目的 探讨养心生脉颗粒联合注射用丹参多酚酸盐治疗冠心病心绞痛的临床疗效。方法 选取2020年9月-2022年8月中国中医科学院广安门医院收治的124例冠心病心绞痛患者,按随机数字表法将所有患者分为对照组和治疗组,每组各62例。对照组静脉滴注注射用丹参多酚酸盐,200 mg加入5%葡萄糖注射液250mL中充分溶解,1次/d。治疗组在对照组基础上口服养心生脉颗粒,1袋/次,3次/d,温开水冲服。两组疗程均为2周。观察两组的临床疗效,比较治疗前后两组心绞痛发作情况、相关评估表评分及血浆肿瘤坏死因子-α(TNF-α)、纤维蛋白原(FIB)、D-二聚体(D-D)水平。结果 治疗后,治疗组心绞痛总有效率和心电图总有效率分别是93.55%、87.10%,显著高于对照组的80.65%、72.58%(P<0.05)。治疗后,两组心绞痛发作次数和硝酸甘油用量均显著减少,持续时间均显著缩短(P<0.05);均以治疗组改善更显著(P<0.05)。治疗后,两组Duke评分均显著增加,血瘀证评分均显著降低(P<0.05);均以治疗组改善更显著(P<0.05)。治疗后,两组SAQ中各维度评分及其总分均显著增加(P<0.05),且均以治疗组升高更显著(P<0.05)。较之治疗前,两组治疗后血浆TNF-α、FIB、D-D水平均显著下降(P<0.05);且治疗后,治疗组患者血清TNF-α、FIB、D-D水平均显著低于对照组(P<0.05)。结论 养心生脉颗粒联合注射用丹参多酚酸盐治疗冠心病心绞痛的整体效果显著,能安全有效地控制患者心绞痛发作,缓解临床症状,减轻机体炎性损伤和凝血功能紊乱,改善生活质量及控制病情发展。

Objective To investigate the clinical efficacy of Yangxin Shengmai Granules combined with salvianolic acids in treatment of angina pectoris of coronary heart disease. Methods A total of 124 patients with angina pectoris of coronary heart disease admitted to Guang’anmen Hospital of the Chinese Academy of Traditional Chinese Medicine from September 2020 to August 2022 were selected, and they were divided into control group and treatment group according to random number table method, with 62 patients in each group. Patients in the control group were iv administered with Salvianolic Acids for injection, 200 mg was added into 250 mL of 5% glucose injection for full dissolution, once daily. Patients in the treatment group were po administered with Yangxin Shengmai Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, angina pectoris attack, scores of relevant evaluation forms, plasma tumor necrosis factor- α (TNF-α), fibrinogen (FIB) and D-dimer (D-D) were compared between the two groups before and after treatment. Results After treatment, the total effective rate of angina pectoris in the treatment group and the total effective rate of electrocardiogram were 93.55% and 87.10%, respectively, which were significantly higher than those in the control group (80.65% and 72.58%, P＜0.05). After treatment, the number of angina attacks and the amount of nitroglycerin were significantly reduced in both groups, and the duration was significantly shortened (P＜0.05). The improvement was more significant in treatment group (P＜0.05). After treatment, Duke score was significantly increased and blood-stasis syndrome score was significantly decreased in both groups (P＜0.05). The improvement was more significant in treatment group (P＜0.05). After treatment, SAQ scores of all dimensions and total scores in both groups were significantly increased (P＜0.05), and the increases were more significant in the treatment group (P＜0.05). Compared with before treatment, serum TNF-α, FIB, and D-D levels in two groups were significantly decreased after treatment (P＜0.05). After treatment, levels of TNF-α, FIB, and D-D in treatment group were significantly lower than those in control group (P＜0.05). Conclusion Yangxin Shengmai Granules combined with Salvianolic Acids for injection has overall effect in treatment of angina pectoris of coronary heart disease, can safely and effectively control the attack of angina pectoris, relieve clinical symptoms, reduce inflammatory injury and coagulation dysfunction, improve the quality of life and control the development of the disease.

R914

北京市医院管理局"青苗"计划项目(QML20182301)