目的 探讨脑心清片联合马来酸桂哌齐特和丹参酮Ⅱ_A磺酸钠治疗冠心病心绞痛的临床疗效。方法 选取2015年1月-2016年1月在辽宁中医药大学附属医院心内科接受治疗的96例冠心病心绞痛患者,随机分为对照组(48例)和治疗组(48例)。所有患者均给予低盐低脂饮食、抗凝、降血脂等基础治疗。对照组静脉滴注马来酸桂哌齐特注射液,320 mg加入生理盐水500 mL中,1次/d;同时静脉滴注丹参酮Ⅱ_A磺酸钠注射液,60 mg加入生理盐水250 mL中,1次/d。治疗组在对照组基础上口服脑心清片,2片/次,3次/d。两组患者均连续治疗14 d。观察两组的临床疗效,同时比较两组血清学指标、症状和血液流变学指标改善情况。结果 治疗后,对照组和治疗组总有效率分别为79.17%和93.75%,两组比较差异具有统计学意义(P<0.05)。治疗后两组血清脂联素(APN)、一氧化氮(NO)水平较同组治疗前明显增高(P<0.05),肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)、内皮素(ET)、血栓素B2(TXB2)水平均比同组治疗前明显降低(P<0.05);与对照组比较,治疗组的血清学指标改善更明显(P<0.05)。治疗后两组心绞痛发作次数、持续时间以及缓解所需硝酸甘油剂量较同组治疗前明显降低(P<0.05),但治疗组降低的更明显(P<0.05)。治疗后两组全血黏度、FIB、血浆黏度、HCT均较同组治疗前明显降低,差异具有统计学意义(P<0.05);且治疗组比对照组降低的更明显,差异具有统计学意义(P<0.05)。结论 脑心清片联合马来酸桂哌齐特和丹参酮Ⅱ_A磺酸钠治疗冠心病心绞痛疗效显著,可明显改善患者血清学指标、临床症状以及降低血液流变学指标。

Objective To explore the clinical efficacies of Naoxinqing Tablets combined with cinepazide maleate and tanshinone Ⅱ_A sodium sulfonate in treatment of coronary heart disease with angina pectoris. Methods Patients (96 cases) with coronary heart disease with angina pectoris from January 2015 to January 2016 in Affiliated Hospital of Liaoning University of TCM were randomly divided into control (48 cases) and treatment (48 cases) groups. All patients were given basic treatment with low salt and low fat diet, anticoagulation, lipid lowering, etc. Patients in the control group were iv administered with Cinepazide Maleate Injection, 320 mg added into normal saline 500 mL, once daily. At the same time, they were iv administered with Tanshinone Ⅱ_A Sodium Sulfonate Injection, 60 mg added into normal saline 250 mL, once daily. The patients in the treatment group were po administered with Naoxinqing Tablets on the basis of control group, 2 tablets/time, three times daily. The patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the improvement of serum indexes, symptoms and hemorheology indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment group were 79.17% and 93.75%, respectively, and there were differences between two groups (P < 0.05). After treatment, serum adiponectin (APN) and nitric oxide (NO) in two groups were significantly increased (P < 0.05), and tumor necrosis factor-α (TNF-α), hypersensitive C-reactive protein (hs-CRP), endothelin (ET) and thromboxane B2 (TXB2) were significantly decreased (P < 0.05). For serum indexes, the treatment group improved more significantly than the control group (P < 0.05). After treatment, frequency and duration of angina pectoris, and also nitroglycerin dosage of two groups were significantly decreased (P < 0.05); Compared with the control group, the serum indexes in the treatment group decreased more obviously (P < 0.05). After treatment, hematocrit, fibrinogen, whole blood viscosity and plasma viscosity of two groups were decreased more than those before treatment with significant difference (P < 0.05). And these hemorheology indexes in treatment group were decreased more than those in the control group, and the difference was significant (P < 0.05). Conclusion Naoxinqing Tablets combined with Cinepazide Maleate Injection and Tanshinone Ⅱ_A Sodium Sulfonate Injection has clinical curative effect in the treatment of coronary heart disease with angina pectoris, can significantly improve the serum indexes, clinical symptoms, and reduce hemorheology indexes.