丹参舒心胶囊联合地尔硫卓治疗血瘀型难治型心绞痛的临床研究
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摘要
目的:探讨对血瘀型难治型心绞痛患者应用丹参舒心胶囊与地尔硫卓联合治疗后对其临床疗效的影响情况。方法:选取98例血瘀型难治型心绞痛患者作为临床研究对象,入院时间为2016年12月—2018年3月期间,采用随机数字表法分为对照组(地尔硫卓治疗,49例)和观察组(丹参舒心胶囊与地尔硫卓联合治疗,49例)。对比治疗后患者的心功能以及各临床症状改善情况。结果:经治疗后,观察组血浆黏度(1.44±0.100)、红细胞压积(39.09±3.26)%、低切(10.19±1.02)CP以及高切(3.57±0.41)CP水平明显低于对照组的血浆黏度(1.51±0.129)、红细胞压积(44.42±3.87)%、低切(11.40±1.09)CP以及高切(3.72±0.30)CP;观察组LVESD(0.95±0.10)mm、LVEDD(46.24±8.11)mm以及LVEF(54.33±9.99)%水平明显高于对照组的LVESD(1.18±0.12)mm、LVEDD(52.04±9.32)mm以及LVEF(48.76±9.47)%;观察组心绞痛发作次数(2.48±1.98)次/周以及心绞痛持续时间(2.01±1.18)min明显低于对照组的心绞痛发作次数(5.12±2.31)次/周以及心绞痛持续时间(5.01±1.88)min,差异均具有统计学意义(P<0.05)。结论:对于血瘀型难治型心绞痛患者,采用丹参舒心胶囊与地尔硫卓联合治疗可有效改善患者心功能水平,降低心绞痛发作频率及时间。
Objective: To investigate the clinical effect of Danshen Shuxin Capsule combined with diltiazem on patients with refractory angina pectoris of blood stasis type. Methods: Ninety-eight patients with blood stasis type of refractory angina pectoris were selected as clinical subjects. According to the time of admission from December 2016 to March 2018,the patients were divided into control group(diltiazem treatment, 49 cases) and observation group(combination of Danshen Shuxin Capsule and diltiazem, 49 cases). The cardiac function and the improvement of clinical symptoms were compared after treatment. Results: After treatment, the plasma viscosity(1.44±0.100), hematocrit(39.09±3.26)%, whole blood viscosity low cut(10.19±1.02)CP and whole blood viscosity high cut(3.57±0.41)CP in the observation group were significantly lower than those of the control group[plasma viscosity(1.51±0.129), hematocrit(44.42±3.87)%,whole blood viscosity low cut(11.40±39.09)CP and whole blood viscosity high cut(3.72±0.30)CP]. The levels of LVESD(0.95±0.10)mm, LVEDD(46.24±8.11)mm and LVEF(54.33±9.99)% in the observation group were significantly higher than those of the control group[LVESD(1.18±0.12) mm, LVEDD(52.04±9.32) mm and LVEF(48.76±9.47)%]. The duration of angina pectoris(2.01±1.18) min was significantly lower than that of the control group(5.12±2.31)/week and the duration of angina pectoris(5.01±1.88)min. and the difference was statistically significant(P<0.05). Conclusion: The combination of Danshen Shuxin Capsule and diltiazem can effectively improve the cardiac function and reduce the frequency and time of angina pectoris in patients with refractory angina pectoris.
Objective: To investigate the clinical effect of Danshen Shuxin Capsule combined with diltiazem on patients with refractory angina pectoris of blood stasis type. Methods: Ninety-eight patients with blood stasis type of refractory angina pectoris were selected as clinical subjects. According to the time of admission from December 2016 to March 2018,the patients were divided into control group(diltiazem treatment, 49 cases) and observation group(combination of Danshen Shuxin Capsule and diltiazem, 49 cases). The cardiac function and the improvement of clinical symptoms were compared after treatment. Results: After treatment, the plasma viscosity(1.44±0.100), hematocrit(39.09±3.26)%, whole blood viscosity low cut(10.19±1.02)CP and whole blood viscosity high cut(3.57±0.41)CP in the observation group were significantly lower than those of the control group[plasma viscosity(1.51±0.129), hematocrit(44.42±3.87)%,whole blood viscosity low cut(11.40±39.09)CP and whole blood viscosity high cut(3.72±0.30)CP]. The levels of LVESD(0.95±0.10)mm, LVEDD(46.24±8.11)mm and LVEF(54.33±9.99)% in the observation group were significantly higher than those of the control group[LVESD(1.18±0.12) mm, LVEDD(52.04±9.32) mm and LVEF(48.76±9.47)%]. The duration of angina pectoris(2.01±1.18) min was significantly lower than that of the control group(5.12±2.31)/week and the duration of angina pectoris(5.01±1.88)min. and the difference was statistically significant(P<0.05). Conclusion: The combination of Danshen Shuxin Capsule and diltiazem can effectively improve the cardiac function and reduce the frequency and time of angina pectoris in patients with refractory angina pectoris.
引文
[1] 隋吉峰,邓虎,陈岩,等.升降散联合血必净治疗气滞血瘀型冠心病心绞痛的临床疗效观察[J].世界中西医结合杂志,2018,13(2):213,216.
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[10] 李红英,陈少军,马友合,等.益气活血汤治疗气虚血瘀型不稳定性心绞痛疗效观察[J].北京中医药,2017,36(7):633,636.
[11] 段丙军,林德智,熊富权,等.通心络胶囊治疗气虚血瘀型冠心病心绞痛的疗效及作用机制[J].疑难病杂志,2016,15(10):1065-1068.
[12] Erdem O,Memetoglu ME,Tekin Ai,et al.Effects of intraoperative diltiazem infusion on flow changes in arterial and venous grafts in coronary artery bypass graft surgery[J].Braz J Cardiovasc Surg,2015,30(4):459-465.
[13] 季英敏.地尔硫卓合并疏血通注射液治疗变异性心绞痛临床观察[J].中西医结合心脑血管病杂志,2016,14(16):1911-1912.
[14] 申勇,花冠杰,莫昌干.地尔硫卓联合前列地尔治疗变异型心绞痛疗效分析[J].中国循证心血管医学杂志,2017,9(4):476-477,487.
[15] Parhi R,Suresh P.Transdermal delivery of Diltiazem HCl from matrix film:Effect of penetration enhancers and study of antihypertensive activity in rabbit model[J].J Adv Res,2016,7(3):539-550.
[16] 田云朋.贝尼地平联合尼可地尔治疗冠状动脉痉挛综合征1例[J].重庆医学,2017,46(30):4318,4319.
[17] 刘先文,许静,唐学良,等.地尔硫卓治疗非ST段抬高型急性冠状动脉综合征难治性心肌缺血的疗效分析[J].中国循证心血管医学杂志,2017,9(4):456-459.
[18] Park T,Park JY,Rha SW,et al.Impact of Diltiazem Alone versus Diltiazem with Nitrate on Five-Year Clinical Outcomes in Patients with Significant Coronary Artery Spasm[J].Yonsei Med J,2017,58(1):80-90.
[19] 杨娜.刘冰,梁晗,等.艾司洛尔治疗不稳定型心绞痛疗效及相关因素[J].西南国防医药,2017,27(1):14,17.
[20] 徐丽,朱庆贵.四逆汤结合地尔硫卓治疗变异型心绞痛临床疗效[J].陕西中医,2017,8(1):14-15.
[21] Rosenson R S,Kent S T,Brown T M,et al.Underutilization of high-intensity statin therapy after hospitalization for coronary heart disease[J].Journal of the American College of Cardiology,2015,65(3):270-277.
[22] 陈金红,李建军,倪蓓.益气活血汤对气虚血瘀型冠心病心绞痛患者心功能的影响及作用机制研究[J].四川中医,2018,36(2):79,82.
[23] 汪强,谷惠敏,朱建中,等.补阳还五汤治疗气虚血瘀型冠心病心绞痛的临床回顾性研究[J].南京中医药大学学报,2017,33(6):579-582.
[2] 谢达奇.丹参酮联合阿托伐他汀钙片治疗冠心病伴心绞痛的临床观察[J].中华中医药学刊,2016,34(2):412-414.
[3] Anderson L,Oldridge N,Thompson DR,et al.Exercisebased cardiac rehabilitation for coronary heart disease:Cochrane systematic review and meta-analysis[J].Journal of the American College of Cardiology,2016,67(1):1-12.
[4] 杨威,宁微,李滕,等.养心氏片治疗气虚血瘀型冠心病PCI术后心绞痛的临床观察[J].世界中医药,2018,13(3):614-615.
[5] 温屯清,黄鹰,周昊,等.柴郁胸痹汤加减合穴位注射治疗气郁血瘀型冠心病心绞痛60例临床观察[J].中医药导报,2017,23(19):69,71.
[6] van Diepen S,Lin M,Bakal JA,et al.Do stable non-ST-segment elevation acute coronary syndromes require admission to coronary care units[J].Am Heart J,2016,1(175):184-192.
[7] 付生弟,杜丽辉,许德俊.血栓通配合稳心颗粒治疗气虚血瘀型冠心病心绞痛临床疗效观察[J].中华中医药学刊,2018,36(4):1000-1003.
[8] 王贺,周亚滨.穴位贴敷疗法治疗冠心病不稳定性心绞痛气虚血瘀型临床观察[J].辽宁中医药大学学报,2017,19(4):109-111.
[9] Catena C,Colussi G,Brosolo G,et,a1.Aldosterone and left ventricular remodeling[J].Horm Metab Res,2015,47(13):98l-986.
[10] 李红英,陈少军,马友合,等.益气活血汤治疗气虚血瘀型不稳定性心绞痛疗效观察[J].北京中医药,2017,36(7):633,636.
[11] 段丙军,林德智,熊富权,等.通心络胶囊治疗气虚血瘀型冠心病心绞痛的疗效及作用机制[J].疑难病杂志,2016,15(10):1065-1068.
[12] Erdem O,Memetoglu ME,Tekin Ai,et al.Effects of intraoperative diltiazem infusion on flow changes in arterial and venous grafts in coronary artery bypass graft surgery[J].Braz J Cardiovasc Surg,2015,30(4):459-465.
[13] 季英敏.地尔硫卓合并疏血通注射液治疗变异性心绞痛临床观察[J].中西医结合心脑血管病杂志,2016,14(16):1911-1912.
[14] 申勇,花冠杰,莫昌干.地尔硫卓联合前列地尔治疗变异型心绞痛疗效分析[J].中国循证心血管医学杂志,2017,9(4):476-477,487.
[15] Parhi R,Suresh P.Transdermal delivery of Diltiazem HCl from matrix film:Effect of penetration enhancers and study of antihypertensive activity in rabbit model[J].J Adv Res,2016,7(3):539-550.
[16] 田云朋.贝尼地平联合尼可地尔治疗冠状动脉痉挛综合征1例[J].重庆医学,2017,46(30):4318,4319.
[17] 刘先文,许静,唐学良,等.地尔硫卓治疗非ST段抬高型急性冠状动脉综合征难治性心肌缺血的疗效分析[J].中国循证心血管医学杂志,2017,9(4):456-459.
[18] Park T,Park JY,Rha SW,et al.Impact of Diltiazem Alone versus Diltiazem with Nitrate on Five-Year Clinical Outcomes in Patients with Significant Coronary Artery Spasm[J].Yonsei Med J,2017,58(1):80-90.
[19] 杨娜.刘冰,梁晗,等.艾司洛尔治疗不稳定型心绞痛疗效及相关因素[J].西南国防医药,2017,27(1):14,17.
[20] 徐丽,朱庆贵.四逆汤结合地尔硫卓治疗变异型心绞痛临床疗效[J].陕西中医,2017,8(1):14-15.
[21] Rosenson R S,Kent S T,Brown T M,et al.Underutilization of high-intensity statin therapy after hospitalization for coronary heart disease[J].Journal of the American College of Cardiology,2015,65(3):270-277.
[22] 陈金红,李建军,倪蓓.益气活血汤对气虚血瘀型冠心病心绞痛患者心功能的影响及作用机制研究[J].四川中医,2018,36(2):79,82.
[23] 汪强,谷惠敏,朱建中,等.补阳还五汤治疗气虚血瘀型冠心病心绞痛的临床回顾性研究[J].南京中医药大学学报,2017,33(6):579-582.