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[摘要]
目的 探讨养心生脉颗粒联合非洛地平缓释片治疗冠心病心绞痛的临床疗效。方法 选取2017年4月—2018年4月在大连市第三人民医院治疗的冠心病心绞痛患者96例,根据用药的差别分为对照组(48例)和治疗组(48例)。对照组口服非洛地平缓释片,初始剂量为5 mg/次,1次/d,根据病情可减至2.5 mg/次,或增至10 mg/次,调整剂量间隔时间≥2周。治疗组在对照组治疗基础上口服养心生脉颗粒,14 g/次,3次/d。两组患者均治疗12周。观察两组患者临床疗效,同时比较治疗前后两组患者心绞痛发作次数和持续时间以血清学、血液流变学和心功能指标。结果 治疗后,对照组和治疗组临床有效率分别为81.25%和97.92%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组心绞痛发作次数及持续时间均显著减少(P<0.05),且治疗组心绞痛发作次数和持续时间明显低于对照组(P<0.05)。治疗后,两组白细胞介素-1β(IL-1β)、可溶性细胞间黏附分子1(sICAM-1)、核转录因子-κB(NF-κB)、基质金属蛋白酶-9(MMP-9)、全血黏度(WBV)、血浆黏度(PV)、纤维蛋白原(FIB)和血小板黏附率(PAR)水平均显著降低(P<0.05),且治疗组这些指标水平明显低于对照组(P<0.05)。治疗后,两组左心室射血分数(LVEF)和心输出量(CO)均显著升高(P<0.05),左心室收缩末期内径(LVESD)显著降低(P<0.05),且治疗组心功能明显好于对照组(P<0.05)。结论 养心生脉颗粒联合非洛地平缓释片治疗冠心病心绞痛可有效降低心绞痛发作次数,降低机体炎症因子水平,促进血液流变学指标和心功能改善。
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[Abstract]
Objective To explore the clinical effect of Yangxin Shengmai Granules combined with Felodipine in treatment of angina pectoris of coronary heart disease. Methods Patients (96 cases) with angina pectoris of coronary heart disease in the Third People's Hospital of Dalian from April 2017 to April 2018 were divided into control (48 cases) and treatment (48 cases) groups according to different treatments. Patients in the control group were po administered with Felodipine Sustained Release Tablets, and the initial dose was 5 mg/time, once daily. The dose can be reduced to 2.5 mg/time or increased to 10 mg/time according to the patient's condition, the interval time of adjusting dose ≥ 2 weeks. Patients in the treatment group were po administered with Yangxin Shengmai Granules on the basis of the control group, 14 g/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the frequency and duration of angina pectoris, serological, hemorheological and cardiac function indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 81.25% and 97.92% respectively, and there were differences between two groups (P<0.05). After treatment, the frequency and duration of angina pectoris in two groups was significantly decreased (P<0.05), which in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the IL-1β, sICAM-1, NF-κB, MMP-9, WBV, PV, FIB and PAR levels in two groups were significantly decreased (P<0.05), and these indexes in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the LVEF and CO in two groups were significantly increased (P<0.05), but LVESD was significantly increased (P<0.05), and the cardiac function indexes in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Yangxin Shengmai Granules combined with Felodipine in treatment of angina pectoris of coronary heart disease can effectively reduce the frequency of angina pectoris, the level of inflammatory factors, improve the hemorheological indexes and the heart function.
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