丹蒌片对痰瘀互结型急性冠状动脉综合征患者经皮冠状动脉介入治疗后心绞痛症状和心功能的影响

目的探讨痰瘀互结型急性冠状动脉综合征（ACS）患者经皮冠状动脉介入治疗（PCI）后在常规药物治疗基础上加用丹蒌片对缓解心绞痛症状和保护心功能的作用，同时与麝香保心丸进行比较。 方法选取浙江省人民医院2018年1月至12月诊断为ACS并行PCI、中医辨证为痰瘀互结型的75例患者，将患者分成A组（常规药物+丹蒌片）、B组（常规药物+麝香保心丸）、C组（常规药物），每组各25例。丹蒌片每次1.5 g，每日3次；麝香保心丸每次45 mg，每日3次。3组患者均在PCI后连续服药1个月，比较3组患者的一般资料、西雅图心绞痛量表（SAQ）评分、加拿大心血管病学会（CCS）分级、左室舒张末期内径（LVEDd）、左室射血分数（LVEF）、峰值摄氧量（VO₂ peak）、6 min步行试验（6MWT）。 结果治疗1个月后，A、B、C组患者心绞痛稳定状态（76 ± 18）、（77 ± 20）、（65 ± 17）分]、心绞痛发作情况（82 ± 13）、（86 ± 15）、（75 ± 12）分]及治疗满意程度（80 ± 12）、（83 ± 13）、（74 ± 14）分]比较，差异均有统计学意义（F = 3.451、6.852、4.511，P = 0.037、0.002、0.014）；而治疗后CCS分级比较，差异无统计学意义（H = 2.362，P = 0.307）。3组患者治疗前后LVEDd、LVEF、VO₂ peak和6MWT比较，差异均有统计学意义（F = 11.370、25.802、3.367、9.267，P均< 0.05）。进一步两两比较发现，治疗后A、B组患者LVEDd（44 ± 7）、（44 ± 7）、（51 ± 7）mm]均较C组显著降低，LVEF（58 ± 5）%、（58 ± 6）%、（48 ± 5）%]、VO₂ peak（20 ± 3）、（19 ± 3）、（17 ± 4）mL·min^-1·kg^-1]和6MWT（467 ± 68）、（462 ± 68）、（412 ± 65）m]均较C组显著升高（P均< 0.05）。 结论对于痰瘀互结型ACS患者，PCI术后用丹蒌片联合常规药物治疗能明显缓解患者临床症状，减少心绞痛发作，同时改善心功能，提高生活质量。

Effects of Danlou tablets on angina pectoris symptom and heart function after percutaneous coronary intervention in acute coronary syndrome patients with phlegm and blood stasis syndrome

ObjectiveTo investigate the effect of Danlou tablets on relieving angina pectoris symptom and protecting cardiac function after percutaneous coronary intervention (PCI) in acute coronary syndromes (ACS) patients with phlegm and blood stasis syndrome. Meanwhile, its effectiveness was compared with Shexiang Baoxin pills. MethodsSeventy-five patients with ACS who were diagnosed with phlegm and blood stasis syndrome and underwent PCI in Zhejiang Provincial People's Hospital from January to December 2018 were randomly divided into three groups: group A (conventional medicine + Danlou tablets), group B (conventional medicine + Shexiang Baoxin pills) and group C (conventional medicine), with 25 patients in each group. Danlou tablets were taken for 1.5 g each time, 3 times a day, and Shexiang Baoxin pills for 45 mg each time, 3 times a day. All patients took medicine continuously for one month after PCI. The general data, Seattle angina questionnaire (SAQ) score, Canadian Cardiovascular Society (CCS) grading, left ventricular end-diastolic diameter (LVEDd), left ventricular ejection fraction (LVEF), peak oxygen uptake (VO₂ peak) and 6-min walking test (6MWT) among the three groups were compared. ResultsAfter one month of treatment, anginal stability (76 ± 18), (77 ± 20), (65 ± 17)], anginal frequency (82 ± 13), (86 ± 15), (75 ± 12)] and treatment satisfaction (80 ± 12), (83 ± 13), (74 ± 14)] of patients in groups A, B and C were significantly different (F = 3.451, 6.852, 4.511; P = 0.037, 0.002, 0.014); whereas, there was no significant difference in CCS grading after treatment (H = 2.362, P = 0.307). There were significant differences in LVEDd, LVEF, VO₂ peak and 6MWT before and after treatment among the three groups (F = 11.370, 25.802, 3.367, 9.267; all P < 0.05). The further pairwise comparisons showed that LVEDd in groups A and B (44 ± 7), (44 ± 7), (51 ± 7) mm] were significantly lower than that in the group C, while LVEF (58 ± 5)%, (58 ± 6)%, (48 ± 5)%], VO₂ peak (20 ± 3), (19 ± 3), (17 ± 4) mL·min^-1·kg^-1] and 6MWT (467 ± 68), (462 ± 68), (412 ± 65) m] were significantly higher than those in the group C (all P < 0.05). ConclusionDanlou tablets combined with conventional medicine can significantly alleviate the clinical symptoms, reduce attack frequency of angina pectoris, strengthen cardiac function, and improve the quality of life in patients with ACS of phlegm stasis type after PCI.