灯盏生脉胶囊联合单硝酸异山梨酯治疗冠心病心绞痛的临床研究

目的观察灯盏生脉胶囊联合单硝酸异山梨酯治疗冠心病心绞痛的临床疗效。方法选取2015年8月—2017年6月在北京市东城区第一人民医院内科确诊的84例冠心病心绞痛患者,将研究对象随机分为对照组和治疗组,每组各42例。对照组泵入单硝酸异山梨酯注射液,60 mg/次,1次/d,10 d后转为口服单硝酸异山梨酯片,20 mg/次,2次/d。治疗组在对照组的治疗基础上口服灯盏生脉胶囊,2粒/次,3次/d。两组患者均连续治疗4周。观察两组的临床疗效和心电图疗效,比较两组治疗前后心绞痛发作频率、持续时间、血脂四项、超敏C-反应蛋白(hs-CRP)、纤维蛋白原(FIB)、D-二聚体的变化情况。结果治疗后,对照组和治疗组的临床总有效率分别为76.19%、92.86%;心电图总有效率分别为71.43%、88.10%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者心绞痛发作频率较治疗前明显减少,持续时间的较治疗前明显缩短,同组治疗前后差异有统计学意义(P0.05);治疗后,治疗组心绞痛发作频率少于对照组,每次的持续时间短于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)均低于治疗前,但高密度脂蛋白(HDL-C)高于治疗前,同组治疗前后差异有统计学意义(P0.05);治疗后,治疗组TC、TG、LDL-C低于对照组,HDL-C高于对照组,两组比较差异有统计学意义(P0.05)。治疗后,对照组患者hs-CRP降低,治疗组hs-CRP、FIB、D-二聚体水平较治疗前显著降低,同组治疗前后差异有统计学意义(P0.05);治疗后,治疗组hs-CRP、FIB、D-二聚体低于对照组,两组比较差异有统计学意义(P0.05)。结论灯盏生脉胶囊联合单硝酸异山梨酯治疗冠心病心绞痛具有较好的临床疗效,可显著改善症状,降低炎症指标,具有一定的临床推广应用价值。

Clinical study on Dengzhan Shengmai Capsules combined with isosorbide mononitrate in treatment of coronary heart disease with angina pectoris

Objective To observe the clinical curative effect of Dengzhan Shengmai Capsules combined with isosorbide mononitrate in treatment of coronary heart disease with angina pectoris. Methods Patients (84 cases) with coronary heart disease with angina pectoris in Department of Internal Medicine in the First People''s Hospital of Dongcheng District in Beijing from August 2015 to June 2017 were randomly divided into control (42 cases) and treatment (42 cases) groups. Patients in the control group were iv administered with Isosorbide Mononitrate Injection, 60 mg/time, once daily. After 10 d, they were po administered with Isosorbide Mononitrate Tablets, 20 mg/time, twice daily. Patients in the treatment group were po administered with Dengzhan Shengmai Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy and electrocardiogram effect was evaluated, and the changes of angina pectoris frequency and duration, blood lipids, hs-CRP, FIB, and D-dimer in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 76.19% and 92.86%, respectively, and electrocardiogram efficacy were 71.43% and 88.10%, respectively, there was difference between two groups (P < 0.05). After treatment, angina pectoris frequency in two groups was decreased, and duration time was shorted, and the difference was statistically significant in the same group (P < 0.05). After treatment, angina pectoris frequency was less than that in the control group, and duration time was shorted than that in the control group, and there was difference between two groups (P < 0.05). After treatment, TC, TG, and LDL-C in two groups were decreased, but HDL-C was increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, TC, TG, and LDL-C in treatment group were lower than those in the control group, but HDL-C was higher than that in the control group, there was difference between two groups (P < 0.05). After treatment, hs-CRP in the control group was decrease, and hs-CRP, FIB, and D-dimer in the treatment group were decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, hs-CRP, FIB, and D-dimer in the treatment group were lower than those in the control group, there was difference between two groups (P < 0.05). Conclusion Dengzhan Shengmai Capsules combined with isosorbide mononitrate has clinical curative effect in treatment of coronary heart disease with angina pectoris, and can significantly improve symptoms, also can reduce inflammatory indicators, which has a certain clinical application value.