目的 研究芪蛭胶囊联合阿托伐他汀和依折麦布治疗老年冠心病合并高脂血症的临床疗效。方法 选取2014年3月—2015年3月咸阳市第一人民医院心血管内科收治的老年冠心病合并高脂血症患者110例,随机分为对照组和治疗组,每组各55例。对照组在基础治疗上口服阿托伐他汀钙片,1片/次,1次/d;同时口服依折麦布片,1片/次,1次/d。治疗组在对照组的基础上口服芪蛭胶囊,2粒/次,3次/d。两组均连续治疗8周。观察两组患者的临床疗效,比较两组患者治疗前后三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)的变化,同时比较两组心血管不良事件的发生情况。结果 治疗后,对照组和治疗组冠心病总有效率分别为78.18%、89.09%;两组血脂总有效率分别为72.73%、87.27%,两组冠心病总有效率和血脂总有效率比较差异均有统计学意义(P <0.05)。治疗后,两组TC、TG、LDL-C均较治疗前显著降低,HDL-C显著升高,同组治疗前后差异有统计学意义(P <0.05);且治疗组这些观察指标的改善程度优于对照组,两组比较差异有统计学意义(P <0.05)。对照组和治疗组心血管不良事件发生率分别为29.09%、7.27%,两组比较差异有统计学意义(P <0.05)。结论 芪蛭胶囊联合阿托伐他汀和依折麦布治疗老年冠心病合并高脂血症具有较好的临床疗效,能显著降低患者血脂水平,降低心血管不良事件的发生率,具有一定的临床推广应用价值。

Objective To observe the clinical curative effect of Qizhi Capsules combined with atorvastatin and ezetimibe in treatment of elderly coronary heart disease with hyperlipidemia. Methods Patients (110 cases) with coronary heart disease with hyperlipidemia in Department of Cardiovascular Internal Medicine of the First People's Hospital of Xianyang City from March 2014 to March 2015 were randomly divided into control and treatment groups, and each group had 55 cases. The patients in control group were po administered with Atorvastatin Calcium Tablets on the basis of foundation treatment, 1 tablet/time, once daily. At the same time, they were po administered with Ezetimibe Tablets, 1 tablet/time, once daily. The patients in treatment group were po administered with Qizhi Capsules on the basis of control group, 2 grains/time, three times daily. Two groups were treated for 8 weeks. After treatment, the efficacy was evaluated. The changes of TC, TG, LDL-C, HDL-C, and the occurrence of cardiovascular adverse events in two groups were compared. Results The clinical efficacies of coronary heart disease in control and treatment groups were 78.18% and 89.09%, respectively, while clinical efficacies of blood lipid in two groups were 72.73% and 87.27%, respectively, and there were differences between two groups (P < 0.05). After treatment, TG, TC, and LDL-C in two groups were significantly reduced, while HDL-C was significantly increased, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant differences between two groups (P < 0.05). The incidence of cardiovascular adverse events in the control and treatment groups were 29.09% and 7.27%, respectively, and there were differences between two groups (P < 0.05). Conclusion Qizhi Capsules combined with atorvastatin and ezetimibe has good clinicalefficacy in treatment of elderly coronary heart disease with hyperlipidemia, and can significantly decrease blood lipid level, and also can reduce the incidence of cardiovascular adverse events, which has a certain clinical application value.