冠心宁片联合艾司洛尔治疗不稳定型心绞痛的临床研究

Clinical study on Guanxinning Tablets combined with esmolol in treatment of unstable angina pectoris

目的探究冠心宁片联合盐酸艾司洛尔注射液治疗不稳定型心绞痛的临床疗效。方法选取2015年1月—2016年6月凤翔县医院收治的不稳定性心绞痛患者86例为研究对象,所有患者随机分为对照组(46例)和治疗组(40例)。对照组静脉注射盐酸艾司洛尔注射液0.5 mg/(kg·min),1 min后以0.05 mg/(kg·min)静脉滴注维持,治疗中根据心功能情况随时调整给药速度。治疗组在对照组的基础上口服冠心宁片,3片/次,3次/d。两组患者连续治疗8周。观察两组的临床疗效,比较两组心绞痛发作次数、持续时间、血清超敏C反应蛋白(hs-CRP)、基质金属蛋白酶-9(MMP-9)和B型利钠肽(BNP)水平。结果治疗后,对照组和治疗组的总有效率分别为71.74%、90.00%,两组比较差异有统计学意义(P<0.05)。治疗后,对照组和治疗组的心电图总有效率分别为32.61%、52.50%,两组比较差异有统计学意义(P<0.05)。治疗后,两组心绞痛发作次数和心绞痛持续时间明显降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组hs-CRP、MMP-9和BNP水平显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P<0.05)。结论冠心宁片联合盐酸艾司洛尔注射液治疗不稳定型心绞痛具有较好的临床疗效,可改善临床症状,降低hs-CRP、MMP-9和BNP水平,安全性较好,具有一定的临床推广应用价值。

Objective To observe the clinical effect of Guanxinning Tablets combined with Esmolol Hydrochloride Injection in treatment of unstable angina pectoris. Methods Patients （86 cases） with unstable angina pectoris in Fengxiang County Hospital from January 2015 to June 2016 were randomly divided into the control group （46 cases） and treatment group （40 cases）. Patients in the control group were iv administered with Esmolol Hydrochloride Injection 0.5 mg/（kg·min）, maintenance dose of 0.05 mg/（kg·min） after 1 min according to the cardiac function to adjust the injection speed. Patients in the treatment group were po administered with Guanxinning Tablets on the basis of the control group, 3 tablets/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacies were evaluated, and angina pectoris frequency, pectoris duration, and the level of hs-CRP, MMP-9, and BNP in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 71.74% and 90.00%, respectively, and there was difference between two groups （P 〈 0.05）. After treatment, the electrocardiogram efficacies in the control and treatment groups were 32.61% and 52.50%, respectively, and there was difference between two groups （P 〈0.05）. After treatment, angina pectoris frequency and pectoris duration in two groups were significantly decreased, and the difference was statistically significant in the same group （P 〈 0.05）. And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups （P 〈 0.05）. After treatment, the levels of hs-CRP, MMP-9, and BNP in two groups were significantly decreased, and the difference was statistically significant in the same group （P 〈0.05）. And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups （P 〈 0.05）. Conclusion Guanxinning Tablets combined with Esmolol Hydrochloride Injection has clinical curative effect in treatment of unstable angina pectoris, can improve clinical symptoms, and decrease level of hs-CRP, MMP-9, and BNP, with good safety, which has a certain clinical application value.