目的 探討?zhàn)B心生脈顆粒聯(lián)合注射用丹參多酚酸鹽治療冠心病心絞痛的臨床療效。方法 選取2020年9月-2022年8月中國中醫(yī)科學(xué)院廣安門醫(yī)院收治的124例冠心病心絞痛患者,按隨機(jī)數(shù)字表法將所有患者分為對照組和治療組,每組各62例。對照組靜脈滴注注射用丹參多酚酸鹽,200 mg加入5%葡萄糖注射液250mL中充分溶解,1次/d。治療組在對照組基礎(chǔ)上口服養(yǎng)心生脈顆粒,1袋/次,3次/d,溫開水沖服。兩組療程均為2周。觀察兩組的臨床療效,比較治療前后兩組心絞痛發(fā)作情況、相關(guān)評估表評分及血漿腫瘤壞死因子-α(TNF-α)、纖維蛋白原(FIB)、D-二聚體(D-D)水平。結(jié)果 治療后,治療組心絞痛總有效率和心電圖總有效率分別是93.55%、87.10%,顯著高于對照組的80.65%、72.58%(P<0.05)。治療后,兩組心絞痛發(fā)作次數(shù)和硝酸甘油用量均顯著減少,持續(xù)時(shí)間均顯著縮短(P<0.05);均以治療組改善更顯著(P<0.05)。治療后,兩組Duke評分均顯著增加,血瘀證評分均顯著降低(P<0.05);均以治療組改善更顯著(P<0.05)。治療后,兩組SAQ中各維度評分及其總分均顯著增加(P<0.05),且均以治療組升高更顯著(P<0.05)。較之治療前,兩組治療后血漿TNF-α、FIB、D-D水平均顯著下降(P<0.05);且治療后,治療組患者血清TNF-α、FIB、D-D水平均顯著低于對照組(P<0.05)。結(jié)論 養(yǎng)心生脈顆粒聯(lián)合注射用丹參多酚酸鹽治療冠心病心絞痛的整體效果顯著,能安全有效地控制患者心絞痛發(fā)作,緩解臨床癥狀,減輕機(jī)體炎性損傷和凝血功能紊亂,改善生活質(zhì)量及控制病情發(fā)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

北京市醫(yī)院管理局"青苗"計(jì)劃項(xiàng)目(QML20182301)