麝香保心丸与曲美他嗪联合治疗老年冠心病心绞痛的疗效及对血浆BNP水平的影响
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摘要
目的:分析麝香保心丸联合曲美他嗪治疗老年冠心病心绞痛的疗效及对血浆B型脑钠肽(BNP)水平的影响。方法:选取2010年1月-2015年1月我院收治的老年冠心病心绞痛患者128例作为研究对象,采用随机数字表法将其分为实验组(64例)和对照组(64例),单纯使用曲美他嗪对对照组患者进行治疗,联合使用麝香保心丸和曲美他嗪对实验组患者进行治疗,观察两组患者的临床疗效,比较治疗前后两组血浆BNP水平、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)以及左室射血分数(LVEF),统计两组的不良反应。结果:实验组的治疗总有效率为92.19%,明显高于对照组的62.50%,差异具有统计学意义(P<0.05);治疗后,实验组与对照组血浆BNP、LVEDD、LVESD、LVEF均得到改善,但是实验组改善更明显,差异具有统计学意义(P<0.05);两组不良反应率比较,无统计学差异(P>0.05)。结论:应用麝香保心丸联合曲美他嗪治疗老年冠心病心绞痛的临床疗效显著,且明显降低血浆BNP水平,值得在临床上推广应用。
Objective: To analyze the effect of Shexiang Baoxin Pill combined with trimetazidine in the treatment of senile patients with coronary heart disease angina pectoris and its influence on plasma brain natriuretic peptide(BNP) levels. Methods: 128 cases of senile patients with coronary heart disease angina pectoris treated in our hospital were selected as the objects from January 2010 to January 2015, they were divided into experimental group(64 cases) and control group(64 cases) according to the random number table method. The control group was treated by Trimetazidine, the experimental group was treated by Shexiang Baoxin Pill combined with trimetazidine. Observed and compared the clinical efficacy of the two groups and compared the plasma BNP level, left ventricular end diastolic diameter(LVEDD), left ventricular end systolic diameter(LVESD) and left ventricular ejection fraction(LVEF) of two groups before and after treatment, analyzed the adverse reations in the two groups. Results: The total effective rate of treatment group was 92.19%, which was significantly higher than 62.50% in control group(P<0.05). After treatment, the plasma BNP level, LVEDD, LVESD,LVEF in experimental group and control group were improved, but the experimental group improved more significantly, and the differences were statistically significant(P<0.05). The incidence of adverse reactions between the two groups had no significant difference(P>0.05). Conclusion: The Shexiang Baoxin Pill combined with trimetazidine has better clinical effect in the treatment senile patients with coronary heart disease angina pectoris, which could significantly decreases the plasma BNP level, it is worthy of clinical application.
Objective: To analyze the effect of Shexiang Baoxin Pill combined with trimetazidine in the treatment of senile patients with coronary heart disease angina pectoris and its influence on plasma brain natriuretic peptide(BNP) levels. Methods: 128 cases of senile patients with coronary heart disease angina pectoris treated in our hospital were selected as the objects from January 2010 to January 2015, they were divided into experimental group(64 cases) and control group(64 cases) according to the random number table method. The control group was treated by Trimetazidine, the experimental group was treated by Shexiang Baoxin Pill combined with trimetazidine. Observed and compared the clinical efficacy of the two groups and compared the plasma BNP level, left ventricular end diastolic diameter(LVEDD), left ventricular end systolic diameter(LVESD) and left ventricular ejection fraction(LVEF) of two groups before and after treatment, analyzed the adverse reations in the two groups. Results: The total effective rate of treatment group was 92.19%, which was significantly higher than 62.50% in control group(P<0.05). After treatment, the plasma BNP level, LVEDD, LVESD,LVEF in experimental group and control group were improved, but the experimental group improved more significantly, and the differences were statistically significant(P<0.05). The incidence of adverse reactions between the two groups had no significant difference(P>0.05). Conclusion: The Shexiang Baoxin Pill combined with trimetazidine has better clinical effect in the treatment senile patients with coronary heart disease angina pectoris, which could significantly decreases the plasma BNP level, it is worthy of clinical application.
引文
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[13]Xiong XJ,Wang Z,Wang J.Innovative Strategy in Treating Angina Pectoris with Chinese Patent Medicines by Promoting Blood Circulation and Removing Blood Stasis:Experience from Combination Therapy in Chinese Medicine[J].Curr Vasc Pharmacol,2015,13(4):540-553
[14]Tsioufis K,Andrikopoulos G,Manolis A.Trimetazidine and cardioprotection:facts and perspectives[J].Angiology,2015,66(3):204-210
[15]Xiang L,Jiang P,Zhan C,et al.The serum metabolomic study of intervention effects of the traditional Chinese medicine Shexiang Baoxin Pilland a multi-component medicine polypill in the treatment of myocardial infarction in rats[J].Mol Biosyst,2012,8(9):2434-2442
[16]Wei G,Ningfu W,Xianhua Y,et al.N-terminal pro-B-type natriuretic peptide is associated with severity of the coronary lesions in unstable angina patients with preserved left ventricular function[J].J Interv Cardiol,2012,25(2):126-131
[17]Yücel M,Avsarogullari L,Durukan P,et al.BNP shows myocardial injury earlier than Troponin-I in experimental carbon monoxide poisoning[J].Eur Rev Med Pharmacol Sci,2016,20(6):1149-1154
[18]Wei P,Wang HB,Fu Q,et al.Levels of BNP and stress blood glucose in acute coronary syndrome patients and their relationships with the severity of coronary artery lesion[J].Cell Biochem Biophys,2014,68(3):535-539
[19]Romel SM,Faruque M,Bari MA,et al.Association between elevated B-type Natriuretic Peptide levels with extent of coronary artery disease in patients with unstable angina and NSTEMI[J].Mymensingh Med J,2014,23(3):544-551
[20]Fan FF,Xu Q,Sun Q,et al.Assessment of the Reporting Quality of Randomized Controlled Trials on Treatment of Coronary Heart Disease with Traditional Chinese Medicine from the Chinese Journal of Integrated Traditional and Western Medicine:A Systematic Review[J].PLo S One,2014,9(1):e86360
[2]Jiang P,Dai W,Yan S,et al.Biomarkers in the early period of a cute myocardial infarction in rat serum and protective effects of Shexiang Baoxin Pill using a metabolomic method[J].J Ethnopharmacol,2011,138(2):530-536
[3]Chrusciel P,Rysz J,Banach M.D efining the Role of Trimetazidine in the Treatment of Cardiovascular Disorders:Some Insights on Its Role in Heart Failure and Peripheral Artery Disease[J].Drugs,2014,74(9):971-980
[4]Lee PH,Ahn JM,Chang M,et al.Left Main Coronary Artery Disease:Secular Trends in Patient Characteristics,Treatments,and Outcomes[J].J Am Coll Cardiol,2016,68(11):1233-1246
[5]Mc Carthy CP,Mullins KV,Kerins DM.The role of trimetazidine in cardiovascular disease:beyond an anti-anginal agent[J].Eur Heart J Cardiovasc Pharmacother,2016,2(4):266-272
[6]王爽,武卫党,耿蓬勃,等.硝酸异山梨酯片联合美托洛尔治疗老年冠心病心绞痛的疗效及对IL-18及hs-CRP水平的影响[J].现代生物医学进展,2013,13(27):5292-5295Wang Shuang,Wu Wei-dang,Geng Peng-bo,et al.Clinical Effect of Isosorbide Dinitrate Tablets Combined with Metoprolol on Senile Patients with Angina Pectoris and its Influence on IL-18 and hs-CRP Levels[J].Progress in Modern Biomedicine,2013,13(27):5292-5295
[7]Jiang B,Cai F,Gao S,et al.Induction of cytochrome P450 3A by Shexiang Baoxin Pill and its main components[J].Chem Biol Interact,2012,195(2):105-113
[8]Suner A,Cetin M.The effect of trimetazidine on ventricular repolarization indexes and left ventricular diastolic function in patients with coronary slow flow[J].Coron Artery Dis,2016,27(5):398-404
[9]Zhang J,He S,Wang X,et al.Effect of trimetazidine on heart rate variability in elderly patients with acute coronary syndrome[J].Pak J Med Sci,2016,32(1):75-78
[10]Xu X,Zhang W,Zhou Y,et al.Effect of trimetazidine on recurrent angina pectoris and left ventricular structure in elderly multivessel coronary heart disease patients with diabetes mellitus after drug-eluting stent implantation:a single-centre,prospective,randomized,double-blind study at 2-year follow-up[J].Clin Drug Investig,2014,34(4):251-258
[11]Li Y,Wang D,Hu C,et al.Efficacy and Safety of Adjunctive Trimetazidine Therapy for Acute Myocardial Infarction:A Systematic Review and Meta-Analysis[J].Cardiology,2016,135(3):188-195
[12]Kim JS,K im CH,Chun KJ,et al.Effects of trimetazidine in patients with acute myocardial infarction:data from the Korean Acute Myocardial Infarction Registry[J].Clin Res Cardiol,2013,102(12):915-922
[13]Xiong XJ,Wang Z,Wang J.Innovative Strategy in Treating Angina Pectoris with Chinese Patent Medicines by Promoting Blood Circulation and Removing Blood Stasis:Experience from Combination Therapy in Chinese Medicine[J].Curr Vasc Pharmacol,2015,13(4):540-553
[14]Tsioufis K,Andrikopoulos G,Manolis A.Trimetazidine and cardioprotection:facts and perspectives[J].Angiology,2015,66(3):204-210
[15]Xiang L,Jiang P,Zhan C,et al.The serum metabolomic study of intervention effects of the traditional Chinese medicine Shexiang Baoxin Pilland a multi-component medicine polypill in the treatment of myocardial infarction in rats[J].Mol Biosyst,2012,8(9):2434-2442
[16]Wei G,Ningfu W,Xianhua Y,et al.N-terminal pro-B-type natriuretic peptide is associated with severity of the coronary lesions in unstable angina patients with preserved left ventricular function[J].J Interv Cardiol,2012,25(2):126-131
[17]Yücel M,Avsarogullari L,Durukan P,et al.BNP shows myocardial injury earlier than Troponin-I in experimental carbon monoxide poisoning[J].Eur Rev Med Pharmacol Sci,2016,20(6):1149-1154
[18]Wei P,Wang HB,Fu Q,et al.Levels of BNP and stress blood glucose in acute coronary syndrome patients and their relationships with the severity of coronary artery lesion[J].Cell Biochem Biophys,2014,68(3):535-539
[19]Romel SM,Faruque M,Bari MA,et al.Association between elevated B-type Natriuretic Peptide levels with extent of coronary artery disease in patients with unstable angina and NSTEMI[J].Mymensingh Med J,2014,23(3):544-551
[20]Fan FF,Xu Q,Sun Q,et al.Assessment of the Reporting Quality of Randomized Controlled Trials on Treatment of Coronary Heart Disease with Traditional Chinese Medicine from the Chinese Journal of Integrated Traditional and Western Medicine:A Systematic Review[J].PLo S One,2014,9(1):e86360