心达康滴丸联合辛伐他汀治疗冠心病心绞痛的临床研究

目的探讨心达康滴丸联合辛伐他汀治疗冠心病心绞痛的临床效果。方法选取2016年10月—2018年10月韶关市铁路医院收治的112例冠心病心绞痛患者,随机分为对照组和治疗组,每组各56例。对照组口服辛伐他汀片,1片/次,1次/d。治疗组在对照组治疗基础上口服心达康滴丸,18粒/次,3次/d。两组均连续治疗8周。观察两组的临床疗效,比较两组治疗前后心绞痛发作情况、血脂水平、血流变学指标、超声心动图指标和血清学指标的变化情况。结果治疗后,对照组和治疗组的心电图总有效率分别是82.1%、94.6%,两组疾病疗效总有效率分别是76.8%、91.1%,两组比较差异均具有统计学意义(P0.05)。治疗后,两组心绞痛发作次数、VAS评分、持续时间及硝酸甘油用量较治疗前均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组心绞痛发作情况优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平均显著降低,而高密度脂蛋白胆固醇(HDL-C)水平均显著增高,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组TC、TG、LDL-C低于对照组,而HDL-C高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血浆黏度(PV)、红细胞比容(HCT)、沉降(ESR)、聚集指数(RCAI)较治疗前均显著下降,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组PV、HCT、ESR、RCAI值显著低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组左室射血分数(LVEF)值较治疗前均显著提高,而左室舒张及收缩末期内径(LVEDd和LVESd)值均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组LVEF值高于对照组,而LVEDd、LVESd值低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血清内皮素(ET)、基质金属蛋白酶(MMP)-9、C反应蛋白(CRP)水平较治疗前均显著降低,一氧化氮(NO)水平显著升高,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组ET、MMP-9、CRP水平低于对照组,而NO水平高于对照组,两组比较差异具有统计学意义(P0.05)。结论心达康滴丸联合辛伐他汀治疗冠心病心绞痛具有较好的临床疗效,能有效控制心绞痛发作,正性调节血脂和血管内皮功能,改善血流变学及微炎症状态,具有一定的临床推广应用价值。

Clinical study on Xindakang Dropping Pills combined with simvastatin in treatment of angina pectoris of coronary heart disease

Objective To investigate the clinical effect of Xindakang Dropping Pills combined with simvastatin in treatment of angina pectoris of coronary heart disease. Methods Patients (112 cases) with angina pectoris of coronary heart disease in Shaoguan Railway Hospital from October 2016 to October 2018 were divided into control (56 cases) and treatment (56 cases) groups. Patients in the control group were po administered with Simvastatin Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Xindakang Dropping Pills on the basis of the control group, 18 grains/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, and the changes of angina attack, lipid levels, hemorheology indicators, echocardiography indicators and serology indicators in two groups before and after treatment were compared. Results After treatment, the electrocardiogram efficacy in the control and treatment groups were 82.1% and 94.6%, respectively, and the disease efficacy in the control and treatment groups were 76.8% and 91.1%, respectively, and there were differences between two groups (P < 0.05). After treatment, angina pectoris frequency, VAS score, angina duration and nitroglycerin dosage in two groups were significantly decreased, and there were differences in the same group (P < 0.05). After treatment, angina pectoris attacks in the treatment group were better than those in the control group, and there were differences between two groups (P < 0.05). After treatment, TC, TG, LDL-C in two groups was significantly decreased, but HDL-C was significantly increased, and there were differences in the same group (P < 0.05). After treatment, TC, TG, LDL-C in the treatment group was lower than those in the control group, but HDL-C was higher than that in the control group, and there were differences between two groups (P < 0.05). After treatment, PV, HCT, ESR, RCAI in two groups was significantly decreased, and there were differences in the same group (P < 0.05). After treatment, PV, HCT, ESR, RCAI in the treatment group was lower than those in the control group, and there were differences between two groups (P < 0.05). After treatment, LVEF in two groups was significantly increased, but LVEDd and LVESd was significantly decreased, and there were differences in the same group (P < 0.05). After treatment, LVEF in the treatment group was higher than those in the control group, but LVEDd and LVESd were lower than those in the control group, and there were differences between two groups (P < 0.05). After treatment, ET, MMP-9, CRP in two groups was significantly decreased, but NO was significantly increased, and there were differences in the same group (P < 0.05). After treatment, ET, MMP-9, CRP in the treatment group was lower than those in the control group, but NO was higher than that in the control group, and there were differences between two groups (P < 0.05). Conclusion Xindakang Dropping Pills combined with simvastatin has significant effect in treatment of angina pectoris of coronary heart disease, and can effectively control angina pectoris attack, positively regulate blood lipid and vascular endothelial function, and improve hemorheology and microinflammation, which has a certain clinical application value.