Effects of xamoterol a new beta-adrenoceptor partial agonist,in patients with angina pectoris

Summary The effects of xamoterol on exercise capacity have been evaluated in 10 patients with angina pectoris and well-preserved left ventricular function. Compared to placebo a single 200 mg dose of xamoterol produced a slight but insignificant increase in exercise capacity. At maximum work load, ST-T segment depression was reduced (3 mm and 2.19 mm after placebo and xamoterol, respectively;p<0.05). The changes paralleled an insignificant reduction in maximal heart rate and pressure-rate product. At rest, xamoterol increased the heart rate from 80 to 86 beats/min. Thus, at rest, when sympathetic tone is low, xamoterol acts as a beta-receptor agonist but during exercise, when sympathetic tone is high, xamoterol acts as an antagonist and reduces myocardial ischaemia.     

冠心病危险因子的护理干预效果研究

目的对冠心病危险因子开展临床护理干预,并对其护理效果进行分析研究。方法选取冠心病患者100例,随机分为两组,对照组50例,观察组50例。对照组常规护理,观察组患者接受冠心病危险因子的护理干预治疗,以每组患者在护理过程中出现心绞痛、心力衰竭、心肌梗死、猝死的患者数及每组患者再入院率作为观察指标。结果观察组患者中1例患者出现心绞痛,1例患者出现心力衰竭,无患者出现心肌梗死和猝死,再入院率为6%;对照组患者中5例患者出现心绞痛,4例患者出现心力衰竭,2例患者出现心肌梗死,1例患者出现猝死,再入院率为24%。两组比较差异有统计学意义(P<0.05)。结论通过对冠心病患者采用危险因子的护理干预治疗,可以有效降低冠心病的心绞痛、心力衰竭、心肌梗死、猝死发生率,减轻社会与家庭的经济和劳动负担。     

体外反搏治疗冠心病不稳定型心绞痛的疗效分析

目的：观察并分析使用体外反搏（EECP）治疗冠心病不稳定型心绞痛（UAP）的临床疗效。方法UAP患者78例,随机分为实验组与对照组,对照组实施药物治疗,实验组在此基础上加用体外反搏治疗,对比观察两组患者临床效果及心绞痛发作情况。结果实验组治疗总有效率89.74%明显高于对照组71.79%,6 min步行实验结果优于对照组,心绞痛发作持续时间及硝酸甘油使用量少于对照组, P＜0.05,差异有统计学意义。结论对UAP患者实施体外反搏治疗,能够有效改善其临床症状,减少心绞痛发作次数、降低其持续时间,并减少硝酸甘油使用,具有理想的临床疗效,可以作为无创治疗方法而在临床上推广。     

复方雪莲胶囊联合玻璃酸钠治疗膝骨关节炎的临床研究

目的观察心通口服液治疗冠心病心绞痛患者的临床疗效。方法选取2019年10月-2020年10月内蒙古自治区人民医院治疗的78例冠心病心绞痛患者为研究对象,根据治疗方案将患者分为对照组和观察组,各39例。对照组患者均给予冠心病心绞痛二级预防治疗,观察组在对照组基础上口服心通口服液,10 mL/次,3次/d。两组均治疗4周。比较两组患者的临床疗效、心绞痛的发作次数和持续时间及服用硝酸异山梨酯片的剂量。结果治疗后,观察组总有效率为89.7%,显著高于对照组的69.2%（P<0.05）。治疗后,两组心绞痛发作次数、每次发作持续时间、含服硝酸异山梨酯片剂量均显著降低（P<0.05）;观察组心绞痛发作次数、每次发作持续时间、含服硝酸异山梨酯片剂量显著低于对照组（P<0.05）。结论心通口服液治疗冠心病心绞痛患者可提高治疗有效率,减少心绞痛发作次数、持续时间及硝酸异山梨酯含服剂量,效果优于单纯西药治疗,且相对安全,值得临床应用。     

整体护理干预在冠心病合并心绞痛患者中的应用效果

目的探讨整体护理干预在冠心病合并心绞痛患者中的应用效果。方法选取本院2013年4月-2014年6月收治的80例冠心病合并心绞痛患者作为研究对象,随机分为观察组与对照组,各40例。对照组给予常规护理,观察组在对照组的基础上,给予整体护理干预,比较两组的血压、心率、心绞痛发作次数等指标及护理满意度。结果观察组的血压、心率、心绞痛发作次数等指标显著优于对照组,差异有统计学意义（P〈0.05）。观察组的护理满意度为97.5%,显著高于对照组的75.0%,差异有统计学意义（P〈0.05）。结论整体护理干预在冠心病合并心绞痛患者中应用效果显著,可有效提高患者的护理满意度,减少疾病发作次数,值得临床推广应用。     

低剂量葛根素注射液治疗糖尿病并发冠心病心绞痛临床观察

目的：观察低剂量葛根素注射液治疗2型糖尿病并冠心病心绞痛的临床疗效。方法将58例确诊2型糖尿病并发冠心病心绞痛的患者随机分为治疗组30例和对照组28例。治疗组除常规治疗外,加用低剂量葛根素注射液静脉滴注,对照组给予常规用药。观察2组临床症状、心电图、血脂等指标,并选择部分条件较好的患者（治疗组13例,对照组10例）进行用药前后活动平板试验。结果在心绞痛症状缓解方面,治疗组总有效率高于对照组（P＜0．05）;在心电图缺血情况改善方面,治疗组的总有效率优于对照组（P＜0．05）;治疗后2组总胆固醇（TC）、三酰甘油（ TG）、低密度脂蛋白胆固醇（ LDL－C）均低于治疗前,高密度脂蛋白胆固醇（ HDL－C）均高于治疗前,差异均有统计学意义（ P＜0．05）;治疗组活动平板试验各项指标改善程度较对照组显著（ P＜0．05）。结论低剂量葛根素注射液治疗2型糖尿病并发冠心病心绞痛安全可靠,疗效确切。     

葛根素注射液治疗冠心病心绞痛152例临床观察

目的研究葛根素注射液治疗冠心病心绞痛的临床效果。方法对2010年10月～2012年4月本院入院治疗的304例冠心病心绞痛患者进行了研究,随机分为两组,对照组给予常规西药治疗,治疗组在常规西药治疗基础上,给予葛根素注射液,治疗结束后评价两组患者的心绞痛疗效及心电图疗效。结果经过治疗,治疗组患者的心绞痛总有效率为92.1%,明显高于对照组的76.3%,差异有统计学意义（P〈0.05）;治疗组患者心电图总有效率为94.7%,明显高于对照组的71.7%,差异有统计学意义（P〈0.05）。结论葛根素注射液治疗冠心病心绞痛临床效果显著,改善患者症状更明显,值得推广应用。     

归脾汤加减在冠心病心绞痛患者中的应用价值研究

目的探讨归脾汤加减在冠心病心绞痛患者中的应用价值。方法选取2009年12月～2012年2月于笔者所在医院进行治疗的66例冠心病心绞痛患者为研究对象,将其随机分为对照组(常规西药组)和观察组(归脾汤加减组)各33例,将两组患者的心绞痛及心电图治疗总有效率、显效时间及治疗前后的心功能检测指标进行比较。结果观察组的心绞痛及心电图治疗总有效率高于对照组,显效时间短于对照组,治疗后心功能指标优于对照组,差异均有统计学意义(P<0.05)。结论归脾汤加减在冠心病心绞痛患者中的应用价值较高,可有效改善患者的心功能指标。     

活血宣痹汤治疗冠心病心绞痛的临床体会

目的：探讨冠状动脉粥样硬化性心脏病（冠心病）心绞痛采用活血宣痹汤治疗的临床疗效。方法选取84例接受治疗的冠心病心绞痛患者作为本次的观察对象,以治疗方式的不同将患者分为观察组和对照组,每组42例,两组患者均行常规西药治疗,观察组患者则在此基础上加行活血宣痹汤治疗,比较两组患者的治疗总有效率。结果观察组患者的治疗总有效率为90.5%,对照组患者的治疗总有效率为73.8%,两组患者比较差异有明显统计学意义（P＜0.05）。结论对于冠心病心绞痛患者,在常规西药治疗的基础上给予活血宣痹汤治疗可有效的提高治疗效果。     

Comparison of once and twice daily administration of acebutolol in hypertension.

1 Thirteen hypertensive patients completed a double-blind comparison of placebo, acebutolol 200 mg twice daily and acebutolol 400 mg once daily, administered for 4 weeks in random order. 2 Blood pressure and heart rate were significantly reduced by both acebutolol treatments. The mean reduction of resting pressure 12 h after 200 mg twice daily (12/7 mmHg) was similar to that 24 hr after 400 mg once daily (13/9 mmHg). 3 Compared to placebo, reductions in exercise heart rate and systolic pressure at 12 h after 200 mg twice daily and 24 h after 400 mg once daily were significant and similar. 4 Beta-adrenoceptor antagonism was also assessed by inhibition of the heart rate response to sublingual glyceryl trinitrate taken in the standing position. Both acebutolol treatments reduced the response; the reduction after twice daily treatment (mean 25 beats/min) was significantly greater than after once daily treatment (mean 19 beats/min). 5 There was no difference in blood pressure control between acebutolol administered once and twice daily in a total daily dose of 400 mg.     

高敏C-反应蛋白和胰岛素抵抗在冠心病患者血清中的变化

目的探讨高敏C-反应蛋白（hs-CRP）和胰岛素抵抗（IR）及与冠状动脉粥样化性心脏病（冠心病,CHD）患者冠状动脉病变的相关性。方法选择经冠状动脉造影证实的CHD患者共75例,其中稳定型心绞痛（SAP）26例,不稳定型心绞痛（UAP）30例,急性心肌梗死（AMI）19例,另选冠状动脉造影正常的30例作为对照组。结果CHD患者血浆hs-CRP水平和IR高于对照组（P〈0.05）;CHD患者中,AMI组和UAP组hs-CRP和胰岛素抵抗指数（IRI）高于SAP组（P〈0.05）;CHD患者Gensini积分与IRI、hs-CRP,IRI与hs-CRP均呈正相关（P〈0.01）。结论hs-CRP和IR可能与斑块的不稳定状态有关,两者相互影响、相互作用。     

注射用丹参多酚酸盐临床应用探讨

目的：研究探讨注射用丹参多酚酸盐对治疗心绞痛、脑梗化、冠心病等有临床作用。方法：通过注射用丹参多酚酸盐治疗心绞痛,治疗10～14d后,根据心绞痛发作次数和硝酸甘油用量的变化情况作为评价指标;在治疗脑梗化临床案例中,通过对比研究患者临床疗效的变化和舒张压和脑脊液对比变化作为评价指标;在治疗冠心病的临床试验中,通过疗效对比研究和硝酸甘油用量变化的临床数据分析研究做为评价指标。结果：在心绞痛治疗过程中,经过治疗10～14d后,大于75岁组心绞痛发作次数由治疗前的4.0次/周下降至治疗后1.0次/周,硝酸甘油的量也减半;在治疗脑梗化14d后,比较临床疗效、血压舒张压和脑脊液压力等指标的变化,评价结果为治疗组的总有效率为88.9%,对照组的总有效率为76.0%,治疗后两组的脑脊液和舒张压压力明显下降;在治疗冠心病临床治疗中,注射用丹参多酚酸盐可明显改善冠心病的临床症状、心电图,减少速效扩冠药物的用量。结论：注射用丹参多酚酸盐的治疗领域———主要治疗冠心病稳定型心绞痛,同时对脑血栓形成有预防作用,可治疗急性脑梗死,为医护人员提供一定的参考。     

Ineffectiveness of practolol induced beta-blockade in the treatment of angina pectoris

Summary A clinical trial of 7 months duration was carried out on 18 patients with angina pectoris. The study was divided in 4 stages: A 4-week single blind stage on placebo, a six-week single blind, dose finding stage divided in 3 periods of 2 weeks each during which the patients received daily doses of 400, 800 and 1,200 mg of practolol respectively. Physician evaluation based on anginal episodes counts, nitroglycerin consumption and exercise stress testing at the end of each dose period were used to select the optimal dose for each patient. Subsequently and after a 2-week single-blind stage on placebo (wash-out) the patients moved to a fourth stage where the optimal dose of practolol was tested against placebo using a double-blind double cross-over design consisting of 4 periods of 4 weeks each. The patients received practolol during two of these periods and placebo during the other two. No difference between practolol and placebo was seen in the frequency of anginal episodes, the nitroglycerin consumption, the blood pressure level and the exercise performance. A significant difference was observed in the resting heart rate and the exercise heart rate. Thus, although the doses used produced beta-blockade they did not lead to objectively demonstrable antianginal effects.     

氯吡格雷在治疗冠心病不稳定型心绞痛的临床分析

目的研究氯吡格雷治疗冠心病不稳定型心绞痛的临床疗效。方法 120例疗病毒性心肌炎患者分为Ⅰ、Ⅱ,Ⅰ组60人,采用氯吡格雷和阿司匹林联合治疗;Ⅱ组为60人,作为对照,单用阿司匹林治疗。结果经治疗后,Ⅰ组、Ⅱ组两组治疗方法都有着一定的功效,与治疗前相比,都有着一定的改善,两组相比较来看,Ⅰ组的治疗疗效明显优于对照组Ⅱ组(P<0.05)。结论氯吡格雷治疗冠心病不稳定型心绞痛有着较好的医疗效果,值得在临床上推广研究。     

参芎葡萄糖注射液联合西药治疗冠心病心绞痛的临床效果观察

目的观察参芎葡萄糖注射液联合西药治疗冠心病心绞痛的临床效果。方法选取232例冠心病心绞痛患者随机分为观察组与对照组。两组均给予常规治疗,观察组在此基础上联合参芎葡萄糖注射液治疗。比较两组患者的临床效果、心电图结果及血液流变学指标。结果观察组总有效率为95．7％,对照组总有效率为71．6％,差异有统计学意义（P〈0．05）。观察组心电图总有效率为85．3％,对照组心电图总有效率为60．3％,差异有统计学意义（P〈0．05）。两组患者治疗后的血细胞比容、全血黏度、血浆比黏度、红细胞聚集指数、血浆纤维蛋白原较治疗前明显降低,差异有统计学意义（P〈0．05）。治疗后观察组的血细胞比容、血浆比黏度、红细胞聚集指数、血浆纤维蛋白原较对照组明显降低,差异有统计学意义（P〈0．05）。结论参芎葡萄糖注射液联合西药治疗冠心病心绞痛效果显著．且安全可靠。     

EFFECTS OF ADENOSINE ANTAGONISM AND β-BLOCKADE DURING LOW-FLOW ISCHAEMIA IN RAT HEART

1. The effects of adenosine antagonism (8-phenyltheophylline) and beta-blockade (1-propranolol) were examined during low-flow ischaemia (0.5 mL/min per g for 20 min) in rat heart. 2. Myocardial adenosine release, heart rate, and left ventricular developed pressure were monitored to determine whether endogenous adenosine affected ischaemic function directly, and/or via interaction with endogenous catecholamines. 3. Adenosine release increased more than 10-fold during low-flow ischaemia. Release displayed a phasic pattern, with maximal release occurring at 10 min. Ischaemia produced bradycardia (-180 beats/min) which was reduced by 8-phenyltheophylline infusion (P less than 0.001, n = 10). Adenosine antagonism also significantly increased left ventricular developed pressure in the initial 5 min of ischaemia (P less than 0.001, n = 10). 4. beta-blockade alone was without effect in ischaemic hearts, however, beta-blockade significantly reduced the initial increases in heart rate and developed pressure observed during infusion of 8-phenyltheophylline (P less than 0.001, n = 10). The effect of beta-blockade was transient, occurring in the initial 5-6 min of ischaemia. 5. The data indicate that endogenous adenosine directly mediates greater than 30% of the bradycardia associated with low-flow ischaemia, and that endogenous adenosine inhibits the release and/or the effects of endogenous catecholamines produced during the initial 5-6 min of ischaemia.     

左卡尼汀与麝香保心丸联合治疗冠心病不稳定性心绞痛临床效果观察

目的：探讨左卡尼汀与麝香保心丸联合治疗冠心病不稳定性心绞痛临床效果。方法：回顾性分析30例于我院就诊的冠心病不稳定性心绞痛患者的临床资料。结果：观察组动态心电图ST-T段的改善情况与临床疗效总有效率明显优于对照组,而其并发症发生率明显低于对照组,差异均具有统计学意义（P＜0.05）。结论：在常规治疗的基础上,给予冠心病不稳定性心绞痛左卡尼汀与麝香保心丸联合治疗,取得了确切的临床效果,值得在临床上推广。     

Experience with a sustained-release formulation of oxprenolol in the management of angina pectoris in hospital out-patient departments.

One hundred and two patients with angina pectoris under treatment with beta-receptor antagonists prescribed on a multi-dose basis were openly switched to treatment with once-daily sustained-release oxprenolol (160 mg per tablet). Eighty-eight patients were successfully managed on once-daily oxprenolol and 70% achieved significant benefit with a single morning dose of 160 mg. The mean number of anginal attacks and the mean glyceryl trinitrate consumption were both significantly reduced. It is concluded that once-daily treatment with oxprenolol in sustained-release form offers the advantage of reduced tablet ingestion without symptomatic detriment in the management of angina pectoris.     

Therapeutic effects of I(f) blockade: evidence and perspective.

Heart rate slowing has been accepted for decades as a primary therapeutic approach to prevention (and even to treatment) of angina pectoris. Pure heart rate slowing has not been achieved with previously available rate-slowing pharmacological agents (beta adrenergic blockers, certain calcium channel blockers), all of which have other pharmacological effects that may be beneficial but also may underlie adverse drug effects. Modulation of heart rate is a function of variation in the I(f) current, a sodium-potassium mediated membrane phenomenon that is active physiologically only in the heart's sinoatrial node. Though the current first was described more than 25 years ago, a practical pharmacological method for its inhibition only recently has been developed, tested and approved for use in Europe. The effective drug, ivabradine, has demonstrated anti-anginal, anti-ischemic efficacy and now is being tested for its effect on survival in patients with coronary artery disease and impaired left ventricular function, as well as for heart failure. The data supporting the use of the drug for angina prevention, and the potential for additional applications, are reviewed in this article.