益氣活血化痰方對氣虛痰瘀型不穩(wěn)定型心絞痛PCI術(shù)后患者LP-PLA2和IL-10的影響及生存質(zhì)量研究

益氣活血化痰方對氣虛痰瘀型不穩(wěn)定型心絞痛PCI術(shù)后患者LP-PLA2和IL-10的影響及生存質(zhì)量研究摘要：目的：探討益氣活血化痰方對氣虛痰瘀型不穩(wěn)定型心絞痛PCI術(shù)后患者LP-PLA2和IL-10的影響及生存質(zhì)量研究。方法：選取2017年1月至2019年7月在我院行PCI手術(shù)的患者，根據(jù)病情分為兩組，分別為益氣活血化痰方組和對照組，每組100例。益氣活血化痰方組在基礎(chǔ)治療的基礎(chǔ)上加用益氣活血化痰方，對照組僅進行基礎(chǔ)治療。兩組均在手術(shù)后1、3、6個月進行LP-PLA2和IL-10檢測，并評估生存質(zhì)量。結(jié)果：益氣活血化痰方組與對照組比較，手術(shù)后1、3、6個月，益氣活血化痰方組LP-PLA2水平明顯低于對照組，差異有統(tǒng)計學(xué)意義(P<0.05)。益氣活血化痰方組IL-10水平明顯高于對照組，差異有統(tǒng)計學(xué)意義(P<0.05)。益氣活血化痰方組生存質(zhì)量評分明顯高于對照組，差異有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論：益氣活血化痰方可以顯著降低氣虛痰瘀型不穩(wěn)定型心絞痛PCI術(shù)后患者LP-PLA2的水平，提高IL-10的水平，改善患者的生存質(zhì)量。

關(guān)鍵詞：氣虛痰瘀型；不穩(wěn)定型心絞痛；PCI；益氣活血化痰方；LP-PLA2；IL-10；生存質(zhì)量

EffectofYiqiHuoxueHuatanFangonLP-PLA2andIL-10inpatientswithunstableanginapectorisofQi-deficiency-Phlegm-stasistypeafterPCIandstudyonqualityoflife.

Abstract:Objective:ToinvestigatetheeffectofYiqiHuoxueHuatanFangonLP-PLA2andIL-10inpatientswithunstableanginapectorisofQi-deficiency-Phlegm-stasistypeafterPCIandstudyonthequalityoflife.Methods:200patientswhounderwentPCIsurgeryfromJanuary2017toJuly2019wereselectedanddividedintotwogroupsaccordingtothecondition,YiqiHuoxueHuatanFanggroupandcontrolgroup,with100casesineachgroup.YiqiHuoxueHuatanFangwasaddedtothebasictreatmentintheYiqiHuoxueHuatanFanggroup,whilethecontrolgrouponlyreceivedbasictreatment.LP-PLA2andIL-10weredetectedat1,3,and6monthsaftersurgeryinbothgroups,andthequalityoflifewasevaluated.Results:Comparedwiththecontrolgroup,theLP-PLA2levelintheYiqiHuoxueHuatanFanggroupwassignificantlylowerthanthatinthecontrolgroupat1,3,and6monthsaftersurgery,withstatisticallysignificantdifferences(P<0.05).TheIL-10levelintheYiqiHuoxueHuatanFanggroupwassignificantlyhigherthanthatinthecontrolgroup,withstatisticallysignificantdifferences(P<0.05).ThequalityoflifescoreintheYiqiHuoxueHuatanFanggroupwassignificantlyhigherthanthatinthecontrolgroup,withstatisticallysignificantdifferences(P<0.05).Conclusion:YiqiHuoxueHuatanFangcansignificantlyreducethelevelofLP-PLA2inpatientswithunstableanginapectorisofQi-deficiency-Phlegm-stasistypeafterPCI,increasethelevelofIL-10,andimprovethequalityoflifeofpatients.

Keywords:Qi-deficiency-Phlegm-stasistype;unstableanginapectoris;PCI;YiqiHuoxueHuatanFang;LP-PLA2;IL-10;qualityoflif5.Discussion

Inthisstudy,weinvestigatedtheeffectofYiqiHuoxueHuatanFangonLP-PLA2andIL-10levelsinpatientswithunstableanginapectorisofQi-deficiency-Phlegm-stasistypeafterPCI,aswellastheirqualityoflife.TheresultsshowedthatYiqiHuoxueHuatanFangcansignificantlyreducethelevelofLP-PLA2,increasethelevelofIL-10,andimprovethequalityoflifeofpatients.

LP-PLA2isanenzymethatismainlyproducedbymacrophagesandisinvolvedintheinflammatoryprocessofatherosclerosis.Itcanhydrolyzeoxidizedlow-densitylipoprotein(ox-LDL)andgenerateproductsthatpromoteinflammatoryreactions,leadingtotheformationofunstableplaquesandsubsequentacutecardiovascularevents(20,21).StudieshaveshownthatthelevelofLP-PLA2issignificantlyhigherinpatientswithunstableanginapectorisandisassociatedwiththeseverityofthedisease(22,23).Therefore,reducingthelevelofLP-PLA2isanimportantstrategyforthepreventionandtreatmentofunstableanginapectoris.

IL-10isananti-inflammatorycytokinethatcaninhibittheproductionofpro-inflammatorycytokinesandreducetheinflammatoryresponseinthebody(24).StudieshaveshownthatIL-10levelsarelowerinpatientswithunstableanginapectorisandareassociatedwiththeprognosisofthedisease(25,26).Therefore,increasingthelevelofIL-10isalsoanimportantstrategyforthetreatmentofunstableanginapectoris.

YiqiHuoxueHuatanFangisatraditionalChinesemedicineformulaconsistingofAstragalusmembranaceus,Salviamiltiorrhiza,Paeonialactiflora,Ligusticumchuanxiong,andBorneolumsyntheticum.Ithasbeenwidelyusedinthetreatmentofcardiovasculardiseases,includingunstableanginapectoris(17,18).ThemainpharmacologicaleffectsofYiqiHuoxueHuatanFangincludepromotingbloodcirculation,removingbloodstasis,andregulatingimmunefunction(19).

Inthisstudy,wefoundthatYiqiHuoxueHuatanFangcansignificantlyreducethelevelofLP-PLA2inpatientswithunstableanginapectorisofQi-deficiency-Phlegm-stasistypeafterPCI.Thismayberelatedtoitsabilitytopromotebloodcirculationandremovebloodstasis,whichcanreducetheformationandruptureofunstableplaques.Inaddition,YiqiHuoxueHuatanFangcanincreasethelevelofIL-10,whichmayberelatedtoitsabilitytoregulateimmunefunctionandinhibittheinflammatoryresponseinthebody.

Furthermore,wefoundthatYiqiHuoxueHuatanFangcanimprovethequalityoflifeofpatientswithunstableanginapectorisofQi-deficiency-Phlegm-stasistypeafterPCI.Thismayberelatedtoitsabilitytopromotebloodcirculation,reducechestpainanddiscomfort,andimprovesleepquality.

Inconclusion,ourstudysuggeststhatYiqiHuoxueHuatanFangcansignificantlyreducethelevelofLP-PLA2,increasethelevelofIL-10,andimprovethequalityoflifeofpatientswithunstableanginapectorisofQi-deficiency-Phlegm-stasistypeafterPCI.However,therearesomelimitationstoourstudy,suchasthesmallsamplesizeandshortfollow-upperiod.Therefore,furtherstudieswithlargersamplesizesandlongerfollow-upperiodsareneededtoconfirmourfindingsInadditiontothelimitationsmentionedabove,thereareotherpotentialfactorsthatcouldhaveaffectedtheoutcomesofourstudy.Forexample,theparticipants’adherencetotheYiqiHuoxueHuatanFangregimenwasnotmonitored,whichcouldhaveinfluencedtheresults.Additionally,theuseofcertainmedicationsbytheparticipantscouldhavehadanimpactontheirLP-PLA2levelsandoverallhealthoutcomes.

Anotherlimitationisthelackofacontrolgroupinourstudy.WhilecomparingtheresultsofourinterventiongroupbeforeandaftertreatmentprovidessomeinsightintotheeffectivenessofYiqiHuoxueHuatanFang,arandomizedcontrolledtrialwithaplacebogroupwouldprovidestrongerevidence.

Despitetheselimitations,ourstudycontributestothegrowingbodyofresearchontheuseoftraditionalChinesemedicineinthetreatmentofunstableanginapectoris.YiqiHuoxueHuatanFangoffersapromisingalternativetoconventionaltreatments,particularlyforpatientsofQi-deficiency-Phlegm-stasistype.FuturestudiesshouldcontinuetoinvestigatetheefficacyandsafetyofthisandothertraditionalChinesemedicineinterventions,inordertoprovidepatientswithadiverserangeoftreatmentoptionsInadditiontoinvestigatingtheeffectivenessoftraditionalChinesemedicineforthetreatmentofunstableanginapectoris,itisalsoimportanttoconsiderthepotentialmechanismsofaction.YiqiHuoxueHuatanFang,forexample,isbelievedtoworkbyimprovingbloodcirculation,resolvingphlegm,andeliminatingstasis.Theseactionsarethoughttohelpreducethefrequencyandseverityofanginaepisodes,aswellasimproveoverallcardiovascularhealth.

However,thereisstillmuchtolearnaboutthespecificmechanismsunderlyingtraditionalChinesemedicineinterventions.Forexample,furtherresearchisneededtobetterunderstandtheroleofacupunctureinthetreatmentofunstableanginapectoris.Whilesomestudieshavesuggestedthatacupuncturecanimprovebloodflowandreduceinflammation,othershavebeeninconclusiveorconflicting.Additionally,thereisaneedformoreresearchonthesafetyoftraditionalChinesemedicine,particularlyinthecontextoflong-termuseorcombinationwithothertreatments.

Ultimately,thegoalofresearchintotraditionalChinesemedicineforthetreatmentofunstableanginapectorisshouldbe