Abstract:

Objective　To investigate the effects of Guanxin Ⅱ granules on vascular endothelial function and prognosis in patients after coronary stenting. Methods　From March 1, 2021 to February 28, 2022, 120 patients with coronary heart disease after coronary stenting in Shunde Hospital of Guangzhou University of Traditional Chinese Medicine were selected and were divided into two groups by the random number table method, with 60 cases in each group. There were 32 males and 28 females in the control group, aged (52.34±7.86) years. There were 35 males and 25 females in the research group, aged (51.63±8.42) years. The control group was treated with conventional western medicine after operation, and the research group took Guanxin Ⅱ granules on the basis of the control group for 6 months. The efficacies of the two groups and the changes of traditional Chinese medicine (TCM) syndrome score, Seattle Angina Questionnaire (SAQ) score, flow-mediated humeral artery endothelial-dependent diastolic function (FMD value), serum nuclear transcription factor-κB (NF-κB), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), nitric oxide (NO), and endothelin-1 (ET-1) before and after treatment were evaluated. Both groups were observed until 6 months after operation to record the incidences of in-stent restenosis (ISR) and major adverse cardiovascular events (MACE). The statistical methods used were independent sample t test, paired t test, and χ² test. Results　The total effective rate of the research group was higher than that of the control group [91.67% (55/60) vs. 73.33% (44/60)], with a statistically significant difference (χ²=6.984, P=0.008). After treatment, the SAQ score, FMD value, and serum NO level in both groups were higher than those before treatment, the TCM syndrome score and serum NF-κB, TNF-α, IL-6, and ET-1 levels were lower than those before treatment, and the improvement was more significant in the research group (all P<0.05). Six months after surgery, the incidences of ISR [1.67% (1/60) vs. 13.33% (8/60)] and MACE [5.00% (3/60) vs. 16.67% (10/60)] in the research group were lower than those in the control group (χ²=4.324, P=0.038; χ²=4.227, P=0.040). Conclusion　Guanxin Ⅱ granules are effective after coronary stenting, which can effectively inhibit the inflammation, improve the vascular endothelial function, relieve the clinical symptoms, reduce the risk of MACE and ISR after operation, and thus improve the prognosis.

Key words:

Coronary stenting, Coronary heart disease, Vascular endothelial function, Prognosis, Guanxin Ⅱ , granules

摘要：

目的　探讨冠心Ⅱ号方颗粒对冠脉支架植入术后患者血管内皮功能及预后的影响。方法　选择2021年3月1日至2022年2月28日于广州中医药大学顺德医院行冠脉支架植入术的冠心病患者120例，按随机数字表法分组，各60例。对照组男32例，女28例，年龄（52.34±7.86）岁；研究组男35例，女25例，年龄（51.63±8.42）岁。对照组术后予常规西药治疗，研究组在对照组基础上加服冠心Ⅱ号方颗粒，持续治疗6个月。评价两组疗效及治疗前后中医证候积分、西雅图心绞痛量表（SAQ）评分、血流介导的肱动脉内皮依赖性舒张功能（FMD值）、血清核转录因子-κB（NF-κB）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、一氧化氮（NO）、内皮素-1（ET-1）水平变化。另两组均观察至术后6个月，记录支架内再狭窄（ISR）、主要不良心血管事件（MACE）发生率。统计学方法采用独立样本t检验、配对t检验、χ²检验。结果　两组比较，研究组总有效率高于对照组［91.67%（55/60）比73.33%（44/60）］，差异有统计学意义（χ²=6.984，P=0.008）；治疗后两组SAQ评分及FMD值、血清NO水平均高于治疗前，中医证候积分及血清NF-κB、TNF-α、IL-6、ET-1水平均低于治疗前，且研究组改善均更明显（均P<0.05）；术后6个月，研究组ISR发生率［1.67%（1/60）比13.33%（8/60）］、MACE发生率［5.00%（3/60）比16.67%（10/60）］均低于对照组（χ²=4.324、4.227，P=0.038、0.040）。结论　冠心Ⅱ号方颗粒用于冠脉支架植入术后疗效确切，能有效抑制炎症，改善血管内皮功能，缓解临床症状，降低术后MACE、ISR风险，从而改善预后。

关键词:

冠脉支架植入术, 冠心病, 血管内皮功能, 预后, 冠心Ⅱ号方颗粒