脑心通胶囊联合盐酸曲美他嗪治疗老年冠心病心力衰竭气虚血瘀证临床研究
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摘要
目的:观察脑心通胶囊联合盐酸曲美他嗪治疗对老年冠心病心力衰竭气虚血瘀证的疗效及对血管内皮功能和抗氧化的影响。方法:将冠心病慢性心力衰竭患者130例按随机数字表法分为2组各65例。2组予常规治疗措施。对照组给予盐酸曲美他嗪片。观察组在对照组基础上给予脑心通胶囊。连续治疗8周后,比较2组心功能、气虚血瘀证评分、疗效以及血管性血友病因子(vWF)、内皮素-1 (ET-1)、过氧化物歧化酶(SOD)、丙二醛(MDA)水平。结果:治疗后,2组左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)较前减少(P <0.01),且观察组LVEDD、LVESD低于对照组(P <0.01)。治疗后,2组气虚血瘀证症状评分显著下降,观察组气虚血瘀证症状评分显著低于对照组(P <0.01)。总有效率观察组为90.77%,对照组为76.92%,2组比较,差异有统计学意义(P <0.05)。治疗后,2组血中vWF、ET-1、MDA水平降低及SOD水平升高,且观察组血中vWF、ET-1、MDA水平低于对照组及SOD水平高于对照组,差异有统计学意义(P <0.01)。结论:脑心通胶囊联合盐酸曲美他嗪治疗冠心病心力衰竭气虚血瘀证的疗效显著,且可改善血管内皮功能以及发挥抗氧化作用。
Objective: To observe the curative effect of Naoxintong capsules combined with trimetazidine hydrochloride tablets for coronary heart disease with heart failure in senile with syndrome of qi deficiency and blood stasis and its effect on the vascular endothelial function and antioxidation. Methods:A total of 130 cases of patients with coronary heart disease with chronic heart failure were divided into two groups according to the random number table method,65 cases in each group. The two groups were given routine treatment. The control group was given trimetazidine hydrochloride tablet for treatment,and the conservation group was additionally given Naoxintong capsules based on the treatment of the control group. After continuous treatment of eight weeks,the heart function,the scores of the syndrome of qi deficiency and blood stasis,the curative effect, and the levels of von Willebrand factor(vWF), endothelin-1(ET-1), superoxide dismutase(SOD) and malondialdehyde(MDA) in the two groups were compared. Results: After treatment, the left ventricular end-diastolic dimension(LVEDD) and the left ventricular end-systolic dimension(LVESD) in the two groups were decreased when compared with those before treatment(P < 0.01),and the LVEDD and LVESD in the observation were lower than those in the control group(P < 0.01). After treatment,the symptom scores of syndrome of qi deficiency and blood stasis in the two groups were significantly decreased,and the decrease in the observation group was more obvious than that in the control group(P < 0.01).The total effective rate was 90.77% in the observation group and 76.92% in the control group,the difference being significant(P < 0.05). After treatment,the levels of vWF,ET-1 and MDA were decreased in blood in the two groups,and the level of SOD in the two groups were increased. The levels of vWF,ET-1 and MDA in the observation group were lower than those in the control group,and the level of SOD in the observation group was higher than that in the control group, the difference being significant(P < 0.01). Conclusion:The therapy of Naoxintong capsules combined with trimetazidine hydrochloride tablets for coronary heart disease with heart failure in senile with syndrome of qi deficiency and blood stasis has significant curative effect,which can improve the vascular endothelial function with antioxidation.
Objective: To observe the curative effect of Naoxintong capsules combined with trimetazidine hydrochloride tablets for coronary heart disease with heart failure in senile with syndrome of qi deficiency and blood stasis and its effect on the vascular endothelial function and antioxidation. Methods:A total of 130 cases of patients with coronary heart disease with chronic heart failure were divided into two groups according to the random number table method,65 cases in each group. The two groups were given routine treatment. The control group was given trimetazidine hydrochloride tablet for treatment,and the conservation group was additionally given Naoxintong capsules based on the treatment of the control group. After continuous treatment of eight weeks,the heart function,the scores of the syndrome of qi deficiency and blood stasis,the curative effect, and the levels of von Willebrand factor(vWF), endothelin-1(ET-1), superoxide dismutase(SOD) and malondialdehyde(MDA) in the two groups were compared. Results: After treatment, the left ventricular end-diastolic dimension(LVEDD) and the left ventricular end-systolic dimension(LVESD) in the two groups were decreased when compared with those before treatment(P < 0.01),and the LVEDD and LVESD in the observation were lower than those in the control group(P < 0.01). After treatment,the symptom scores of syndrome of qi deficiency and blood stasis in the two groups were significantly decreased,and the decrease in the observation group was more obvious than that in the control group(P < 0.01).The total effective rate was 90.77% in the observation group and 76.92% in the control group,the difference being significant(P < 0.05). After treatment,the levels of vWF,ET-1 and MDA were decreased in blood in the two groups,and the level of SOD in the two groups were increased. The levels of vWF,ET-1 and MDA in the observation group were lower than those in the control group,and the level of SOD in the observation group was higher than that in the control group, the difference being significant(P < 0.01). Conclusion:The therapy of Naoxintong capsules combined with trimetazidine hydrochloride tablets for coronary heart disease with heart failure in senile with syndrome of qi deficiency and blood stasis has significant curative effect,which can improve the vascular endothelial function with antioxidation.
引文
[1]傅国胜,邱福宇.冠心病合并心力衰竭的介入治疗策略[J].中国循环杂志,2017,32(8):729-731.
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[4]范亚坤,梁芳,赵旭兰,等.曲美他嗪对老年冠心病心力衰竭患者内皮功能的影响[J].河北医药,2015,37(21):3285-3287.
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[8]冠心病中医临床研究联盟,中国中西医结合学会心血管疾病专业委员会.慢性心力衰竭中医诊疗专家共识[J].中医杂志,2014,55(14):1258-1260.
[9]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:77-85.
[10]顾琰华,韩旭.谫论韩旭教授从气论治冠心病的临床经验[J].浙江中医药大学学报,2017,41(10):831-833.
[11] Wannamethee SG,Papacosta O,Lennon L,et al.Serum magnesium and risk of incident heart failure in older men:The British Regional Heart Study[J].Eur J Epidemiol,2018,33(9):873-882.
[2]顾丽萍,胡菁,严蜀华.美托洛尔与曲美他嗪治疗老年冠心病心力衰竭的疗效及对患者心功能、心肌重塑和炎症因子的影响[J].中国老年学杂志,2017,37(1):89-91.
[3]于占文,朱志芳,姚惠亚.脑心通胶囊联合常规疗法治疗冠心病心力衰竭临床观察[J].新中医,2017,49(12):14-16.
[4]范亚坤,梁芳,赵旭兰,等.曲美他嗪对老年冠心病心力衰竭患者内皮功能的影响[J].河北医药,2015,37(21):3285-3287.
[5] Radovanovic S,Savic-Radojevic A,Pljesa-Ercegovac M,et al.Markers of oxidative damage and antioxidant enzyme activities as predictors of morbidity and mortality in patients with chronic heart failure[J].J Card Fail,2012,18(6):493-501.
[6]中华医学会心血管病学分会.中国心力衰竭诊断和治疗指南2014[J].中华心血管病杂志,2014,42(2):675-690.
[7]颜红兵.临床冠心病诊断与治疗指南[M].北京:人民卫生出版社,2010:17-55.
[8]冠心病中医临床研究联盟,中国中西医结合学会心血管疾病专业委员会.慢性心力衰竭中医诊疗专家共识[J].中医杂志,2014,55(14):1258-1260.
[9]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:77-85.
[10]顾琰华,韩旭.谫论韩旭教授从气论治冠心病的临床经验[J].浙江中医药大学学报,2017,41(10):831-833.
[11] Wannamethee SG,Papacosta O,Lennon L,et al.Serum magnesium and risk of incident heart failure in older men:The British Regional Heart Study[J].Eur J Epidemiol,2018,33(9):873-882.