通窍救心油舌下给药治疗冠心病不稳定型心绞痛30例临床观察

Clinical Observation on Sublingual Tongqiao Jiuxin You (通窍救心油) in Treating 30 Cases of Unstable Angina

目的评价通窍救心油舌下给药治疗冠心病不稳定型心绞痛的疗效及安全性。方法选择冠心病不稳定型心绞痛患者118例,随机分为舌下组30例、口服组29例、外搽组31例及对照组28例。在西医标准疗法的基础上,舌下组舌下含服通窍救心油;口服组口服通窍救心油;外搽组用通窍救心油外搽人中穴;对照组口服硝酸异山梨酯片,心绞痛发作时可临时增加1次用药,各组均治疗7天。治疗前后观察每周心绞痛发作次数、胸痛程度积分、胸闷程度积分,并于治疗后评价患者心绞痛缓解时间疗效、心电图疗效及安全性。结果治疗后各组每周心绞痛发作次数、胸痛程度积分、胸闷程度积分、心绞痛缓解时间疗效、心电图疗效均较治疗前好转(P<0.05);治疗后舌下组心绞痛缓解时间总有效率与口服组、外搽组、对照组比较差异均无统计学意义,但舌下组每周心绞痛发作次数、胸痛程度积分、胸闷程度积分、心绞痛缓解时间显效率及心电图有效率均优于口服组与外擦组(P<0.0167),与对照组比较疗效相当。观察期间,对各组患者试验前后肝、肾功能,血、尿、便常规的异常结果进行了统计描述,各组均无加重。结论通窍救心油舌下给药治疗冠心病不稳定型心绞痛疗效确切且安全,在快速缓解心绞痛、减少心绞痛发作次数、减轻胸痛胸闷程度、改善心电图心肌缺血方面与硝酸异山梨酯片疗效相当,起效时间明显优于外搽及口服给药。

Objective To evaluate the efficacy and safety of sublingual Tongqiao Jiuxin You（ 通窍救心油,TJY）in treating unstable angina. Methods Totally 118 patients with unstable angina were selected,and they were randomized into a sublingual group（ 30 cases）,an oral group（ 29 cases）,a topical application group（ 31 cases） and a control group（ 28 cases）. In addition to the standard western medicine treatment,the sublingual group was given sublingual TJY,while the oral group was given oral TJY,the topical application group TJY externally applied to point Renzhong（ DU26） and the control group was given oral Isosorbide Dinitrate Tablets. All patients could additionally take the same medicine when angina attacked. All groups were treated for 7 days. Before and after treatment,weekly angina attack number,chest pain score and chest tightness score were observed. The efficacy of angina remission time and electrocardiogram（ ECG） efficacy and safety were evaluated after treatment. Results After treatment,the weekly angina attack number,chest pain score,chest tightness score,efficacy of angina remission time and ECG efficacy in each group were all improved significantly than before（ P 0. 05）. There was no significant difference in total effective rate of angina remission time between the sublingual group and the oral group,the topical application group and the control group. Compared with those in the oral group and the topical application group,the weekly angina attack number,chest pain score,chest tightness score,efficacy of angina remission time and ECG efficacy in the sublingual group were significant better（ P 0. 0167）,while there were the equal effecy in the weekly angina attack number,chest pain score,chest tightness score,efficacy of angina remission time and ECG efficacy between the sublingual group and the control group. There were no differences in the abnormal results of liver and kidney function,as well as the blood,urine and stool routine tests between before and after treatment in all groups. Conclusion Sublingual TJY in the treatment of unstable angina seems effective and safe. It seems equivalent to Isosorbide Dinitrate Tablets in rapidly relieving angina,reducing the number of angina attacks,reducing chest pain and chest tightness degrees and improving myocardial ischemia showed in ECG. The effective time in the sublingual administration seems better than the topical application and the oral administration.