麝香保心丸对心脏X综合征患者心肌微血管阻力的影响

Effect of Shexianbaoxin Pill on Intramyocardial Microvascular Resistance in Patients with Cardiac Syndrome X

目的:观察麝香保心丸对心脏X综合征(CSX)的疗效及其对心肌微血管阻力的影响。方法:选取江门市人民医院收治的76例CSX患者,在标准抗心绞痛治疗基础上随机分为麝香保心丸治疗组(n=38)和安慰剂对照组(n=38);随访6个月,观察两组患者临床疗效及冠脉循环生理学指标变化。结果:治疗组总有效率91.9%高于对照组的69.7%,差异具有统计学意义(P<0.05);治疗前两组患者的冠脉血流储备(CFR)、血流储备分数(FFR)及微血管阻力指数(IMR)比较,差异均无统计学意义(P>0.05)。治疗6个月后,治疗组的IMR明显低于对照组,FFR明显高于对照组,差异具有统计学意义(P<0.05);两组的CFR均升高,但差异无统计学意义(P>0.05)。结论:麝香保心丸通过降低心肌微血管阻力显著改善CSX的临床表现。

Objective To explore clinical efficacy of Shexiangbaoxin Pill and its effect on cardiac microvascular resistance in patients with cardiac syndrome X （CSX）. Methods 76 CSX patients, on the basis of standard antiangina therapy, were randomly divided into the Shexiangbaoxin Pill treatment group （treatment group, n=38） and the placebo group （control group, n=38）. The clinical outcomes and changes of coronary circulation physiology indexes were observed after 6 months follow up. Results The total effective rate （91.6 % vs 69.7, P〈0.05） and fractional flow reserve （FFR, 0.85 ±0.09 vs 0.75 ± 0.10, P 〈 0.05） were significantly higher, and the index of microvascular resistance （IMR, 19.2 ± 5.7U vs 30.5 ± 8.3U, P 〈 0.05） was significantly lower in the treatment group than in the control group, but here was no significant difference in the coronary flow reserve （CFR, 2.67 ± 0.81 vs 2.51 ± 0.67, P 〉 0.05） between two groups. After 6 months treatment, IMR was decreased （33.6 ± 7.6U vs 19.2± 5.7U, P 〈 0.05）, FFR was increased （0.73 ± 0.22 vs 0.85 ± 0.09, P 〈 0.05）, and CFR was not changed （2.33 ±0.79 vs 2.67 ± 0.81, P 〉 0.05）, significantly in the treatment group; however, IMR （33.4 ±7.9U vs 30.5 ± 8.3U,P 〉 0.05）, FFR （0.72 ± 0.24 vs 0.75 ± 0.10,P〉 0.05） and CFR （2.31±0.81 vs 2.51±0.67, P 〉 0.05） were not changed significantly in the control group. Conclusion Shexiangbaoxin Pill significantly improved the clinical outcomes of CSX patients by reducing cardiac microvascular resistance.