目的 探讨芪冬颐心口服液联合尼可地尔片治疗冠心病心绞痛的临床疗效。方法 选择2020年1月—2020年12月中国人民解放军陆军特色医学中心收治的123例冠心病心绞痛患者,根据随机数字表法将所有患者分为对照组(61例)和治疗组(62例)。对照组口服尼可地尔片,5 mg/次,3次/d。治疗组患者在对照组基础上口服芪冬颐心口服液,20 mL/次,3次/d。两组均治疗4周。观察两组的疗效,比较两组的心绞痛发作频率、持续时间、硝酸甘油用量、心功能指标、心肌酶谱指标、炎性因子指标。结果 治疗后,治疗组总有效率(91.94%)明显高于对照组的总有效率(78.69%),组间比较差异具有显著性(P<0.05)。治疗后,两组心绞痛发作频率降低,硝酸甘油用量减少,心绞痛持续时间缩短(P<0.05),且治疗组的临床症状指标改善优于对照组(P<0.05)。治疗后,两组左室舒张末期内径(LVEDd)、左室收缩末期内径(LVESd)明显降低,左心室射血分数(LVEF)明显升高(P<0.05),且治疗组的心功能指标改善效果优于对照组(P<0.05)。治疗后,两组血清肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、肌钙蛋白(c TnI)水平均显著下降(P<0.05),治疗组的血清CKMB、LDH、cTnI水平明显低于对照组(P<0.05)。治疗后,两组血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、超敏C反应蛋白(hs-CRP)水平均显著下降(P<0.05),且治疗组的血清IL-6、IL-8、hs-CRP水平明显低于对照组(P<0.05)。结论 芪冬颐心口服液联合尼可地尔片治疗冠心病心绞痛可提高临床疗效,减少心绞痛发作频率和硝酸甘油用量,缩短持续时间,改善患者心功能、减轻心肌损伤、降低炎症反应。

Objective To investigate the therapeutic effect of Qidong Yixin Oral Liquid combined with Nicorandil Tablets in treatment of angina pectoris of coronary heart disease.Methods Patients(123 cases) with angina pectoris of coronary heart disease in PLA Army Characteristic Medical Center from January 2020 to December 2020 were divided into the control group(61 cases) and the treatment group(62 cases) according to the random number table method. Patients in the control group were po administered with Nicorandil Tablets, 5 mg/time, three times daily. Patients in the treatment group were po administered with Qidong Yixin Oral Liquid on the basis of the control group, 20 mL/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and the frequency and duration of angina pectoris, nitroglycerin dosage, cardiac function index,myocardial zymogram index, and inflammatory factor index in two groups were compared.Results After treatment, the total effective rate of the treatment group(91.94%) was significantly higher than that of the control group(78.69%), with a significant difference between the groups(P<0.05). After treatment, the attack frequency of angina pectoris in two groups was decreased, the dosage of nitroglycerin was decreased in two groups, and the duration of angina pectoris in two groups was shortened(P<0.05). The improvement effect of clinical symptoms in the treatment group was better than that in the control group(P<0.05). After treatment, the LVEDd and LVESd in two groups were significantly decreased, but LVEF in two groups was significantly increased(P<0.05), and the improvement effect of cardiac function indexes in the treatment group was better than that in the control group(P<0.05). After treatment, the serum levels of CK-MB, LDH, and cTnI in two groups were significantly decreased(P<0.05), and the serum levels of CK-MB, LDH, and cTnI in the treatment group were significantly lower than those in the control group(P<0.05). After treatment,the serum levels of IL-6, IL-8, and hs-CRP in two groups were significantly decreased(P<0.05), and the serum levels of IL-6, IL-8,and hs-CRP in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion Qidong Yixin Oral Liquid combined with Nicorandil Tablets in treatment of angina pectoris of coronary heart disease can improve clinical efficacy, reduce the frequency of angina pectoris attack and the dosage of nitroglycerin, shorten the duration of angina pectoris, improve the cardiac function of patients, reduce myocardial damage and inflammatory response.

R972

重庆市科卫联合医学科研项目(2021KWLH126)