灯盏细辛与单硝酸异山梨酯治疗不稳定型心绞痛的对比研究

目的对比观察灯盏细辛与单硝酸异山梨酯治疗不稳定型心绞痛的临床疗效及其对血液动力学、超敏C-反应蛋白的影响。方法将120例确诊为不稳定型心绞痛的住院患者随机分为两组,每组60例。两组治疗前年龄、性别、血脂、血糖、吸烟史、心功能级别、病程、心绞痛发作次数、持续时间、程度、常规心电图及药物治疗等一般情况,无显著性差异。灯盏组给予灯盏细辛注射液40 mL加入5%的葡萄糖注射液250 mL中静脉点滴;单硝酸异山梨酯组给予单硝酸异山梨酯注射液40 mg加入5%葡萄糖注射液250 mL中静脉点滴,疗程为14 d。观察两组治疗前后的临床疗效、心电图改善情况及血液动力学和超敏C-反应蛋白的变化。结果灯盏组患者心绞痛缓解和心电图改善的总有效率分别是88.3%和80.0%;而单硝酸异山梨酯组患者心绞痛缓解和心电图改善的总有效率分别是95.0%和93.3%,两者相比差异有显著性,达到统计学标准(P<0.05);但灯盏组患者血液动力学指标与治疗前相比明显减少(P<0.05),单硝酸异山梨酯组则无明显变化;两组患者治疗前后血浆C反应蛋白的含量均较治疗前有明显下降,但灯盏细辛治疗组下降更明显,且与单硝酸异山梨酯组比较有显著差异(P<0.05)。另外,灯盏组患者平均收缩压与平均心率的乘积治疗前后明显降低,同时单硝酸异山梨酯组这一积值无明显变化,两者相比有显著差异(P<0.05)。结论灯盏细辛注射液治疗不稳定型心绞痛的疗效及心电图改善方面虽不如硝酸酯类药物,但它在减少心肌耗氧、降低血液黏滞度、减轻斑块炎症方面优于硝酸酯药物,有利于缓解心绞痛发作时的供氧/需氧失衡;有利于钝化稳定已经被激活的粥样斑块;有利于预防继发性血栓的形成,在不稳定心型绞痛患者临床症状缓解、安全渡过急性期及改善预后方面,起重要的辅助治疗作用。

A Comparative Research of Erigeron Breviscapus Injection and Isosorbide 5-mononotrate in Treating With Unstable Angina Patients

Objective To observe the clinical effect of Erigeron Breviscapus Injection and isosorbide 5 - mononotrate in treating with unstable angina pectoris patients and the effect on their haemodynamics and plasma high sensitive C reactive protein. Methods One hundred and twenty patients in - hospital with unstable angina were randomly divided into two groups： Erigeron Breviscapus group who were given Erigeron Breviscapus Injection and isosorbide 5 - mononotrate group who were giving isosorbide 5 - mononitrate. In each group, compare clinical effect, electrocardiography improvement, haemodynamics and plasma high sensitive C reactive protein were compared before and after treatment. Results Com- pared with isosorbide 5 - mononotrate group, in Erigeron Breviscapus group, patients to alleviate angina and ECG im- provement in the total effective rate were 88.3% and 80.0%; and isosorbide mononitrate group were 95.0 % and 93.3 %. There were significant difference between two groups （ P 〈 0. 05）. The haemodynamic was lower in Erigeron Breviscapus group after treatment （ P 〈 0.05）. The plasma level of plasma high sensitive C reactive protein was signifi- cantly descented in both groups （ P 〈 0.05）, But in Erigeron Breviseapus group was more obviously （ P 〈 0. 05）. The mean systolic blood pressure and average heart rate in Erigeron Breviscapus group before and after treatment significantly redueedand at the same time, isosorbide mononitrate group has no significant change. Both groups have significantly dif- ference （ P 〈 0.05）. Conclusion The effects of Erigeron Breviscapus Injection on clinical symptoms and electrocar- diography were not better than isosorbide 5 - mononitrate, but on reducing hemorheology and high sensitive CRP, Erigeron Breviseapus was better. Patients with unstable angina could get benefit from giving Erigeron Breviscapus Injection. It has an important adjunctive therapy function.