舒血宁注射液联合西药治疗老年冠心病不稳定性心绞痛临床研究

目的：观察舒血宁注射液联合西药治疗老年冠心病不稳定性心绞痛心血瘀阻证的临床疗效，以及对血管内皮功能的影响。方法：选取108例老年冠心病不稳定性心绞痛心血瘀阻证患者，按随机数字表法分为舒血宁组和对照组各54例，其中舒血宁组剔除1例，对照组剔除3例，最终纳入研究舒血宁组53例、对照组51例。对照组给予西药治疗，舒血宁组在对照组基础上给予舒血宁注射液治疗。2组均治疗2个月。比较2组临床疗效、心绞痛发作次数、心绞痛发作持续时间、心肌酶[血清乳酸脱氢酶（LDH）、磷酸肌酸激酶同工酶（CK-MB）、磷酸肌酸激酶（CK） ]水平及血管内皮功能指标[血清内皮素（ET）、一氧化氮（NO） ]水平，记录不良反应发生情况。结果：治疗后，经秩和检验，舒血宁组临床疗效优于对照组（P＜0.05）。治疗后，2组心绞痛发作次数均较治疗前减少（P＜0.05），心绞痛发作持续时间均较治疗前缩短（P＜0.05）；舒血宁组心绞痛发作次数少于对照组（P＜0.05），心绞痛发作持续时间短于对照组（P＜0.05）。治疗后，2组血清LDH、CK-MB、CK水平均较治疗前降低（P＜0.05），舒血宁组血清LDH、CK-MB、CK水平均低于对照组（P＜0.05）。治疗后，2组血清ET水平均较治疗前降低（P＜0.05），血清NO水平均较治疗前升高（P＜0.05）；舒血宁组血清ET水平低于对照组（P＜0.05），血清NO 水平高于对照组（P＜0.05）。治疗期间，舒血宁组不良反应发生率5.66%，对照组不良反应发生率7.84%，2组比较，差异无统计学意义（P＞0.05）。结论：在西药基础上联合舒血宁注射液治疗老年冠心病不稳定性心绞痛心血瘀阻证可提高临床疗效，减轻患者的临床症状，改善心肌损伤。

Clinical Study on Shuxuening Injection Combined with Western Medicine for UnstableAngina Pectoris of Coronary Heart Disease in Senile Patients

Abstract： Objective： To observe the clinical effect of the therapy of Shuxuening Injection combinedwith western medicine on senile patients with unstable angina pectoris of coronary heart disease with heartblood stasis obstruction syndrome and its effect on vascular endothelial function. Methods ： A total of108 cases of senile patients with unstable angina pectoris of coronary heart disease with heart blood stasisobstruction syndrome were selected and divided into the Shuxuening group and the control group accordingto the random number table method， with 54 cases in each group. Among them ， 1 case dropped out inthe Shuxuening group and 3 cases dropped out in the control group； finally 53 and 51 cases wererespectively included in each group. The control group was treated with western medicine and theShuxuening group was additionally given Shuxuening Injection for treatment based on the treatment of thecontrol group. The two groups were treated for 2 months. The clinical effects，times and duration of anginapectoris attack， levels of myocardial enzymes， including serum lactate dehydrogenase (LDH)， creatinekinase isoenzyme (CK-MB) and creatine kinase (CK)， and levels of vascular endothelial function indexes，including serum endothelin (ET) and nitric oxide (NO) were compared between the two groups； theincidence of adverse reactions was recorded. Results： After treatment， the clinical effect in theShuxuening group was better than that in the control group by the rank sum test (P＜0.05). After treatment，the times of angina pectoris attack in the two groups were reduced when compared with those beforetreatment (P＜0.05)， and the duration of angina pectoris attack was shortened when compared with thatbefore treatment (P＜0.05)； the times of angina pectoris attack in the Shuxuening group were less thanthose in the control group (P＜0.05)，and the duration of angina pectoris attack was shorter than that in thecontrol group (P＜0.05). After treatment，the levels of serum LDH，CK-MB and CK were decreased whencompared with those before treatment (P＜0.05)，and the above levels in the Shuxuening group were lowerthan those in the control group (P＜0.05). After treatment， the serum ET levels in the two groups weredecreased when compared with those before treatment (P＜0.05)， and the serum NO levels wereincreased when compared with those before treatment (P＜0.05)； the serum ET level in the Shuxueninggroup was lower than that in the control group (P＜0.05)，and the serum NO level was higher than that inthe control group (P＜0.05). During treatment， the incidence of adverse reactions was 5.66% in theShuxuening group and 7.84% in the control group，there being no significance in the difference (P＞0.05).Conclusion：The therapy of Shuxuening Injection combined with western medicine can enhance the clinicaleffect on senile patients with unstable angina pectoris of coronary heart disease with heart blood stasisobstruction syndrome，mitigate the clinical symptoms of patients and improve the myocardial injuries.