目的 探讨复方丹参滴丸联合马来酸桂哌齐特治疗不稳定型心绞痛的临床疗效。方法 选取2014年1月—2014年12月中国人民解放军成都军区总医院收治的不稳定型心绞痛患者120例,随机分为对照组和治疗组,每组各60例。对照组患者静脉滴注马来酸桂哌齐特注射液,8 mL/次,稀释于10%的葡萄糖注射液或生理盐水500 mL中,1次/d,滴注的速度为100 mL/h。治疗组在对照组基础上口服复方丹参滴丸,10丸/次,3次/d。两组均连续治疗12周。观察两组的临床疗效,同时比较两组治疗前后心功能指标包括心脏指数(CI)、心排出量(CO)、左室射血分数(LVEF)、左室收缩末期容积(LESV)、左室舒张末期容积(LEDV)和血液流变学指标包括全血黏度、血浆黏度、血细胞比容、血小板聚集率、纤维蛋白原的变化情况。结果 治疗后,对照组和治疗组的总有效率分别为73.33%、91.67%,两组比较差异有统计学意义(P< 0.05)。治疗后,两组患者的CI、CO、LVEF均显著升高,LESV、LEDV、全血黏度、血浆黏度、血细胞比容、血小板聚集率和纤维蛋白原均显著降低,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,两组比较差异具有统计学意义(P< 0.05)。结论 复方丹参滴丸联合马来酸桂哌齐特治疗不稳定型心绞痛疗效较好,可改善患者的心功能和血流动力学,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Compound Danshen Dripping Pills combined with cinepazide maleate in treatment of unstable angina. Methods Patients (120 cases) with unstable angina in Chengdu Military General Hospital from January 2014 to December 2014 were randomly divided into control and treatment groups, and each group had 60 cases. The patients in the control group were iv administered with Cinepazide Maleate Injection, 8 mL/time which was diluted in 10% glucose injection or physiological saline (500 mL), once daily with the drip speed of 100 mL/h. The patients in the treatment group were po administered with Compound Danshen Dripping Pills, 10 pills/time, three times daily. The patients in two groups were treated for 12 weeks. After treatment, the efficacy was evaluated, the changes of cardiac function indexes including cardiac index (CI), cardiac output (CO), left ventricular ejection fraction (LVEF), left ventricular end systolic volume (LESV), and left ventricular end-diastolic volume (LEDV) and blood rheology indexes including whole blood viscosity, plasma viscosity, hematocrit, platelet aggregation rate, fibrinogen before and after treatment in the two groups were compared. Results After the treatment, the efficacies in the control and treatment groups were 73.33% and 91.67%, respectively, and there was difference between two groups (P < 0.05). After treatment, CI, CO, and LVEF in two groups were significantly increased, and LESV, LEDV, whole blood viscosity, plasma viscosity, hematocrit, platelet aggregation rate, and fibrinogen were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). The improved degree of those observation indicators in the treatment group was better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Compound Danshen Dripping Pills combined with cinepazide maleate has good clinical efficacy in treatment of unstable angina, and can improve cardiac function and hemodynamics, which has a certain clinical application value.