中西医结合治疗冠心病30例临床观察

目的：观察阿托伐他汀和通心络胶囊治疗冠心病的临床疗效与安全性，以及心脑血管事件的发生情况。方法：60例冠心病患者，随机分成治疗组、对照组各30例。所有患者均常规治疗。治疗组加用阿托伐他汀20mg，1次／晚，通心络胶囊，3次／日；对照组加用阿托伐他汀20mg，1次／晚。疗程均为6个月。测定治疗前及治疗后1个月、3个月和6个月血脂水平、观察临床疗效及药物不良反应，治疗6个月后随访心脑血管事件发生情况。结果：心绞痛改善总有效率治疗组与对照组分别为86．6％和66．6％，差异有统计学意义（P〈0．05）；心电图恢复总有效率分别为76．6％和43．2％，差异有统计学意义（P〈0．05）；两组在治疗后1个月、3个月和6个月与治疗前相比均能显著降低总胆固醇（TC），低密度脂蛋白胆固醇（LDL-C）水平（P〈0．01），两组甘油三酯（TC）在治疗3个月后与治疗前相比有明显降低（P〈0．05），两组高密度酯蛋自胆固醇（HDL-C）有逐渐升高趋势，但无统计学意义；6个月随访期间，心绞痛（AP）、心力衰竭（HF）、心律失常治疗组与对照组相比有显著降低（P〈0．05），脑卒中、心肌梗死（MI）、心源性死亡、需再住院治疗亦较对照组低，但无统计学意义。结论：早期阿托伐他汀联用通心络胶囊或单用阿托伐他汀治疗冠心病均能有效调脂，但治疗组在调脂、改善临床症状、心电图恢复、减少心脑血管事件发生的作用更佳，治疗过程中无严重不良反应。

Clinical Study on the Therapeutic Effect and Safety of Combined Atorvastatin and Tongxinluo Capsule in Treating Patients with Coronary Heart Disease

Objective： To investigate the efficacy and safety of combined atorvastatin and Tongxinluo capsule in treating patients with coronary heart disease （CHD）, and to observe the incidence of cardiocerebral vascular events in 6 months. Methods： A total of 60 CHD patients were sorted at random as follows： 30 patients in treatment group （treated with atorvastatin and Tongxinluo capsule）, and 30 patients in control group. All patients were given conventional therapy. In addition, patients in treatment group were administered with 20mg atorvastatin per night and Tongxinluo capsule 4 pills each time, 3 times a day. Patients in control group were administered with only 20mg atorvastatin per night for 6 months. Serum lipid level was measured before treatment and 1 mouth, 3 mouths and 6 mouths after the treatment. Clinical efficacy and adverse drug reactions were observed. All patients were followed up for the observation of cardiocere- bral vascular events. Results： In treatment group and control group, the total effective rote for angina pectoris （AP） was 86.6% and 66.6% respectively （P〈0.05）, and the total effective rate in ECG was 76.6% and 43.2% respectively （P〈0.05） . In both groups, TC and LDL- C levels were lower at 1st mouth, 3rd mouth and 6th mouth of treatment than that of pretreatment （P〈0.01）, and TG was obviously lower at 3rd mouth of treatment than pretreatment （P〈0.05） . The level of HDL- C was heightened, but there was no significant difference in the two groups （P〉0.05） . During the 6 months of following up, the incidence of AP, HF and arrhythmia in treatment group were significantly lower than that in control group （P〈 0.05） . Conclusion： In the early stage of coronary heart disease, combined atorvastatin and Tongxinluo capsule or only atorvastatin can effectively regulate blood lipid. The combination of atorvastatin and Tongxiuluo capsule can better regulate blood lipid, improve clinical symptoms, restore ECG and lower the incidence of eadiocerebral