脑心通胶囊治疗冠心病心绞痛的临床观察

目的 对脑心通胶囊治疗冠心病心绞痛进行临床疗效观察.方法 通过随机对照试验,对40例冠心病心绞痛患者进行治疗观察.治疗组口服脑心通胶囊,每次3粒,每日3次;同时口服单硝酸异山梨酯(欣康)缓释片40 mg,每日1次.对照组仅口服单硝酸异山梨酯(欣康)缓释片40mg,每日1次.疗程均为4周.结果 治疗组心绞痛症状的总有效率90%优于对照组的65%(P<0.05);治疗组中医证候总有效率95%也优于对照组的7O%(P<0.01).治疗组和对照组对心电图缺血性ST-T改变有较明显改善作用,但两组间比较无统计学意义(P>0.05);治疗组对血液流变学指标的改善作用优于对照组(P<0.05).结论 脑心通胶囊对冠心病心绞痛有较显著的疗效.     

倍他乐克与单硝酸异山梨醇酯治疗冠心病心绞痛50例

目的观察倍他乐克与单硝酸异山梨醇酯治疗冠心病心绞痛的疗效。方法治疗组在常规抗凝及调脂治疗基础上加用倍他乐克，初始剂量为6．25mg，每日2次，口服，如无明显副作用，每周加1倍量至50mg，每日2次，口服，加单硝酸异山梨醇酯片30～60mg，每日1次，口服，观察1-4周。对照组在常规抗凝调脂治疗的基础上单用单硝酸异山梨醇酯治疗，观察1～4周。结果治疗组治疗后患者心率平均下降77％，心绞痛缓解，心电图示心肌缺血改善，其中显效率78％，有效率14％，无效率8％，总有效率92％。对照组心率下降70％，其中显效率60％，有效率13．3％，无效率26．6％，总有效率73．3％。结论倍他乐克和单硝酸异山梨醇酯治疗冠心病心绞痛有效，可以缓解心绞痛发作，使心率减慢，改善心肌缺血。     

硝苯地平缓释片对老年冠心病心绞痛的疗效观察

目的　比较硝苯地平缓释片与 5-单硝酸异山梨酯对老年冠心病心绞痛的疗效。方法　 62例老年冠心病心绞痛患者停用抗心绞痛药物 1 w,随机分组 ,治疗组服用硝苯地平缓释片 ,对照组服用 5-单硝酸异山梨酯共 4 w。在疗程开始和结束后 2 4 h检查 2 4 h动态心电图并考察指标。结果　硝苯地平缓释片 (40 mg,每日一次 )与 5-单硝酸异山梨酯 (2 0 mg,每日 2次 )均能减少心绞痛发作次数及硝酸甘油消耗量 ,分别在末次服药 (疗程结束 )后 2 4 h仍然存在抗心肌缺血效应 ,但治疗组疗效高于对照组 (P<0 .0 5)。结论　硝苯地平缓释片与 5-单硝酸异山梨酯均能改善老年冠心病心绞痛患者的症状和心电图的缺血改变 ,硝苯地平缓释片有效作用可持续 2 4 h以上     

养心氏片联合单硝酸异山梨酯缓释片治疗冠心病心绞痛的疗效观察

目的观察养心氏片联合单硝酸异山梨酯缓释片治疗冠心病心绞痛的临床疗效。方法采用随机对照法分为治疗组(52例)与对照组(51例),对照组给予常规治疗,治疗组在常规治疗基础上加服养心氏片(每次3片,每日3次),治疗4周后比较两组病人临床症状和心电图疗效。结果治疗组心绞痛症状有效率为82.70%,对照组为56.87%,两组比较差异有统计学意义(P0.05);治疗组心电图有效率为78.85%,对照组为47.05%,两组比较差异有统计学意义(P0.05)。结论养心氏片联合单硝酸异山梨酯缓释片治疗冠心病心绞痛疗效确切。     

长效5-单硝酸异山梨酯对稳定型心绞痛的疗效观察

目的比较5-单硝酸异山梨酯缓释片与硝酸异山梨酯对稳定型心绞痛的疗效.方法49例稳定型的心绞痛患者停用抗心绞痛药物1周,随机分组,A组服用5-单硝酸异山梨酯缓释片,B组服用硝酸异山梨酯共4周,以平板运动负符心电图作为考察指标.结果5-单硝酸异山梨酯缓释片60mg每日一次与硝酸异山梨酯均能减少心绞痛发作,提高运动能力,但A组疗效明显高于B组(P＜0.05).结论长效5-单硝酸异山梨酯是治疗冠心病心绞痛安全有效的药物之一.     

长效5—单硝酸异山梨酯对稳定型心绞痛的疗效观察

目的：比较5－单硝酸异山梨酯缓释片与硝酸异山梨酯对稳定型心绞痛效。方法：49例稳定型的心绞痛患者停用抗心绞痛药物1周,随机分组,A组服用5－单硝酸异山梨酯缓释片,B组服用硝酸异山梨酯共4周,以平板运动负符心电图作为考察指标。结果：5－单硝酸异山梨酯缓释片60mg每日一次与硝酸异山梨酯均能减少心绞痛发作,提高运动能力,但A组疗效明显高于B组（P＜0．05）。结论：长效5－单硝酸异山梨酯是治疗冠心病心绞痛安全有效的药物之一。     

晚间加服硝酸异山梨酯片联合倍他乐克片治疗不稳定型心绞痛疗效观察

目的分析研究晚间加服硝酸异山梨酯片联合倍他乐克片治疗不稳定型心绞痛的疗效。方法观察病例120例,随机分为两组,每组60例。治疗组每天白天口服单硝酸异山梨酯胶囊40mg,每晚睡前口服硝酸异山梨酯缓释片10mg加倍他乐克片12.5mg,,每天1次,疗程40天;对照组每白天口服单硝酸异山梨酯胶囊40mg,每天1次,疗程40天。结果治疗组总有效率为93.3%,对照组为76.7%,两组相比差异有显著性(P0.05)。结论晚间加服硝酸异山梨酯片联合倍他乐克片治疗不稳定型心绞痛夜间心绞痛可减轻临床症状,减少夜间发作次数。     

单硝酸异山梨酯缓释片联合琥珀酸美托洛尔缓释片预防心绞痛再发作的临床研究

目的观察单硝酸异山梨酯缓释片联合琥珀酸美托洛尔缓释片预防心绞痛再发作的疗效,并探讨其作用机制。方法将52例心绞痛患者随机分为两组,治疗组26例患者口服单硝酸异山梨酯缓释片联合琥珀酸美托洛尔缓释片,对照组26例患者口服单硝酸异山梨酯缓释片,服药4周,观察其临床预防效果。结果治疗组临床总有效率为92.31%,对照组总有效率为65.39%,治疗组高于对照组(P0.05)。两组服药2、3、4 W后心绞痛发作次数和发作持续时间均较治疗前显著减少和缩短(P均0.01),但治疗后1 W与治疗前比较差异无统计学意义(P0.05)。心电图总有效率治疗组与对照组比较差异无统计学意义(P0.05)。两组均未出现严重不良反应。结论单硝酸异山梨酯缓释片联合琥珀酸美托洛尔缓释片能安全、有效预防心绞痛再发作,且疗效优于单纯用单硝酸异山梨酯缓释片。     

红花逍遥片治疗不稳定型心绞痛患者的临床疗效观察

目的观察红花逍遥片治疗不稳定型心绞痛患者的临床疗效。方法选择冠心病不稳定型心绞痛患者60例,随机分为两组,治疗组口服红花逍遥片加单硝酸异山梨酯,对照组给予口服单硝酸异山梨酯,同时两者都给予阿司匹林肠溶片及他汀类药物常规治疗。观察两组临床疗效。结果治疗组与对照组相比较,治疗组明显优于对照组,有显著差异性。结论红花逍遥片用于冠心病不稳定型心绞痛患者的治疗,可明显提高疗效,减少冠心病不稳定型心绞痛的发作次数,降低冠心病不稳定型心绞痛的恶化率,且无毒副作用。     

心可舒片治疗老年稳定型心绞痛临床观察

目的 观察心可舒片对老年稳定型心绞痛患者的疗效及其安全性.方法 83例老年稳定型心绞痛患者随机分为两组,观察组42例予心可舒片,每次4片,每日3次口服;对照组41例予单硝酸异山梨酯片,每次10 mg, 每日3次口服,疗程3个月.结果 两组治疗后都能有效地缓解患者心绞痛症状、减少心肌缺血发作次数和硝酸甘油用量,观察组疗效优于对照组(P<0.05),且无明显副反应, 经治疗后心电图改变判断心肌缺血情况,两组得到明显改善,观察组有效率为73.81%,对照组为60.98%(P>0.05).结论 心可舒片是治疗老年稳定型心绞痛较为理想的药物之一.     

尼可地尔治疗稳定型心绞痛有效性和安全性的临床研究

目的：探讨尼可地尔治疗冠心病稳定型心绞痛（SAP）的疗效和安全性。方法：收集我院2010年4月至2012年4月门诊及住院的60例SAP患者,随机分为尼可地尔组（28例,口服：尼可地尔5mg,3次/d）,单硝酸异山梨酯组（32例,口服：单硝酸异山梨酯缓释片30mg/d）,两组均同时服用美托洛尔25mg,2次/d、阿托伐他汀20mg,1次/d、阿司匹林100mg,1次/d。4周治疗后分别观察两组心绞痛、心电图、运动耐量和不良事件情况。结果：与单硝酸异山梨酯组比较,尼可地尔组治疗心绞痛有效率（71.9%比96.4%）、改善运动耐量率（68.8%比92.9%）均显著提高（P均〈0.05）;尼可地尔组轻微头痛（25%比10.7%）显著减少（P〈0.05）。结论：尼可地尔能在不增加患者不良事件的基础上,明显提高对稳定型心绞痛患者的疗效。     

Selection of therapy with nitrates in patients with stable effort angina: results of comparative study of common isosorbide dinitrate and long acting preparation of isosorbide-5-mononitrate

AIM: To assess efficacy and tolerability of a novel drug form of isosorbide-5-mononitrate in patients with ischemic heart disease and stable effort angina as compared with common isosorbide dinitrate pills. MATERIAL AND METHODS: Patients with stable class II-III effort angina (n=30) were included into a randomized crossover study in which they received isosorbide dinitrate (nitrosorbide, 10-20 mg t.i.d.) and long acting isosorbide-5-mononitrate (ephox-long, 50-100 mg o.d.) for 3 weeks each. Efficacy of treatment was assessed by clinical data and treadmill exercise tests. Questionnaires were used for registration of frequency and intensity of attacks of headache. RESULTS: The use of both isosorbide dinitrate and 5-mononitrate was associated with significant improvements of exercise tolerance however effect of mononitrate lasted longer. Nitroglycerine requirement diminished during first week of use of both drugs and remained on this level by the end of 3-rd week of treatment with mononitrate but substantially rose by the end of treatment with dinitrate. Number of attacks of headache increased during first week of treatment with both drugs, became even higher by the end of use of dinitrate and decreased by the end of use of mononitrate. CONCLUSION: Long acting form of isosorbide-5-mononitrate ephox-long taken once daily provides sufficient antianginal effect throughout a day and is better tolerated than nitrosorbide preparation of isosorbide dinitrate with moderately prolonged activity.     

单硝酸异山梨酯缓释胶囊治疗心绞痛的疗效分析

目的：探讨单硝酸异山梨酯缓释胶囊治疗心绞痛的疗效。方法选取2012年10月至2013年6月我院收治的100例心绞痛患者,将其随机分成两组,每组50例,观察组采用单硝酸异山梨酯缓释胶囊配合心绞痛常规治疗,对照组采用心绞痛常规治疗,观察两组的治疗效果。结果经治疗,观察组的心电图改善情况明显优于对照组（94.0％ vs 70.0％）,临床疗效也明显高于对照组（96.0％ vs 78.0％）,P〈0.05,具有统计学意义。结论单硝酸异山梨酯缓释胶囊治疗心绞痛的疗效显著,相对安全,有助于缓解心绞痛患者的症状,值得临床推广应用。     

A double-blind, parallel-group study of amlodipine versus long-acting nitrate in the management of elderly patients with stable angina.

Ninety-seven elderly patients with stable angina were included in a 28-week, randomized, double-blind, parallel-group comparison of amlodipine 5-10 mg and isosorbide mononitrate 25-50 mg once daily. The total exercise time, as limited by angina, was recorded together with the median incidence per week of angina attacks and glyceryl trinitrate consumption. Safety was assessed by adverse event frequency, measurement of vital signs and laboratory parameters, and quality of life. At the final visit, the total exercise time was significantly greater relative to baseline with amlodipine than isosorbide mononitrate (final/baseline difference: 112.2 vs. 32.2, p = 0.016). There were no statistically significant differences between the groups in relation to the incidence of adverse events. Once daily amlodipine provides significantly better control of stable angina than isosorbide mononitrate in this elderly population.     

硝苯地平控释片与5-单硝异山梨醇酯对稳定性心绞痛疗效的比较

目的　比较硝苯地平控释片与 5 单硝异山梨醇酯对稳定性心绞痛的疗效。方法　 5 3例稳定性心绞痛患者停用抗心绞痛药物 1周 ,然后经 2～ 3周的单盲安慰剂治疗后 ,进入为期 6周的单盲随机对照试验 ,以平板运动负荷心电图为考察指标。结果　经过 6周的治疗后 ,硝苯地平控释片( 3 0mg ,每日 1次 )与 5 单硝异山梨醇酯 ( 2 0mg ,每日 2次 )均能显著减少心绞痛发作次数 (分别下降87%和 5 1% ,P <0 0 5 )及硝酸甘油消耗量 (分别下降 91%和 5 4 % ,P <0 0 5 ) ;提高运动能力 ,延长运动时间 (分别延长 114秒和 2 5秒 ,P <0 0 1) ,且对运动能力的改善作用分别在末次服药 (疗程结束 )后 2 4小时和 12小时仍然存在。结论　硝苯地平控释片和 5 单硝异山梨醇酯均能有效改善稳定性心绞痛患者的临床症状 ,心电图及运动能力 ,其有效作用分别持续 2 4和 12小时。     

Sustained-release isosorbide mononitrate (50 mg): optimization of a once-daily dosage form for long-term treatment of angina pectoris

A capsule formulation containing 50 mg of isosorbide mononitrate has been developed, 30% of which is in a nonsustained-release form to ensure rapid attainment of initial plasma levels. The remaining 70% is in a sustained-release form that ensures a long-lasting effect and the convenience of once-daily dosing. This formulation of sustained-release isosorbide mononitrate (Elantan LA 50 mg) provides plasma levels greater than 100 ng/ml for 17 hours after oral administration. For the remaining 7 hours, the nitrate plasma level ranges between 50 and 100 ng/ml.     

丹红注射液治疗130例不稳定型心绞痛的临床疗效分析

目的 观察丹红注射液治疗不稳定型心绞痛的临床疗效.方法 将长江医院和如皋市第四人民医院内科就诊的130例不稳定型心绞痛患者分为两组,常规治疗的对照组（65例）和丹红注射液治疗组（65例）.观察治疗前后两组患者心绞痛发作次数、单硝酸异山梨醇酯用量及心电图ST-T改变.结果 与常规对照组比较,丹红治疗组患者心绞痛症状得到明显改善,65例中显效40例、有效21例、无效4例,总有效率达93.8%;对照组65例中显效34例、有效9例、无效22例,总有效率66.2%,两组比较差异具有统计学意义（P＜0.01）.心电图结果显示,丹红注射液治疗组显效36例、有效19例、无效10例,总有效率84.6%;对照组显效18例、有效24例、无效23例,总有效率64.6%,两组相比差异具有统计学意义（P＜0.01）.结论 丹红注射液能显著降低患者心绞痛发作次数,常规心电图改善明显,治疗不稳定型心绞痛安全有效.     

Isosorbide mononitrate 30% immediate-release 70% sustained-release formulation: a review. DUMQOL (DUtch Mononitrate Quality of Life) Study Group

Since the first publication of isosorbide mononitrate 30% immediate-release 70% sustained-release (IR-SR) formulation in 1985, a considerable body of literature concerning its clinical efficacy and safety has become available. Theoretically, the formulation has the advantage over conventional isosorbide mononitrate or dinitrate (ISMN/ISDN) that it has a simpler and more predictable pharmacokinetic profile. The objectives of this paper are to review published data so far and to see whether the theoretical advantages translate into better clinical effectiveness. 1. After oral administration, isosorbide mononitrate IR-SR has a rapid onset of action (30 minutes), and effects are evident for up to 17 hours. 2. The antianginal effects of once-daily isosorbide mononitrate IR-SR increased with increasing dosages, were generally larger than those of either placebo or equipotent doses of conventional ISMN/ISDN, and were somewhat larger than those of the beta blocker bupranolol. The effects were generally similar to those of sustained release nifedipine. 3. Patients showed significantly greater improvement in some quality-of-life indices with once-daily isosorbide mononitrate IR-SR than with twice or three times daily regimens of conventional ISMN/ISDN. This was particularly so with mobility, psychological distress, and life satisfaction indices. 4. Tolerance did not develop after 13 months of once daily isosorbide dinitrate IR-SR. No rebound increase in incidence of ischemic episodes was observed after discontinuation of treatment. 5. Long-term efficacy data both of isosorbide mononitrate IR-SR and of conventional ISMN/ISDN are limited so far. Large studies in patients with angina pectoris and patients with heart failure addressing long-term effects are ongoing, and some of the data will be completed within the next months. Isosorbide mononitrate IR-SR has a rapid onset of action and has been shown to be clinically efficient and, in addition, to be more so than conventional ISMN / ISDN. Nitrate tolerance with continued use of the formulation has not yet been reported. Long-term effects on morbidity and mortality are currently being assessed.     

Comparison of 50-mg and 100-mg sustained-release isosorbide mononitrate in the treatment of stable angina pectoris: effects on quality-of-life indices. Dutch Mononitrate Quality of Life (DUMQOL) Study Group

High-dosage nitrates are more effective for the management of anginal symptoms but produce more adverse effects, including development of tolerance and the zero-hour effect (rebound angina at the end of the dosing interval). Such effects may reduce the beneficial effect of treatment on quality of life. In a self-controlled, 6-month study, the effects on symptoms and quality of life of 50 mg and 100 mg sustained-release isosorbide mononitrate (SR ISMN), administered once daily, on anginal symptoms and quality of life (QOL) were assessed in 453 patients with stable angina pectoris. QOL was assessed by means of a test battery based on the Medical Outcomes Short-Form 36 Health Survey and the Angina Pectoris Quality of Life Questionnaire. The internal consistency and reliability of the multiitem scales were estimated by use of Cronbach's alpha coefficient. Based on their improvements in New York Heart Association (NYHA) angina classification, patients who received 100 mg daily showed greater improvement than those who received 50 mgdaily; the mean difference between treatments was consistent with a significantly greater improvement of mobility and angina indices. Adverse effects, as estimated by side-effect index, including rebound angina at times of rest, and by patient compliance rating, differed slightly between the two treatment regimens and were even less problematic with the higher dosage than with the lower dosage. Psychological distress index and life satisfaction scores also were significantly higher with 100 mg than with 50 mg daily. The results of this study suggest that SR ISMN 100 mg once daily provided a better NYHA angina classification than SR ISMN 50 mg did and did not produce further adverse effects. In addition SR ISMN 100 mg improved various QOL indices more than SR ISMN 50 mg did, particularly the mobility index and certain life satisfaction scores, which are the most important indicators of QOL in this category of patients.     

A randomised double-blind crossover study of isosorbide mononitrate and nifedipine retard in chronic stable angina

In order to evaluate and compare the efficacy and safety of nifedipine retard and isosorbide-5-mononitrate as monotherapy in the treatment of stable angina, 18 patients with abnormal exercise electrocardiograms and angiographically proven coronary arterial disease were studied in a randomised placebo controlled double-blind crossover study comparing isosorbide 20 mg twice a day, sustained released isosorbide 40 mg once daily and nifedipine 20 mg twice a day each given for two weeks. Patients were assessed subjectively by counting the frequency of anginal attacks and glyceryl trinitrate consumed and objectively by maximal symptom-limited treadmill stress tests performed at "trough" therapeutic blood levels on the last day of each treatment period. There were no significant differences in all parameters between entry and run-out placebo. Compared to placebo, all three active treatments showed significant improvement in exercise time to 1 mm ST segment depression, amount of maximum ST segment depression and exercise duration. All three active treatments also significantly reduced the consumption of glyceryl trinitrate and frequency of anginal attacks. There were no significant differences between active treatments. Thus similar clinical improvements were produced by nifedipine retard and isosorbide, both being shown to be equally effective starting therapy for the treatment of patients with stable angina pectoris. Although anginal frequency was reduced by one third and exercise time increased residual symptoms and exercise ischaemia suggest that nifedipine retard and isosorbide may be more clinically useful in combination therapy. Neither demonstrated tolerance after two weeks of therapy.