黄芪注射液合丹参注射液治疗冠心病心绞痛68例

目的:探讨黄芪注射液合复方丹参注射液静脉滴注治疗冠心病心绞痛的治疗效果.方法:将符合纳入标准的冠心病心绞痛患者116例,随机分为治疗组68例与对照组48例.治疗组用黄芪注射液20ml,合复方丹参注射液20ml加入5%葡萄糖250ml,静脉滴注,每日1次.对照组用复方丹参注射液20ml加入5%葡萄糖250ml,静脉滴注,每日1次.均14d为1个疗程,2个疗程观察疗效.评定心绞痛、心电图疗效及硝酸甘油停减率.结果:疗程结束后2组心电图有效率分别为85.30%、64.60%,2组比较差异有显著性(P＜0.05).结论:黄芪注射液合复方丹参注射液静脉滴注,能够明显改善心绞痛症状,对于气虚血瘀所致心绞痛疗效显著,未发现明显副作用,值得临床推广应用.     

丹参酮ⅡA磺酸钠联合低分子肝素钙对不稳定型心绞痛的疗效观察

目的:观察丹参酮ⅡA磺酸钠注射液联合低分子肝素钙注射液对不稳定型心绞痛的临床疗效。方法:对80例不稳定心绞痛患者随机分为对照组和治疗组各40例,对照组予丹参粉干针和常规治疗,治疗组采用丹参酮ⅡA磺酸钠注射液联合低分子肝素钙治疗加常规治疗,观察两组临床疗效、心电图及凝血、生化指标。结果:治疗组缓解心绞痛症状和心电图缺血性ST-T改善的有效率均明显高于对照组,P<0.05,而两组凝血、生化指标无显著差异,P>0.05。结论:低分子肝素钙联合丹参酮ⅡA磺酸钠注射液对不稳定心绞痛有较好的疗效,值得推广应用。     

丹参多酚酸盐联合硝酸甘油及尼可地尔治疗冠心病心绞痛

目的:研究丹参多酚酸盐联合硝酸甘油及尼可地尔治疗冠心病心绞痛患者临床疗效。方法:选取我院2016年8月～2018年9月收治的冠心病心绞痛患者124例,按照随机数字表法分为对照组和观察组,各62例。对照组采用硝酸甘油+尼可地尔治疗,观察组给予丹参多酚酸盐+硝酸甘油+尼可地尔治疗。统计两组临床疗效、不良反应发生情况,并对比治疗前后两组硝酸甘油用量、心绞痛发作情况。结果:观察组临床治疗总有效率93.55%,高于对照组的79.03%(P0.05);治疗后,观察组心绞痛发作次数及硝酸甘油用量明显少于对照组,心绞痛持续时间短于对照组(P0.05);观察组不良反应发生率为8.06%(5/62),与对照组4.84%(3/62)相比,差异无统计学意义(χ~2=0.134,P=0.715)。结论:丹参多酚酸盐联合硝酸甘油及尼可地尔治疗冠心病心绞痛可改善患者心绞痛发作,减少硝酸甘油用量,提高临床治疗效果。     

丹参多酚酸盐合尼可地尔治疗冠心病心绞痛患者的疗效观察

目的:探究注射用丹参多酚酸盐联合尼可地尔治疗冠心病心绞痛患者的临床疗效。方法:选取2017年3月～2018年7月我院收治的128例冠心病心绞痛患者,根据随机数字表法分为对照组和观察组,每组64例。对照组给予尼可地尔治疗,观察组在对照组的基础上给予注射用丹参多酚酸盐治疗,观察比较两组的临床疗效、心绞痛持续时间、心绞痛发作时间、硝酸甘油用量、白细胞介素-18(IL-18)、白细胞介素-1β(IL-1β)、肌钙蛋白T(c TnT)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平。结果:观察组的总有效率为93.75%,高于对照组的79.69%,差异有统计学意义,P0.05;治疗后,观察组心绞痛持续时间和心绞痛发作时间均短于对照组,硝酸甘油用量少于对照组,差异均有统计学意义,P0.05;观察组的IL-18、IL-1β、c TnT和LDL-C水平均低于对照组,HDL-C水平高于对照组,差异均有统计学意义,P0.05。结论:注射用丹参多酚酸盐联合尼可地尔治疗冠心病心绞痛疗效确切,可显著改善患者的临床症状,抑制炎症反应,减轻心肌损伤,调节血脂代谢状态。     

丹参多酚酸盐联合琥珀酸美托洛尔缓释片治疗冠心病心绞痛

目的:分析注射用丹参多酚酸盐联合琥珀酸美托洛尔缓释片治疗冠心病心绞痛的临床效果。方法:选取2015年10月～2017年10月我院收治的100例冠心病心绞痛患者为研究对象,随机分为对照组和观察组各50例。对照组予以常规治疗,观察组在对照组基础上予以注射用丹参多酚酸盐联合琥珀酸美托洛尔缓释片治疗。比较两组临床疗效。结果:治疗前,两组心绞痛发作频率及持续时间、血脂水平比较差异无统计学意义(P0.05);治疗后,观察组心绞痛发作频率及持续时间、LDL-C、TC、TG水平明显低于对照组,HDL-C水平高于对照组(P0.05);观察组心电图改善总有效率显著高于对照组(P0.05)。结论:采用注射用丹参多酚酸盐联合琥珀酸美托洛尔缓释片治疗冠心病心绞痛,可显著减少患者心绞痛发作频率,缩短心绞痛发作时间,改善心电图特征,调节血脂水平,延缓疾病进展。     

丹参多酚酸盐注射液联合酒石酸美托洛尔治疗不稳定型心绞痛的临床效果

目的研究丹参多酚酸盐注射液联合酒石酸美托洛尔对不稳定型心绞痛(UAP)患者心电图及血清妊娠相关血浆蛋白A(PAPP-A)、可溶性白细胞分化抗原配体(sCD40L)水平的影响。方法将96例UAP患者按随机数字表法分为研究组(n=48)和对照组(n=48),对照组采用酒石酸美托洛尔治疗,研究组采用丹参多酚酸盐注射液联合酒石酸美托洛尔治疗。比较2组心电图疗效、临床症状(包括发作次数、疼痛程度、持续时间、硝酸甘油用量)评分改善情况及治疗前后血清PAPP-A、sCD40L水平变化情况。结果研究组心电图总有效率显著高于对照组(93.75%比75.00%,χ^2=6.400、P=0.011);研究组治疗后发作次数、疼痛程度、持续时间、硝酸甘油用量等评分均较对照组显著改善(P<0.05);治疗后2组血清PAPP-A、sCD40L水平均显著低于治疗前(P<0.05),且研究组显著低于对照组(P<0.05)。结论丹参多酚酸盐注射液联合酒石酸美托洛尔治疗UAP患者,能显著提高心电图疗效,进一步改善心绞痛症状,降低血清PAPP-A、sCD40L水平,有利于改善预后。     

丹参酮ⅡA磺酸钠注射液联合酒石酸美托洛尔治疗冠心病心绞痛患者临床研究

目的探讨丹参酮ⅡA磺酸钠注射液联合酒石酸美托洛尔在冠心病心绞痛患者中应用效果。方法选取某院冠心病心绞痛患者95例,按照用药方法的不同分组,对照组47例采用酒石酸美托洛尔治疗,观察组48例给予酒石酸美托洛尔联合丹参酮ⅡA磺酸钠注射液治疗,观察两组治疗效果。结果观察组心电图总有效率为87.50%(42/48),高于对照组的70.21%(33/47),P0.05;治疗1个月后观察组血清BNP水平低于对照组(P0.05);观察组不良反应发生率为10.42%(5/48),对照组为10.64%(5/47),组间比较,差异无统计学意义(P0.05)。结论丹参酮ⅡA磺酸钠注射液联合酒石酸美托洛尔可改善冠心病心绞痛患者血清BNP水平,提高心电图疗效,且安全性高。     

丹参多酚酸盐对不稳定型心绞痛疗效及血清MMP-2的影响

目的 观察丹参多酚酸盐治疗心血瘀阻型不稳定型心绞痛(UAP)的临床疗效并探讨其对血清基质金属蛋白酶-2 (MMP-2)水平的影响.方法 将80例心血瘀阻型不稳定型心绞痛患者随机分为常规治疗组40例和丹参多酚酸盐治疗组40例,均治疗14 d,观察两组治疗前后心绞痛疗效、常规心电图ST改变、中医证候、血清MMP-2表达变化.结果 治疗后丹参多酚酸盐组在心绞痛疗效、心电图、中医证候改善方面均优于对照组,差异均有统计学意义(P均＜0.05);且丹参多酚酸盐组的血清MMP-2水平下降程度优于对照组(P＜0.05).结论 丹参多酚酸盐对心血瘀阻型UAP有良好的疗效,同时可降低MMP-2水平,稳定易损斑块可能是其治疗UAP的机制之一.     

丹参多酚酸盐与丹参注射液对不稳定型心绞痛氧化修饰低密度脂蛋白、血友病因子和超敏C反应蛋白的作用比较

目的比较丹参多酚酸盐与丹参注射液对不稳定型心绞痛(UA)氧化修饰低密度脂蛋白(OXLDL)、血友病因子(vWF)和超敏C反应蛋白(hsCRP)的作用。方法将153例UA患者随机分为2组,其中丹参注射液组84例,丹参多酚酸盐组69例,治疗前及治疗14天后,分别检测OXLDL、vWF和hsCRP 3项指标,并统计两组缓解心绞痛的有效率。结果丹参多酚酸盐与丹参注射液均能降低OXLDL、vWF和hsCRP水平,但丹参多酚酸盐降低vWF和hsCRP的幅度更大、作用更强,治疗14天后vWF和hsCRP分别降至(25.4±6.5)μg/L、(2.9±1.4)mmol/L(均P<0.01);丹参多酚酸盐与丹参注射液均能缓解心绞痛,但丹参多酚酸盐组的总有效率为92.8%,丹参注射液组的总有效率为79.8%,两组比较差异有统计学意义(P<0.05)。结论丹参多酚酸盐能够更有效地缓解心绞痛;在抑制血栓形成、保护血管内皮、控制血管炎症方面,丹参多酚酸盐比丹参注射液更具优势。     

丹参酮ⅡA磺酸钠对冠心病心绞痛临床疗效探讨

目的探讨丹参酮ⅡA磺酸钠注射液治疗冠心病心绞痛的疗效。方法将108例冠心病心绞痛患者随机分为治疗组（55例）和对照组（53例）。对照组常规予以硝酸酯类，钙离子拮抗剂、β-受体阻滞剂和阿司匹林等治疗。治疗组在前者的基础上加用丹参酮ⅡA磺酸钠注射液50mg／d，共2周。记录每例患者心绞痛发作的频率、发作时间及硝酸甘油用量及治疗前后心电图（ECG）变化。结果治疗组临床症状改善优于治疗组（P〈0．05），发作频率、发作时间、及硝酸甘油用量下降明显，ECG指标的疗效优于对照组，差异具有显著性（P〈0．05）。结论丹参酮ⅡA磺酸钠有效改善心肌供血减少心绞痛发作，是临床治疗冠心病改善心肌缺血的一种有效药物。     

两种丹参类中药注射剂治疗冠心病心绞痛的系统评价及其药物经济学分析

目的系统评价注射用丹参多酚酸盐与丹参注射液治疗冠心病心绞痛的有效性和安全性,并分析其药物经济性。方法计算机检索PubMed、CENTRAL(2013年第4期)、CNKI、VIP和WanFang Data,查找有关注射用丹参多酚酸盐与丹参注射液比较治疗冠心病心绞痛的随机对照试验(RCT),检索时限均为2004年1月~2013年5月。同时手检相关期刊与会议论文。由2位评价员根据纳入与排除标准独立进行文献筛选、资料提取和质量评价后,采用RevMan 5.2软件进行Meta分析。结果共纳入10个RCT,包括患者1 196例。Meta分析结果显示:注射用丹参多酚酸在治疗冠心病心绞痛方面的有效性[OR=3.79,95%CI(2.78,5.17),P<0.00001]和安全性[OR=0.24,95%CI(0.09,0.64),P=0.004]明显优于丹参注射液,但缺乏经济学优势。结论现有证据表明,注射用丹参多酚酸盐为治疗冠心病心绞痛的安全、有效方案,丹参注射液为较经济方案。受限于纳入研究的数量和质量,上述结论尚需今后开展更多大样本、高质量的RCT加以验证。     

Metabolic efficiency with ranolazine for less ischemia in non-ST elevation acute coronary syndromes (MERLIN TIMI-36) study

Ranolazine is a piperazine derivative believed to reduce anginal symptoms by preventing ischemia-mediated sodium and calcium overload in myocardial cells through inhibition of the late sodium current (late INa). Three small studies demonstrated the antianginal efficacy of ranolazine alone and in combination with betablockers or calcium channel blockers on conventional end points such as total exercise duration and time to ischemia/angina on a treadmill; however, questions of safety related to QT prolongation, efficacy in women and potential utility in higher risk populations remained. Metabolic Efficiency with Ranolazine for Less Ischemia in Non-ST Elevation Acute Coronary Syndromes-Thrombolysis in Myocardial Infarction (MERLIN-TIMI) 36 was a large randomized, double-blind, placebo-controlled trial, which evaluated the efficacy and safety of ranolazine initiated acutely and continued as chronic therapy following a non-ST-segment elevation acute coronary syndrome event. A total of 6560 patients were randomized 1:1 to ranolazine or placebo; the primary efficacy end point of the trial was a composite of cardiovascular death, myocardial infarction or recurrent ischemia. The key safety end points were death from any cause and symptomatic documented arrhythmia. Although statistically significant differences between the ranolazine and placebo groups were not reached in the primary efficacy analysis or in the major secondary outcome end point analyses (cardiovascular death, myocardial infarction or severe recurrent ischemia), the individual component of recurrent ischemia was significantly reduced by ranolazine, and ranolazine was demonstrated to be safe.     

Spinal Cord Stimulation: A Comparison of Efficacy versus Other Novel Treatments for Refractory Angina Pectoris

Abstract: Recently much attention has been directed toward novel treatment alternatives for refractory angina pectoris. Refractory angina is persistent stable class III or IV angina despite maximally tolerated medical treatment in patients with end-stage coronary artery disease. Transmyocardial laser revascularization (TMLR), gene therapy, intermittent urokinase therapy, enhanced external balloon counterpulsation, and spinal cord stimulation have all been employed to treat refractory angina pectoris. TMLR and gene therapy are invasive open-chest procedures that have yielded controversial results. Intermittent urokinase and enhanced external balloon counterpulsation studies have limited follow-up times and require multiple clinic visits for treatment. Spinal cord stimulation has a proven short- and long-term efficacy and cost-effectiveness in the treatment of refractory angina. When compared to coronary artery bypass grafting (CABG), it has been shown to decrease the frequency of anginal attacks and consumption of short-acting nitrates to the same extent in refractory angina. Spinal cord stimulation's safety profile has also been well established and it can be used concurrently with cardiac pacemakers or MRI systems, provided the proper precautions are taken. Since spinal cord stimulation is a minimally invasive procedure with a favorable efficacy and safety profile, it should be considered as a valid treatment alternative after medical management has failed in refractory angina prior to implementing invasive modalities such as TMLR or gene therapy.     

丹参饮合生脉散治疗不稳定性心绞痛

目的：研究丹参饮合生脉散对不稳定性心绞痛的治疗作用。方法：将１１８例患者随机分为丹参饮合生脉散组（治疗组７８例）和西药常规治疗组（对照组４０例）。治疗组在西药常规治疗的基础上加服中药丹参饮合生脉散。观测２组患者心绞痛症状，心电图变化，硝酸甘油消耗量及中医各证型疗效等。结果：２组心绞痛症状疗效比较有显著性差异（Ｐ＜０．０５）；２组心电图疗效比较有显著差异（Ｐ＜０．０５），治疗组疗效优于对照组；硝酸甘油消耗量治疗后较治疗前２组均明显减少（Ｐ＜０．００１或Ｐ＜０．０１）；硝酸甘油停减率治疗组比对照组提高了１０．４５％，但无统计学意义（Ｐ＞０．０５）。治疗组中气虚血瘀型疗效最好，痰湿阻滞型最差，两证型比较有显著差异（Ｐ＜０．０５），其它各证型之间疗效无显著差异（Ｐ＞０．０５）。结论：丹参饮合生脉散治疗不稳定性心绞痛确有一定的疗效，中西药合用有一定的协同作用和优势     

氯吡格雷联合低分子肝素治疗不稳定型心绞痛

目的观察氯吡格雷联合低分子肝素治疗不稳定型心绞痛(UAP)的临床效果及安全性。方法将236例符合不稳定型心绞痛诊断标准的患者随机分为治疗组(120例)和对照组(116例)。治疗组为在对照组治疗基础上加口服氯吡格雷75 mg,1次/d,共1个月,低分子肝素皮下注射7 d。对照组应用阿司匹林及调脂治疗、硝酸酯类、β-受体阻滞剂、钙离子拮抗剂、血管紧张素转换酶抑制剂(ACEI)等类药物。观察两组心绞痛症状控制情况、心电图改变、主要终点事件及不良反应发生情况。结果治疗组症状、心电图缺血性改变有明显好转(P0.01),1个月内心肌梗死及心脏猝死等主要终点事件下降,无严重不良反应。结论氯吡格雷联合低分子肝素治疗不稳定型心绞痛是安全有效的。     

丹参多酚酸盐对不稳定型心绞痛患者血清超敏C反应蛋白及肿瘤坏死因子α水平的影响

目的 探讨丹参多酚酸盐(salvianolate, SV)对不稳定型心绞痛(unstable angina, UA)患者超敏C反应蛋白(hs-CRP)和肿瘤坏死因子α(TNF-α)水平的影响。方法 UA患者96例随机分为两组,观察组和对照组各48例,对照组给予单纯西医治疗,观察组在对照组基础上联用SV进行治疗,治疗2周。治疗前后监测两组hs-CRP、TNF-α水平,并对综合疗效进行评价。结果 治疗前,两组hs-CRP、TNF-α水平差异无统计学意义(P＞0.05);治疗1周和2周后,观察组hs-CRP水平分别为(12.5±2.2) mg/L和(5.2±1.1) mg/L,对照组为(15.3±2.8) mg/L和(8.5±1.5) mg/L,观察组明显低于对照组(P＜0.05);治疗1周和2周后,观察组TNF-α水平与对照组相比明显更低(P＜0.05);观察组有效率为93.8%(45/48),对照组为77.1%(37/48),观察组有效率明显高于对照组(P＜0.05)。结论 SV联合治疗UA能通过有效降低患者的hs-CRP、TNF-α水平改变炎症反应程度,从而改善UA患者的临床症状,值得在临床上进一步推广。     

谷红注射液联合丹参多酚酸盐对急性脑梗死患者神经功能和血液流变学的影响

目的 探讨谷红注射液联合丹参多酚酸盐对患者神经功能和血液流变学的影响.方法 选择我院收治的急性脑梗死患者154例,根据随机数字表法分为对照组77例,采用丹参多酚酸盐治疗;联合组77例,采用丹参多酚酸盐联合谷红注射液治疗.比较两组临床疗效、神经功能缺损程度评分、血液流变学指标,观察治疗期间不良反应发生情况.结果 治疗后,...     

Ranolazine: a novel agent that improves dysfunctional sodium channels

Treatment for coronary heart disease is usually directed at either increasing myocardial oxygen supply or decreasing myocardial oxygen demand. Although combination therapy with beta-blockers, calcium-channel blockers and nitrates are effective, many patients suffer from adverse effects of hypotension and bradycardia. Ranolazine is a novel medication that reduces ischaemia by preventing sodium induced calcium overload in myocardial cells without adversely affecting haemodynamic parameters. This agent is the first in the USA to be approved to treat angina in over 10 years. The purpose of this review is to evaluate the pharmacology, pharmacokinetics, clinical trials for safety and efficacy, precautions, adverse effects, drug interactions, and dosage and administration of ranolazine in the treatment of chronic stable angina and acute coronary syndrome.     

Evaluation of ASPIRE trial: a Phase III pivotal registration trial,using intracoronary administration of Generx (Ad5FGF4) to treat patients with recurrent angina pectoris

The ASPIRE study (a randomized, controlled, parallel group, multicenter study to evaluate the efficacy and safety of Ad5FGF-4 using adenosine single-photon emission computed tomography (SPECT) myocardial perfusion imaging in patients with stable angina pectoris) (ClinicalTrials.gov Identifier: NCT01550614) is a 100-patient, controlled, randomized, multicenter study conducted in six centers in Russia. This trial will assess the therapeutic efficacy of Generx (Ad5-FGF4) using rest and stress SPECT following a one-time, catheter-based administration. Adenovirus-based antianginal therapy represents an interesting option but the difficulties observed in the various trials carried out to date illustrate the complexity of the issue. Large and well-designed studies should be encouraged to provide definitive answers to this important research question.