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[摘要]
目的 探讨舒心通脉胶囊联合阿托伐他汀钙片治疗冠心病的临床疗效。方法 选取2016年1月—2017年12月天津市蓟州区人民医院收治的100例冠心病患者为研究对象,所有患者随机分为对照组(48例)和治疗组(52例)。对照组患者口服阿托伐他汀钙片,10 mg/次,1次/d。治疗组患者在对照组治疗的基础上口服舒心通脉胶囊,0.9 g/次,2次/d。两组患者持续治疗30 d。观察两组的临床疗效,比较两组的心功能指标、血脂水平、心肌酶谱指标、血清因子水平。结果 治疗后,对照组和治疗组的总有效率分别为70.83%、88.46%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者左心室舒张末前后径(LVEDD)、左心室收缩末容量(LVESV)、左心室舒张末容量(LVEDV)均显著降低,左心室射血分数(LVEF)显著升高,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组心功能指标明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)水平均显著降低,高密度脂蛋白胆固醇(HDL-C)水平显著升高,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组血脂水平明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、天门冬氨酸氨基转氨酶(AST)、丙氨酸氨基转移酶(ALT)水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组心肌酶谱指标水平明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者内脏脂肪型丝氨酸蛋白酶抑制剂(vaspin)、人脂肪甘油三酯脂酶(ATGL)水平均显著升高,人碱性磷酸酶(ALP)、血清不规则趋化因子(fractalkine)水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组血清因子水平明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论 舒心通脉胶囊联合阿托伐他汀钙片治疗冠心病具有较好的临床疗效,能改善心功能、血脂水平,降低心肌损伤程度,具有一定的临床推广应用价值。
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[Abstract]
Objective To investigate the efficiency of Shuxin Tongmai Capsules combined with Atorvastatin Calcium Tablets in treatment of coronary heart disease. Methods Patients (100 cases) with coronary heart disease in the People's Hospital of Jizhou District of Tianjin from January 2016 to December 2017 were randomly divided into the control group (48 cases) and the treatment group (52 cases). Patients in the control group were po administered with Atorvastatin Calcium Tablets, 10 mg/time, once daily. Patients in the treatment group were po administered with Shuxin Tongmai Capsules on the basis of the control group, 0.9 g/time, twice daily. Patients in two groups were treated for 30 d. After treatment, the clinical efficacies were evaluated, and cardiac function indexes, blood lipid levels, myocardial enzymogram indexes, and serum factor levels in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 70.83% and 88.46%, respectively, and there was difference between two groups (P<0.05). After treatment, LVEDD, LVESV, and LVEDV in two groups were significantly decreased, but LVEF in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the cardiac function indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of TG, LDL-C, and TC in two groups were significantly decreased, but the levels of HDL-C in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the blood lipid levels in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of CK-MB, LDH, AST, and ALT in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the myocardial enzymogram indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of vaspin and ATGL in two groups were significantly increased, but the levels of ALP and fractalkine in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the serum factor levels in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Shuxin Tongmai Capsules combined with Atorvastatin Calcium Tablets has clinical curative effect in treatment of coronary heart disease, can improve cardiac function and blood lipid level, and reduce the degree of myocardial injury, which has a certain clinical application value.
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