人参养荣汤联合穴位贴敷对冠心病PCI术后患者血脂、心功能和Th1/Th2型细胞因子的影响

摘要 目的：观察人参养荣汤联合穴位贴敷对冠心病经皮冠状动脉介入术（PCI）后患者血脂、心功能和辅助性T细胞1（Th1）/Th2型细胞因子的影响。方法：选取2020年2月~2022年12月期间在我院接收的冠心病PCI术后患者142例。采用双色球法将患者分为对照组（71例,常规西医治疗+穴位贴敷）和实验组（71例,对照组的基础上接受人参养荣汤）,均治疗4周。观察并比较两组中医证候积分、心功能指标[左心室射血分数（LVEF）和每分心输出量（CO）]、血脂四项指标[三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、总胆固醇（TC）]、Th1/Th2型细胞因子[子γ干扰素（IFN-γ）、白细胞介素（IL）-2、IL-4、IL-10]。同时记录两组治疗结束半年内心血管不良事件发生率。结果：两组治疗后主症评分、次症评分、总评分下降,实验组低于照组,数据比较有差异（P<0.05）。治疗后两组LVEF和CO均升高,实验组高于对照组,数据比较有差异（P<0.05）。与对照组相比,实验组治疗后HDL-C高于对照组,TG、TC、LDL-C低于对照组,数据比较有差异（P<0.05）。与对照组相比,治疗后实验组的IL-4、IL-10更高,而IFN-γ、IL-2更低,数据比较有差异（P<0.05）。两组心血管不良事件发生率对比未见统计学差异（P>0.05）。结论：人参养荣汤联合穴位贴敷用于冠心病PCI术后患者,可改善患者的血脂和心功能,调节Th1/Th2型细胞因子,促进临床转归。

Effect of Renshen Yangrong Decoction Combined with Acupoint Application on Blood Lipid, Cardiac Function and Th1/Th2 Cytokines in Patients with Coronary Heart Disease after PCI

ABSTRACT Objective: To observe the effect of renshen yangrong decoction combine with acupoint application on blood lipid, cardiac function and Th1/Th2 cytokines in patients with coronary heart disease after percutaneous coronary intervention (PCI). Methods: 142 postoperative patients with coronary heart disease undergoing PCI who were admitted to our hospital from February 2020 to December 2022 were selected. The patients were divided by the double chromosphere method into a control group and an experimental group using the dual color sphere method, with 71 cases in each group. The control group received routine Western medicine treatment and acupoint application, while the experimental group received ginseng nourishing rong decoction on the basis of the control group, all treated for 4 weeks. Observe and compare two groups of traditional Chinese medicine syndrome scores, cardiac function indicators [left ventricular ejection fraction (LVEF) and cardiac output per minute (CO)], four indicators of blood lipids [triacylglycerol (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)], Th1/Th2 type cytokines [sub γ Interferon (IFN-γ）, Interleukin (IL) -2, IL-4, IL-10. The incidence of cardiovascular adverse events within half a year after the end of treatment in both groups was also recorded. Results: After treatment, the main symptom score, secondary symptom score, and total score of the two groups decreased, and the experimental group was lower than the control group, which showed statistical difference (P<0.05). After treatment, left ventricular ejection fraction (LVEF) and cardiac output per minute (CO) increased in both groups, and the experimental group was higher than the control group, which showed statistical difference(P<0.05). After treatment, HDL-C increased in both groups, and the experimental group was higher than the control group; TG, TC, and LDL-C decreased, and the experimental group was lower than the control group, the difference was statistically significant (P<0.05). After treatment, IL-4 and IL-10 levels increased in both groups, and the experimental group was higher than the control group; IFN-γ, IL-2 decreased and the experimental group was lower than the control group, which showed statistical difference(P<0.05). There was no statistically significant difference in the incidence of cardio vascular adverse events in two groups(P>0.05). Conclusion: Renshen yangrong decoction combine with acupoint application for patients with coronary heart disease after PCI, which can improve the blood lipid and cardiac function of patients, regulate Th1/Th2 cytokines, and promote clinical outcomes.