红花黄色素治疗心血瘀阻型冠心病心绞痛随机平行对照研究

[目的]观察红花黄色素治疗心血瘀阻型冠心病心绞痛疗效。[方法]使用随机平行对照方法,将92例住院患者按随机数字表分为两组。对照组46例硝酸酯类、抗血小板聚集、调节血脂抗凝、控制高血压及高血糖,B受体阻滞剂。治疗组46例红花黄色素20mL＋生理盐水250mL,1次／d,静滴。连续治疗14d为1疗程。观测临床症状、心绞痛发作次数、心电图、不良反应。治疗1疗程,判定疗效。[结果]治疗组显效32例,有效12例,无效2例,总有效率95．60％。对照组显效28例,有效9例,无效9例,总有效率80．40％。治疗组疗效优于对照组（P〈0．05）。心电图疗效治疗组改善优于对照组（P〈0．05）。[结论]红花黄色素治疗心血瘀阻型冠心痛心绞痛,疗效满意,无副作用,值得推广。     

复方龙血竭胶囊治疗稳定型心绞痛随机对照多中心临床研究

目的评价复方龙血竭胶囊治疗稳定型心绞痛（心血瘀阻证）的有效性和安全性。方法采用随机、双盲、阳性药平行对照、多中心临床研究，418例病例中，试验组（314例）给予口服复方龙血竭胶囊，对照组（104例）给予口服复方丹参胶囊，疗程均为28d。结果试验组心绞痛疗效和心电图疗效明显优于对照组（P〈0．05）；而中医证候疗效、硝酸甘油停减率比较，2组差异无统计学意义（P〉0．05）。试验组没有出现严重不良事件。结论复方龙血竭胶囊在治疗稳定型心绞痛（心脉瘀阻证）方面是有效和安全的。     

七龙脉通胶囊治疗冠心病心绞痛(心血瘀阻证)临床观察

[目的]观察七龙脉通胶囊治疗冠心病心绞痛心血瘀阻型的安全性与有效性。[方法]采用区组随机、双盲双模拟、阳性药平行对照、多中心研究的方法,共纳入病例230例,其中试验组115例口服七龙脉通胶囊,对照组115例,口服地奥心血康,疗程为28d,观察用药前后心绞痛疗效、中医证候、硝酸甘油停减率以及心电图改善等情况。[结果]疾病综合疗效:试验组总有效率为50.00%;对照组总有效率为46.00%。心绞痛总疗效:试验组总有效率为82.08%;对照组总有效率为73.00%。中医证候疗效:试验组临床愈显率为44.34%;对照组临床愈显率为34.00%。心电图疗效:试验组总有效率为56.19%;对照组总有效率为55.56%。在疾病综合疗效、心绞痛疗效、中医证候疗效、心电图疗效等方面两组间比较差异无统计意义(P>0.05)。[结论]七龙脉通胶囊与地奥心血康在冠心病心绞痛(气虚血瘀证)的治疗方面均安全有效。     

心血瘀阻证心肌微环境基质金属蛋白酶-2,9表达的实验研究

目的：观察基质金属蛋白酶-2、9在心血瘀阻证心肌微环境的变化。方法：建立大鼠急性心梗心血瘀阻证模型,分为假手术组、健康对照组、心虚瘀阻证组,然后用ELISA方法观测其基质金属蛋白酶2,9的表达。结果：基质金属蛋白酶2血瘀阻证表达高于健康对照和假手术组（P〈0．05）,基质金属蛋白酶9三组间均有差异,其中心血瘀阻证组最高,其次为假手术组、健康对照组（P〈0．05）。结论：基质金属蛋白酶-2、9参与心血瘀阻证心肌微环境的变化,是中医证候本质的物质学基础。     

Apoptosis, myocardial fibrosis and angiotensin Ⅱ in the left ventricle of hyp ertensive rats treated with fosinopril or losartan

Objective To investigate the different effects of an angiotensin Ⅱ type 1 (AT(1)) receptor antagonist, losartan, and an angiotensin converting enzyme (ACE) inhibitor, fosinopril, on cardiomyocyte apoptosis, myocardial fibrosis, and angiotensin Ⅱ (AngⅡ) in the left ventricle of spontaneously hypertensive rats (SHRs). Methods SHRs of 16-week-old were randomly divided into 3 groups: SHR-L (treated with losartan, 30 mg·kg(-1)·d(-1)), SHR-F (treated with fosinopril, 10 mg·kg(-1)·d(-1)), and SHR-C (treated with placebo). Each group consisted of 10 rats. Five rats, randomly selected from each group, were killed at the 8th and 16th week after treatment. Cardiomyocyte apoptosis, collagen volume fraction (CVF), perivascular collagen area (PVCA) and AngⅡ concentrations of plasma and myocardium were examined. Results Compared with the controls at the 8th and 16th week, systolic blood pressures were similarly decreased in both treatment groups. Left ventricular weight and left ventricular mass indexes were significantly lower in both treatment groups. However, the latter parameter at the 16th week was reduced to a less extent in the fosinopril group than that in the losartan group. Compared with the controls, cardiomycyte apoptotic index was significantly reduced at the 8th week only in the fosinopril group, and at the 16th week in both treatment groups. The index of the fosinopril group was lower than that of the losartan group at the latter endpoint examined. Compared with the controls, the left ventricular collagen volume fraction and perivascular collagen area at the 8th and 16th weeks were significantly reduced in the SHRs treated with either fosinopril or losartan. However, the collagen volume fraction at the latter endpoint in the fosinopril group was lower than that in the losartan group. Compared with the controls at endpoints, plasma and myocardium Ang Ⅱ levels were significantly increased in the losartan group. However, plasma Ang Ⅱ concentrations were not altered, and myocardium AngⅡ concentrations at the 8th and 16th weeks were significantly reduced in the fosinopril group. Conclusions Both losartan and fosinopril could effectively inhibit cardiomyocyte apoptosis and myocardial fibrosis and reverse heart hypertrophy. Fosinopril may be more effective in these cardioprotective effects, suggesting that the effects of both drugs are related to the inhibition of myocardium renin-angiotension-aldsterone system.