降脂通络软胶囊与冠心宁片联合西药治疗气滞血瘀型慢性稳定型心绞痛临床研究

目的：观察降脂通络软胶囊与冠心宁片联合西药治疗气滞血瘀型慢性稳定型心绞痛的临床疗效及对心电图指标的影响。方法：将138 例气滞血瘀型慢性稳定型心绞痛患者按照随机数字表法分为对照组和研究组各69 例。2 组均予常规西药治疗，研究组加予降脂通络软胶囊联合冠心宁片口服治疗，2 组均治疗8 周。治疗前后统计患者的心绞痛发作频率、每次心绞痛发作持续时间，评定中医证候评分；进行24 h 动态心电图检查，比较ST 段压低次数、ST 段压低最大值和ST 段压低总时间；测定血清N-末端脑钠肽前体（NT-proBNP）、同型半胱氨酸（Hcy） 含量。比较2 组临床疗效和不良反应发生率。结果：治疗8 周后，研究组总有效率（92.75%） 高于对照组（73.91%），差异有统计学意义（P＜0.05）。2 组心绞痛发作频率均较治疗前降低，心绞痛发作持续时间均较治疗前缩短，差异均有统计学意义（P＜0.05）。研究组心绞痛发作频率低于对照组，心绞痛发作持续时间短于对照组，差异均有统计学意义（P＜0.05）。2 组ST 段压低次数、ST 段压低最大值均较治疗前减少，ST 段压低总时间均较治疗前缩短，差异均有统计学意义（P＜0.05）。研究组ST 段压低次数少于对照组，ST 段压低最大值低于对照组，ST 段压低总时间短于对照组，差异均有统计学意义（P＜0.05）。2 组血清NT-proBNP、Hcy 含量均较治疗前下降（P＜0.05）。研究组血清NT-proBNP、Hcy 含量均低于对照组（P＜0.05）。2 组不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：在常规西药治疗基础上加予降脂通络软胶囊联合冠心宁片治疗，可有效缓解气滞血瘀型慢性稳定型心绞痛患者的临床症状，改善心脏功能，发挥保护心肌作用，且不增加用药风险。

Clinical Study on Jiangzhi Tongluo Soft Capsules and Guanxinning Tablets Combinedwith Western Medicine for Chronic Stable Angina Pectoris of Qi Stagnation and BloodStasis Type

Abstract：Objective：To observe the clinical effect of the therapy of Jiangzhi Tongluo Soft Capsules andGuanxinning Tablets combined with western medicine on chronic stable angina pectoris of qi stagnation andblood stasis type and its influence on electrocardiogram indexes. Methods： A total of 138 patients withchronic stable angina pectoris of qi stagnation and blood stasis type were divided into the control group andthe study group according to random number table method，with 69 patients in each group. The two groupswere treated with conventional western medicine， and the study group was additionally treated withJiangzhi Tongluo Soft Capsules and Guanxinning Tablets orally. Both groups were treated for 8 weeks.Before and after treatment，the frequency of angina pectoris and the duration of each angina pectoris attackwere measured， and the traditional Chinese medicine syndrome scores were evaluated； 24-hour holterelectrocardiogram was performed to compare the times of ST segment depression， the maximum STsegment depression and the total time of ST segment depression； the contents of N-terminal brainnatriuretic peptide precursor (NT-proBNP) and homocysteine (Hcy) in serum were determined. The clinicaleffects and incidence of adverse reactions were compared between the two groups. Results ： After8 weeks of treatment，the total effective rate was 92.75% in the study group，higher than that of 73.91%in the control group， the difference being significant (P＜0.05). The frequency of angina pectoris attack inthe two groups were decreased when compared with those before treatment，and the duration of anginapectoris attack were shortened when compared with those before treatment，differences being significant(P＜0.05). The frequency of angina pectoris attack in the study group was lower than that in the controlgroup， and the duration of angina pectoris attack was shorter than that in the control group， differencesbeing significant (P＜0.05). The times of ST segment depression and the maximum ST segment depressionin the two groups were decreased when compared with those before treatment，and the total time of STsegment depression were shortened when compared with those before treatment， differences beingsignificant (P＜0.05). The time of ST segment depression in the study group was lower than that in thecontrol group， the maximum ST segment depression was lower than that in the control group， and thetotal time of ST segment depression was shorter than that in the control group， differences beingsignificant (P＜0.05). The contents of serum NT-proBNP and Hcy in the two groups were decreased whencompared with those before treatment (P＜0.05). The contents of serum NT-proBNP and Hcy in the studygroup were lower than those in the control group (P＜0.05). There was no significant difference in theincidence of adverse reactions between the two groups (P＞0.05). Conclusion： The therapy of JiangzhiTongluo Soft Capsules and Guanxinning Tablets combined with western medicine can relieve the clinicalsymptoms of chronic stable angina pectoris of qi stagnation and blood stasis type， improve the heartfunction，protect the myocardium，and do not increase the risk of medication.