灯盏细辛联合氯吡格雷治疗不稳定型心绞痛疗效及其对血液学指标的影响

Clinical effect and influence on hemorrheology indexes of herba erigerontis combined with clopidogrel in treating unstable angina pectoris

目的观察灯盏细辛联合氯吡格雷治疗不稳定型心绞痛的临床疗效及其对患者血液流变学指标的影响。方法将2011年9月至2013年9月收治的不稳定型心绞痛患者68例按随机分配的原则分为治疗组35例,对照组33例。对照组予以常规治疗,治疗组在对照组基础上加用硫酸氯吡格雷片、灯盏细辛注射液。3个月后观察两组心绞痛发作情况、心电图心肌缺血情况和血液流变学指标变化情况。结果治疗后观察组心绞痛缓解总有效率为94.2%(33/35),对照组为72.7%(24/33),两组间比较差异有统计学意义(P<0.05)。两组间静态心电图心肌缺血性改变情况比较差异有统计学意义(P<0.05)。治疗后两组患者血浆粘度及血沉指标均有所改善(P<0.01),但治疗组还能够改善纤维蛋白原、红细胞聚集指数、血小板聚集率;两组间比较,治疗组能够更明显地改善血流变学指标(P<0.05)。结论灯盏细辛注射液联合氯吡格雷片治疗不稳定型心绞痛可减少心绞痛发作,改善微循环灌注,改善血流变学指标。

Objective To investigate the clinical effect and influence on hemorrheology indexes of herba erigerontis combined with clopidogrel in treating unstable angina pectoris. Methods Sixty-eight patients with unstable angina pectoris were divided into two groups randomly： the control group （33 cases） was given conventional treatment, and the treatment group （35 cases） was treated with herba erigerontis combined with clopidogrel on the base of conventional therapy. The angina pectoris attacks, myocardial isehemia on ECG, and hemorrheology indexes in two groups were observed after 3 months of treatment. Results After treatment, the total effective rate were 94.2% （33/ 35） in treatment group, and 72.7% （24/33） in control group with statistically significant difference （P〈0.05）. The difference of myocardial isehemic changes on static ECG between two groups was statistically significant （P〈0.05）. After treatment, the plasma viscosities and erythrocyte sedimentation rates in two groups were all improved （P〈0.05）, and the fibrinogen, erythrocyte aggregation index and platelet aggregation rate were also improved in treatment group. However, the hemorrheology indexes in treatment group were improved more obviously than those in control group. Conclusion Herba erigerontis combined with clopidogrel can reduce the angina attacks when treating unstable angina pectoris and it also takes effects on improvement of mierocireulation and hemorrheology indexes.