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[摘要]
目的 探讨心可舒胶囊联合桂哌齐特治疗不稳定型心绞痛的临床效果。方法 选取2016年10-2018年8月平顶山第二人民医院收治的不稳定型心绞痛患者138例,随机分成对照组(69例)和治疗组(69例)。对照组静脉滴注马来酸桂哌齐特注射液,8 mL加入500 mL生理盐水,滴速100 mL/h,1次/d。治疗组在对照组基础上口服心可舒胶囊,4粒/次,3次/d。两组患者均治疗14 d。观察两组患者心电图疗效和临床疗效,同时比较治疗前后两组患者心绞痛发作次数和持续时间、硝酸甘油用量、ST段下移幅度、心功能指标、血小板和血流变指标及丙二醛(MDA)、一氧化氮(NO)和C反应蛋白(CRP)水平。结果 治疗后,对照组心电图和临床有效率分别为81.2%和75.4%,均分别显著低于治疗组的92.8%和89.9%,两组比较差异有统计学意义(P<0.05)。治疗后,治疗组心绞痛发作次数和持续时间、硝酸甘油用量、ST段下移幅度均明显减少(P<0.05),且治疗组患者上述指标水平明显小于对照组(P<0.05)。治疗后,两组左室射血分数(LVEF)、心输出量(CO)及心搏出量(SV)值均显著升高(P<0.05),且治疗组患者心功能明显好于对照组(P<0.05)。治疗后,两组血小板最大聚集率(PAmax)和血浆黏度(PV)值均显著降低(P<0.05),红细胞变形指数(EDI)值均显著升高(P<0.05),且治疗组患者血小板和血流变指标明显好于对照组(P<0.05)。治疗后,两组血清MDA、CRP水平均显著减少(P<0.05),血清NO水平显著上升(P<0.05),且治疗组患者MDA、NO和CRP水平明显好于对照组(P<0.05)。结论 心可舒胶囊联合马来酸桂哌齐特治疗不稳定型心绞痛可明显控制患者病情,改善心功能及微循环,拮抗体内氧化应激,保护血管内皮功能。
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[Abstract]
Objective To investigate the clinical effect of Xinkeshu Capsules combined with cinepazide in treatment of unstable angina pectoris. Methods Patients (138 cases) with unstable angina pectoris in Pingdingshan the Second People's Hospital from October 2016 to August 2018 were randomly divided into control (69 cases) and treatment (69 cases) groups. Patients in the control group were iv administered with Cinepazide Maleate Injection, 8 mL added into 500 mL normal saline, the dropping speed was 100 mL/h, once daily. Patients in the treatment group were po administered with Xinkeshu Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the electrocardiogram and clinical efficacy was evaluated, and the frequency and duration of angina, nitroglycerin dosage, ST-segment descending range, cardiac function, platelets and hemorheological indexes, MDA, NO, and CRP levels in two groups before and after treatment were compared. Results After treatment, the electrocardiogram and clinical efficacy in the control group were 81.2% and 75.4%, which were significantly lower than 92.8% and 89.9% in the treatment group, respectively, and there were differences between two groups (P<0.05). After treatment, the frequency and duration of angina, nitroglycerin dosage, ST-segment descending range in two groups were significantly decreased (P<0.05), and these indexes levels in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the LVEF, CO, and SV values in two groups were significantly increased (P<0.05), and the cardiac function in the treatment group were significantly better than that in the control group (P<0.05). After treatment, the PAmax and PV values in two groups were significantly decreased (P<0.05), but EDI values in two groups were significantly increased (P<0.05), and the platelets and hemorheological indexes in the treatment group were significantly better than that in the control group (P<0.05). After treatment, the serum concentration of MDA and CRP in two groups was significantly decreased (P<0.05), but serum NO levels in two groups were significantly increased (P<0.05), and the MDA, NO, and CRP levels in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Xinkeshu Capsules combined with cinepazide in treatment of unstable angina pectoris can significantly control the patient's condition, improve cardiac function and microcirculation, antagonize oxidative stress and protect vascular endothelial function.
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