麝香保心丸对不稳定型心绞痛患者血流动力学及血管内皮功能的影响

Influence of Shexiang Baoxin Pills on Hemorhelogy and Endothelial function in Patients with Unstable Angina

目的观察麝香保心丸对不稳定型心绞痛患者血流动力学及血管内皮功能的影响。方法选取医院就诊的不稳定型心绞痛患者96例,按就诊时间随机分为对照组和观察组,各48例。对照组患者给予替罗非班静脉滴注,起始量为0.4μg/(kg·min),持续30 min;维持剂量为0.1μg/(kg·min),持续48 h,心绞痛发作患者加服硝酸甘油、1片/次。观察组患者在此基础上加服麝香保心丸,2粒/次,3次、日。两组患者均治疗8周。结果观察组总有效率为89.58%朋显高于对照组的81.25%(P<0.05);治疗后,观察组全血黏度、血浆黏度、红细胞压积、纤维蛋白原及红细胞聚集指数均较治疗前明显降低(P<0.05)对照组患者全血黏度、纤维蛋白原及红细胞聚集指数较治疗前降低(P<0.05),组间比较,除红细胞聚集指数外,观察组上述指标均较对照组降低(P<0.05);观察组肱动脉血流介导内皮依赖性血管舒张功能(FMD)和硝酸甘油介导的非内皮依赖性血管舒张功能(NMD)均较治疗前明显改善(P<0.05),对照组仅NMD较治疗前明显降低(P<0.05),组间比较,观察组2项指标改善程度均优于对照组(P<0.05);观察组不良反应发生率为4.17%,与对照组的6.25%相当(P>0.05)。结论麝香保心丸用于不稳定型心绞痛的临床疗效好,能显著改善患者血流动力学和血管内皮功能,不良反应少,值得临床推广。

Objective To observe the influence of Shexiang Baoxin Pills combined with tirofiban on hemorhelogy and endothelial function in patients with unstable angina.Methods 96 patients diagnosed as unstable angina were randomly divided into the treatment group and the control group,48 cases in each group.The control group was treated with tirofiban,with 0.4 μg/（kg·min） at the beginning,lasting for 30 min,and the maintenance dosage of 0.1 μg/（kg·min）,lasting for 48 h.For patients who were hard to relieve himself with angina,Nitroglycerin Tablets,1 piece/time was given.Patients in treatment group took Shexiang Baoxin Pills,2 pills/time,bid.Both treatment courses continued for 8 weeks.Results The total effective rate of the observation group was 89.58%,which was significantly higher than 81.25%of the control group（P〈0.05）;after treatment,whole blood viscosity,plasma viscosity,hematocnt,fibrinogen and erythrocyte aggregation index in the observation group were obviously decreased than those before treatment（P〈0.05）,and the whole blood viscosity,erythrocyte aggregation and fibrinogen index in the control group decreased than those before treatment（P〈0.05）;compared between the two groups,except for the red blood cell aggregation index,the indexes above in the observation group decreased more than the control group（P〈0.05）.After treatment,the FMD and NMD of the observation group were significantly improved（P〈0.05）,and only NMD in the control group reduced significantly than before treatment（P〈0.05） compared between the two groups,the improvement of the two indexes in the observation group were superior to the control group（P〈0.05）.The occurrence rate of adverse reactions in the observation group was 4.17%,which had no statistically significant difference with 6.25%in the control group（P〉0.05）.Conclusion Shexiang Baoxin Pills combined with tirofiban can decrease the hemorhelogy and improve the endothelial function,with distinct clinical efficacy and fewer adverse reactions,which is worthy of clinical promotion.