治疗组的实际临床有效率明显高于常规西药对照组。治疗后，两组 TCM 证候评分、心绞痛发作持续时间、心绞痛发作频率、心肌酶谱指标水平、血清 Lp-PLA2 和 TNF-α水平均明显低于治疗前，且中药综合治疗组明显低于常规西药对照组（P<0.05）。中药综合治疗组 MACE 事件发生率明显低于常规西药对照组（P<0.05）。
