川芎嗪及参麦注射液治疗缺血性心脏病心力衰竭50例

目的观察川芎嗪注射液联合参麦注射液治疗缺血性心脏病心力衰竭的近期疗效。方法100例缺血性心脏病心力衰竭病人按数字表法随机分为两组。对照组（50例）采用常规治疗，如血管紧张素转换酶抑制剂（ACEI）、洋地黄制剂、利尿剂、血管扩张剂等；治疗组（50例）应用川芎嗪注射液200mg联合参麦注射液50mL静脉输注，均每日1次；除不用洋地黄制剂、消心痛、硝酸甘油等扩血管药物外，其余治疗同对照组。两组均以10d为1个疗程，连用2个疗程。观察用药前后心率（HR）、心排血量（CO）、左室射血分数（LVEF）和左室舒张末期压力（LVEDP）等心功能参数及心功能分级、临床症状和体征的变化，并观察两组药物不良反应等。结果治疗组临床疗效明显改善，治疗组总有效率达92．0％，对照组为72．0％（P〈0．01）；两组治疗后LVEF、LVEDP均明显改善，治疗组药物不良反应和毒性作用发生率低于对照组。结论川芎嗪注射液联合参麦注射液治疗缺血性心脏病心力衰竭近期疗效显著，且无明显不良反应。     

自拟涤痰活血汤治疗血管性痴呆45例临床观察

目的观察自拟涤痰活血汤加减治疗血管性痴呆的临床疗效。方法将90例病人随机分为两组,各45例。对照组采用常规西医治疗,包括脑细胞代谢活化剂,改善脑循环药物治疗。治疗组在西医常规治疗的基础上服用自拟涤痰活血汤加减,每日1剂,水煎服,10 d为1个疗程。结果治疗组总有效率82.2%,对照组总有效率64.4%,两组比较差异有统计学意义(P<0.05)。结论在西医治疗的基础上用涤痰活血汤加减治疗血管性痴呆,疗效明显优于西药常规治疗。     

丹芪通脉胶囊治疗脑梗死的临床观察

目的 观察丹芪通脉胶囊治疗脑梗死的临床疗效.方法 将180例脑梗死随机分为两组,108例为丹芪通脉胶囊治疗组,72例为常规西医治疗的对照组,30 d为1个疗程.观察比较两组病例临床疗效、血液流变学指标及血脂变化.结果 治疗组治疗后全血黏度、血浆黏度、红细胞比容、血脂均有显著改变,且优于对照组(P<0.05).治疗组总有效率为93.52%,对照组总有效率为 80.56%.治疗组优于对照组(P<0.05).结论 丹芪通脉胶囊治疗脑梗死治愈率高,后遗症少.     

阿魏酸钠治疗肺心病急性加重期100例临床分析

目的:观察阿魏酸钠注射液对慢性肺源性心脏病急性加重期患者的血液流变学、动脉血气及心功能的疗效.方法:治疗组50例采用西药常规治疗基础上配合阿魏酸钠注射液治疗,对照组50例采用西药常规治疗.结果:治疗组总有效率92%,对照组总有效率78%,两组总有效率比较差异有统计学意义(P<0.05).结论:阿魏酸钠是治疗慢性肺源性心脏病急性加重期的有效药物.     

冠心宁联合酚妥拉明治疗慢性肺源性心脏病心力衰竭38例疗效观察

目的观察冠心宁联合酚妥拉明治疗慢性肺源性心脏病心力衰竭的疗效。方法将78例慢性肺源性心脏病心力衰竭病人随机分为两组,治疗组在综合治疗的基础上加用冠心宁20mL加入酚妥拉明10mg溶于5%葡萄糖250mL中静脉输注,每日1次,10d～15d为1个疗程。对照组采用常规方法,休息,低流量吸氧,改善通气,抗炎,解痉,平喘,祛痰,合理使用强心利尿剂,纠正酸碱失衡及电解质紊乱,对症及并发症治疗。结果治疗组显效率81.6%,总有效率97.4%;对照组显效率42.5%,总有效率75.0%。两组总有效率差异有统计学意义(P<0.05)。结论冠心宁联合酚妥拉明治疗慢性肺源性心脏病心力衰竭疗效较优于传统治疗方法。     

自拟开胸通脉汤治疗冠心病心绞痛临床观察

目的观察自拟开胸通脉汤治疗冠心病心绞痛的临床疗效。方法将124例患者随机分为两组,对照组62例,以口服肠溶阿司匹林片等药治疗;治疗组62例,在对照组治疗基础上加服中药自拟开胸通脉汤治疗。两组疗程均为4周。结果治疗组临床症状总有效率为90.3%,对照组为74.2%,两组比较差异有统计学意义(P<0.05);治疗组心电图总有效率为67.7%,对照组为46.8%,两组比较差异有统计学意义(P<0.05)。结论开胸通脉汤治疗心绞痛能使临床症状好转、心电图显著改善,且作用稳定,未发现明显副作用。     

中西医结合治疗冠心病心绞痛83例的临床观察

目的 观察并分析中西医结合治疗冠心病心绞痛的疗效.方法 抽取经诊断肯定的心绞痛患者165例,随机分成常规药物组(对照组,82例)和常规药物+葛根素注射液+中药煎剂组(观察组,83例)并比较两组治疗前后的心绞痛平均每周发作次数及平均发作持续时间;心电图缺血性变化及治疗总有效率,然后与对照组比较,并作统计学分析.结果 两组患者治疗后心绞痛平均每周发作次数及平均发作持续时间均较治疗前有显著减少(P<0.01),观察组优于对照组(P<0.05);两组治疗后心电图缺血性变化均有改善,观察组心电图总有效率91.6%,对照组70.7%,差异有统计学极显著意义(P<0.01);观察组与对照组的总有效率分别为92.8%与69.5%,差异有统计学极显著意义(P<0.01).疗程中,两组均未见明显药物不良反应.结论 中西医结合治疗冠心病心绞痛疗效肯定,较常规药物治疗有一定优势且无明显药物不良反应,值得临床推荐.     

中药活血化瘀、益气通络法联合西药综合治疗缺血性中风临床疗效与安全性观察

目的 观察自拟汤药联合西药综合治疗缺血性中风的疗效,探讨其临床优势.方法 将确诊为缺血性中风的120例患者按随机数字表分为西医组和中西医结合组,每组各60例,西医组给予常规常规溶栓、降纤、抗凝、脑保护剂及对症治疗,中西医结合组在西医组基础上,加服自拟中药汤剂1号,两组均治疗15d,比较两组临床疗效、血液流变学指标、神经功能缺损评分差异.结果 中西医结合组总有效率为93.33%,西医组为66.67%,中西医结合组的总有效率高于西医组,差异有显著统计学意义(P＜0.01).结论 中西医结合治疗缺血性中风疗效显著,优于单纯西药治疗,更快优化血液流变学指标,改善微循环,恢复大脑神经功能,且安全性好,建议临床推广应用.     

自拟温阳复雾汤治疗老年慢性心力衰竭疗效观察

目的 探索老年慢性心力衰竭更为有效的中医药治疗方法.方法 将90例老年慢性心力衰竭病人随机分为治疗组与对照组,各45例.对照组采用常规西药治疗,治疗组口服自拟温阳复雾汤.观察比较两组临床疗效.结果 治疗组总有效率为100.00%,对照组总有效率为64.44%,治疗组优于对照组(P<0.05).结论 自拟温阳复雾汤治疗老年慢性心力衰竭有一定的治疗作用,优于常规治疗.     

邓老冠心止痛贴辅助治疗稳定型心绞痛疗效观察

目的观察邓老冠心止痛贴辅助治疗稳定型心绞痛的临床疗效。方法 88例稳定型心绞痛患者,随机分为治疗组及对照组,各44例。两组均常规给予抗血小板聚集、调脂、抗心绞痛等治疗,治疗组在给予上述药物治疗的基础上,加用邓老冠心止痛贴分别贴于膻中穴和阿是穴,每日2贴剂,7 d为1个疗程。结果治疗组显效34例、有效9例、无效1例,总有效率97.3%;对照组分别为23、6、13例和65.9%。两组总有效率相比,P<0.05。治疗组中医症候显效29例、有效13例、无效2例,总有效率95.4%,对照组分别为11、28、5例和88.6%,两组中医症候总有效率相比,P<0.05。结论邓老冠心止痛贴辅助治疗稳定型心绞痛疗效满意。     

冠脉宁口服液治疗冠心病心绞痛186例临床研究

目的 :探讨冠脉宁口服液治疗冠心病心绞痛的临床疗效。方法 :应用自研冠脉宁口服液为主 ,中西医结合治疗冠心病心绞痛 186例 (治疗组 ) ,与常规西药治疗 10 0例 (对照组 )作比较。结果 :两组均能缓解冠心病心绞痛症状 ,治疗组疗效显著 ,两组显效率、有效率分别为 47.3 %、93 .5 %与3 4.0 %、87.0 % (P <0 .0 5 ) ;与对照组比较 ,治疗组能明显改善心电图 (P <0 .0 5 ) ,减少硝酸甘油的消耗量 (P <0 .0 5 ) ,改善血液流变学的异常 (P <0 .0 1) ,降低血脂 (P <0 .0 0 1)。结论 :治疗组主要适合于心气不足型、气滞血瘀型 ,能明显缓解稳定型心绞痛 (P <0 .0 5 )。说明冠脉宁口服液是治疗冠心病心绞痛有效药物之一。     

冠通方治疗心肌梗死后心绞痛气虚血瘀型的效果

目的 观察冠通方对心肌梗死后心绞痛气虚血瘀型患者的治疗效果。方法 把80例符合纳入标准的梗死后心绞痛患者随机分成试药组和对照组,每组各40例。试药组给予冠通方加西医基础治疗,对照组给予西医基础治疗。比较两组的临床效果并观察各项指标的变化。结果 试药组中医证候疗效、心绞痛疗效、心电图疗效均优于对照组（均P<0.05)。治疗后试药组与对照组对冠状动脉侧支循环的分级及评分情况具有明显差异(P<0.05)。试药组与对照组对冠状动脉侧支循环的能否建立,差异不显著。结论 冠通方治疗心肌梗死后心绞痛的疗效显著优于西医基础治疗,安全性好。     

银丹心脑通软胶囊联合地尔硫卓治疗冠状动脉痉挛的临床观察

目的观察银丹心脑通软胶囊联合地尔硫卓治疗冠状动脉痉挛的临床疗效。方法将68例患者按完全随机化分组方法分为治疗组36例和对照组32例,两组患者在诊断为冠状动脉痉挛后开始以地尔硫卓、抗血小板及他汀类药物调脂治疗为主的联合治疗。治疗组在对照组基础上加服银丹心脑通软胶囊,每日3次,每次3粒口服,规格0.4 g每粒。3个月后随访,记录患者的胸痛或胸闷发作的频次(次/个月);复查血脂水平;复查腺苷201核素灌注心肌显像负荷试验。结果经过联合治疗3个月后,治疗组心绞痛发作次数及血脂水平比治疗前和对照组都有明显改善,差异有统计学意义(P<0.05);腺苷201核素灌注心肌显像负荷试验结果显示,治疗组显效和总有效率高于对照组,差异有统计学意义[50.00%(18/36)vs.18.75%(6/32),P<0.05;97.22%(35/36)vs.87.50%(28/32),P<0.05]。结论冠状动脉痉挛在地尔硫卓等药物治疗基础上联合使用银丹心脑通软胶囊治疗,有一定疗效,值得临床进一步观察研究。     

麝香通心滴丸对急性心肌梗死经皮冠状动脉介入治疗患者炎性因子及心功能的有益作用

目的:探讨麝香通心滴丸对急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)后炎性因子和心功能的影响。方法:选择2015年1月—2017年12月连续82例STEMI并接受急诊PCI的患者,以1∶1随机分为常规治疗组和麝香通心滴丸组(入院后立即口服麝香通心滴丸6丸,次日起2丸/次,每日3次,持续30 d)。测定PCI前及术后7 d血清炎性因子水平及超声心动图左室功能变化。结果:两组患者PCI前血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hsCRP)水平相近(P均>0.05),术后7 d时上述指标均有一定程度的降低,但麝香通心滴丸组炎性因子降低幅度较常规治疗组更大(P均<0.05)。两组PCI前左室收缩末期容量(LVESV)、左室舒张末期容量(LVEDV)、左室射血分数(LVEF)无明显差异,术后7 d左心室容量无显著变化,但LVEF较术前明显增高(P<0.05)。术后30 d时,两组患者LVESV和LVEDV均较术前明显减低,LVEF较术前明显增高,且麝香通心滴丸组LVEF改善的程度优于常规治疗组(P<0.05)。结论:急诊PCI可改善STEMI患者的炎性反应及左心功能,加用麝香通心滴丸有助于进一步改善上述作用。     

补肾益肺化瘀汤治疗80例COPD患者的疗效评估

目的探讨自拟补肾益肺化瘀汤治疗COPD。方法将我院确诊的80例慢性阻塞性肺疾病患者随机分为观察组42例和对照组38例,观察者予自拟补肾益肺化瘀中药汤配合西医常规治疗,对照组予单纯西医治疗,比较两组积分、治疗效果及心肺功能。结果观察组治疗后症状积分0.98±0.85显著低于对照组积分1.89±0.67(P<0.05),观察组显效率达76.19%、总有效率达95.24%均显著高于对照组(P<0.05);心肺功能改善状况明显优于对照组(P<0.05)。结论自拟补肾益肺化瘀中药汤配合西医治疗慢性阻塞性肺疾病能够明显改善患者心肺功能状态,提高临床疗效,值得临床推广与应用。     

U波异常有助诊断缺血性心脏病—冠脉造影与心电图对照

目的 探讨U波异常在诊断缺血性心脏病中的价值。方法 选择临床拟为冠心病的男性患者52例，排除电解质紊乱，应用常规心电图、运动负荷心电图及冠脉造影，分析ST段缺血性改变、U波异常在诊断缺血性心脏病中的敏感性和特异性。结果 52例临床拟诊冠心病患者，冠脉造影阳性者38例。冠脉造影阳性者中，常规心电图ST段呈缺血性改变者16例，U波异常者8例，其诊断缺血性心脏病的灵敏度分别为42．11％、21．11％(16/38、8/38)；运动试验阳性者26例，运动诱发U波异常者15例，其诊断缺血性心脏病的灵敏度分别为68．42％、39．47％(26/38、15／38)。冠脉造影阴性者(n＝14)中，常规心电图ST段无缺血性改变6例，U波正常13例，特异度分别为42．86％、92．86％(6／14、13／14)5运动负荷时，结果 阴性9例，U波正常14例，特异度分别为64．29％、100％(9／14、14／14)。运动负荷时尚见2例单独U波异常，其冠脉造影证实有病理性狭窄。结论 U波异常在诊断缺血性心脏病中敏感性虽不如ST段下移的高，但U波异常的特异性高，尤其是运动诱发的U波异常更具诊断价值；缺血性U波异常有助诊断冠心病。     

Noninvasive evaluation of cardiac function in patients with ischemic heart disease by the subclavian arterial blood flow response to exercise.

To evaluate cardiac function, the regional blood flow of the subclavian artery as a parameter of cardiac output was measured instead of measuring cardiac output itself in 12 normal subjects and 17 patients with ischemic heart disease. The measurement of the subclavian arterial blood flow was continuously and noninvasively made utilizing the Doppler ultrasonic flowmeter before, during and after exercise. The exercise was performed in the upright position on a bicycle ergometer for 3 minutes at the work load of 230 Kpm/min. Delta F Ratio, that is, the ratio of the increased blood flow during the exercise to the increased blood flow during the first 3 minutes after the termination of the exercise, was calculated in all subjects. Delta F Ratio as well as the response pattern of the blood flow to exercise was investigated. In patients with ischemic heart disease, the increase in the subclavian arterial blood flow during the exercise was slow, and the time required to return to the pre-exercise level was remarkably prolonged in comparison with normal subjects. The mean delta F Ratio of the younger normal group was 7.43, and that of the older normal group was 5.53. While in patients with ischemic heart disease, markedly lower values were observed. The mean delta F Ratio of the following subgroups of patients with ischemic heart disease, the myocardial infarction group, the angina pectoris group, and the group of ischemic heart disease without pain, were 1.25, 1.97, and 2.52 respectively. The difference in the mean delta F Ratio between the older normal group and each subgroup of ischemic heart disease was statistically significant. Low delta F Ratio in patients with ischemic heart disease is supposed to be the manifestation of diminished cardiac reserve due to decreased myocardial contractility. As a simple parameter of cardiac output, the continuous measurement of the subclavian arterial blood flow by the Doppler flowmeter is a useful method for the noninvasive evaluation of cardiac function. Especially, the calculation of delta F Ratio may provide the numerical presentation of cardiac function.     

Ischemic heart disease in a group of men 35 to 44 engaged in stressful mental work (data from the 1st examination)]

A group of 514 males between the ages of 35 and 44, whose occupation involved strained mental work, were examined. Ischemic heart disease was diagnosed in 56 of them (10.7%); 191 formed a group with doubtful signs of ischemic heart disease, and 267 composed a group of practically healthy persons. Hypertensive disease was revealed in 18.4% and hyperlipoproteinemia in 20% of persons examined. There was a statistically significant difference between the group of healthy individuals and that of patients with ischemic heart disease in the frequency of hypertensive disease and hyperlipoproteinemia. Smoking, adiposity, low physical activity, and aggravated heredity were encountered at a practically equal rate in both groups. In half of the patients with ischemic heart disease hypertensive disease and hyperlipoproteinemia were not found, while other risk factors of ischemic heart disease were encountered no more frequently than in the group of healthy persons. Thus, just like most other epidemiologic studies, our investigation showed hypertensive disease and hyperlipoproteinemia to be of highest significance as ischemic heart disease risk factor.     

Hormone profile of the essential hypertension patient with ischemic cardiopathy. I. Renin, angiotensin and aldosterone

To evaluate the characteristics that the renin and aldosterone profile could present in essential hypertensive patients complicated with ischemic heart disease, and as a contribution to the knowledge of the roll that these hormones could have as possible "risk factors" of coronary heart disease, sixty male patients were studied. These were divided in three groups: group I, formed by 15 essential hypertensive patients with objectively demonstrated ischemic heart disease; group II integrated by 15 essential hypertensives with no ischemic heart disease and group III with 30 normal volunteers. Serum levels of plasma renin activity (PRA) and aldosterone determined by radioimmunoassay, and of urinary sodium excretion were measured in all the patients. The distribution of cases with high, normal and low renin and aldosterone were similar in group I and in group II. It was interesting to find that the four patients of group I who were non-smokers, presented the lower renin levels (from 0.36 to 2.8 ng/ml/h). The relation between PRA and the number of occluded coronary arteries revealed an increased number of patients and affected arteries in the subgroup with renin levels above 5 ng/ml/h in comparison with the subgroup with PRA from 0 to 5, although the difference was not statistically significant. By our study, we cannot conclude that the PRA and aldosterone behave in a different fashion in essential hypertensives from those complicated with ischemic heart disease.