研究疾病:
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原发性微血管心绞痛
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研究疾病代码:
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Target disease:
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原发性微血管心绞痛 原发性微血管心绞痛 Primary microvascular angina
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Target disease code:
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研究类型:
Study type:
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干预性研究
Interventional study
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研究设计:
Study design:
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随机平行对照
randomized controlled trial(parallel group design)
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研究所处阶段:
Study phase:
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探索性研究/预试验
Pilot clinical trial
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研究目的:
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①确定痰热瘀阻型PMVA患者增加黄连温胆汤治疗后血浆vWF及Hcy水平的变化情况,进而探讨PMVA的发病机理。
②分析痰热瘀阻型PMVA患者vWF及Hcy水平与健康体检人群的差异。
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Objectives of Study:
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1. Objective to determine the changes of plasma vWF and Hcy levels in PMVA patients with phlegm heat stasis syndrome after Huanglian Wendan Decoction treatment, and to explore the pathogenesis of PMVA.
2. Objective to analyze the differences of vWF and Hcy levels between PMVA patients with phlegm heat stasis syndrome and healthy people.
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药物成份或治疗方案详述:
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Description for medicine or protocol of treatment in detail:
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纳入标准:
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PMVA诊断标准:(1)劳力型心绞痛至少半年,胸痛持续时间大于10min,硝酸甘油治疗效果不佳。(2)心电图或动态心电图至少出现1次ST段典型缺血性下移≥0.01mm。(3)运动平板试验阳性(ST段缺血性下移≥0.01mm)。(4)超声心动图检查无节段性室壁运动异常,左心室功能正常。(5)冠状动脉造影提示血管管腔正常或接近正常(造影结果提示:心外膜下冠脉血管壁正常或不规则、管腔不连续的轻度狭窄,其狭窄程度<20%),无自发冠状动脉痉挛表现,TIMI血流1-2级的患者。
中医诊断标准:痰热瘀阻证,主证:胸闷如窒而痛,灼热感;次证:口干心烦;口干或口苦不欲饮或饮不解渴;形体肥胖,痰多黄黏,面部烘热;苔黄腻,或伴少津中有裂纹或苔浊腻;舌质紫暗或见瘀斑或红,脉滑数或有结代、或弦、或涩。具备主证l项,次证2-3项可入选。
入选标准:年龄18~75岁,符合PMVA诊断标准的患者。
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Inclusion criteria
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PMVA diagnostic criteria:
(1) exertional angina pectoris at least half a year, chest pain lasting more than 10 minutes, nitroglycerin treatment effect is poor.
(2) There was at least one typical ST segment ischemic depression >= 0.01mm in ECG or Holter.
(3) Exercise treadmill test was positive (ST segment ischemic depression >= 0.01mm).
(4) Echocardiography showed no segmental wall motion abnormality and normal left ventricular function.
(5) Coronary angiography showed that the lumen was normal or close to normal (angiography results showed that the subepicardial coronary artery wall was normal or irregular, and the degree of stenosis was less than 20%), there was no spontaneous coronary artery spasm, and TIMI blood flow was 1-2 grade.
Diagnostic criteria of traditional Chinese Medicine: syndrome of phlegm-heat stasis and obstruction, main syndrome: chest tightness, such as suffocation and pain, burning sensation; secondary syndrome: dry and upset mouth; dry or bitter mouth, do not want to drink or drink does not quench thirst; obesity, phlegm yellow sticky, face hot; greasy fur, or with little body fluid cracks or greasy fur; tongue purple dark or see ecchymosis or red, pulse slippery number or knot generation, or string, or astringent. 1 item of main syndrome and 2-3 items of secondary syndrome can be selected.
Inclusion criteria: patients aged 18-75 years who met the diagnostic criteria of PMVA.
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排除标准:
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(1)器质性心脏病:冠状动脉粥样硬化性心脏病、冠脉痉挛、冠脉肌桥、各类心肌病、先天性心脏病、瓣膜性心脏病、肺源性心脏病等;
(2)心肌损伤:心肌炎、全身性疾病合并心肌损伤等;
(3)高血压病、高脂血症、糖尿病患者;
(4)需要药物控制的心律失常;
(5)完全性左束支传导阻滞、Ⅱ和Ⅲ度房室传导阻滞、病窦综合征;
(6)严重充血性心力衰竭;
(7)恶性肿瘤;
(8)肺、食管、主动脉夹层等可引起胸痛的疾病;
(9)严重的肝、肾功能不全者;
(10)严重创伤患者;
(11)内分泌系统疾病;
(12)贫血等血液系统疾病;
(13)外周血管病变;
(14)妊娠期及哺乳期妇女;
(15)3个月内使用抗生素或激素治疗者;
(16)对含有黄连、栀子、枳实、竹茹、半夏、陈皮、茯苓、丹参、郁金、甘草等中药制剂过敏者;
(17)不能坚持治疗或治疗依从性差者。
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Exclusion criteria:
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(1) Organic heart disease: coronary atherosclerotic heart disease, coronary artery spasm, coronary artery muscle bridge, all kinds of cardiomyopathy, congenital heart disease, valvular heart disease, pulmonary heart disease, etc.;
(2) myocardial injury: myocarditis, systemic disease combined with myocardial injury, etc.;
(3) patients with hypertension, hyperlipidemia, diabetes mellitus;
(4) arrhythmia requiring drug control
(5) complete left bundle branch block, degree II and III atrioventricular block, sick sinus syndrome;
(6) severe congestive heart failure;
(7) malignant tumor;
(8) lung, esophagus, aortic dissection and other diseases that can cause chest pain;
(9) severe liver and kidney dysfunction;
(10) severe trauma patients;
(11) endocrine system diseases;
(12) anemia and other blood diseases Systemic diseases;
(13) peripheral vascular diseases;
(14) pregnant and lactating women;
(15) patients treated with antibiotics or hormones within 3 months;
(16) patients allergic to traditional Chinese medicine preparations including Coptis, gardenia, Fructus aurantii Immaturus, Zhuru, pinellia, Pericarpium Citri Reticulatae, Poria cocos, Salvia miltiorrhiza, Curcuma and licorice;
(17) patients unable to persist in treatment or poor treatment compliance.
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研究实施时间:
Study execute time:
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从From
2020-02-01
至To
2022-02-28
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征募观察对象时间:
Recruiting time:
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从From
2021-02-17
至To
2022-02-28
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