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目的:观察化痰祛瘀法联合阿托伐他汀治疗不稳定性心绞痛(UAP)的临床疗效及对内皮细胞功能及血小板活化功能的影响。方法:选取UAP患者70例,随机分为对照组和观察组,每组35例。两组均予常规抗心绞痛、抗血小板聚集药物治疗;对照组另予以阿托伐他汀治疗,观察组另予化痰祛瘀中药汤剂联合阿托伐他汀治疗。治疗后观察临床疗效并比较治疗前后可溶性血管细胞黏附分子-1(s VCAM-1)及可溶性细胞间黏附分子-1(s ICAM-1)、血浆α颗拉膜蛋白-140(GMP-140)水平的变化。结果:(1)观察组临床疗效优于对照组(P<0.05)。(2)治疗后,两组血浆s VCAM-1、s ICAM-1水平均较同组治疗前明显下降(P<0.05或P<0.01),且观察组低于对照组(P<0.05)。(3)治疗后,两组血浆GMP-140水平均较同组治疗前明显下降(P<0.05或P<0.01),且观察组显著低于对照组(P<0.01)。结论:在抗心绞痛、抗血小板聚集的基础上,使用化痰祛瘀方联合阿托伐他汀能有效治疗UAP,降低血浆GMP-140、s VCAM-1、s ICAM-1水平,从而保护血管内皮细胞功能,抑制血小板活化功能,且效果优于单纯使用阿托伐他汀。
Objective: To observe the clinical efficacy of Huatan Quyu Decoction combined with atorvastatin in the treatment of unstable angina pectoris (UAP) and its effect on endothelial cell function and platelet activation. Methods: Seventy patients with UAP were randomly divided into control group and observation group, 35 cases in each group. Both groups were given routine anti-angina pectoris and anti-platelet aggregation drug treatment. The control group was treated with atorvastatin, and the observation group was treated with traditional Chinese medicine decoction and atorvastatin. After treatment, the clinical curative effect was observed and the levels of soluble VCAM-1, s ICAM-1, plasma alpha-membrane protein-140 (GMP-140) Horizontal changes. Results: (1) The observation group had better clinical efficacy than the control group (P <0.05). (2) After treatment, the levels of s VCAM-1 and sICAM-1 in plasma in two groups were significantly lower than those in the same group before treatment (P <0.05 or P <0.01), and were lower in the observation group than in the control group (P <0.05). (3) After treatment, plasma GMP-140 levels of both groups were significantly lower than those before treatment (P <0.05 or P <0.01), and the observation group was significantly lower than the control group (P <0.01). Conclusion: The anti-angina pectoris and anti-platelet aggregation can effectively treat UAP and reduce plasma levels of GMP-140, s VCAM-1 and s ICAM-1 by using Huatanquyu Decoction combined with atorvastatin, thereby protecting the vascular endothelium Cell function, inhibition of platelet activation, and the effect is better than simply using atorvastatin.