大株红景天注射液联合尼可地尔治疗冠心病的临床研究

Clinical study on Sofren Injection combined with nicorandil in treatment of coronary disease

目的探讨应用大株红景天注射液联合尼可地尔治疗冠心病的临床效果。方法选取2016年6月—2018年1月深圳市龙华区人民医院收治的冠心病患者126例,随机分成对照组(63例)与治疗组(63例)。对照组口服尼可地尔片,5 mg/次,3次/d。治疗组在对照组基础上静脉滴注大株红景天注射液,10 mL加入5%葡萄糖液250 mL,1次/d。两组均连续治疗14 d。观察两组患者心绞痛症状和心电图疗效,同时比较治疗前后两组患者E峰与A峰的速度比值(E/A)、左室射血分数(LVEF)、血浆黏度(PV)、红细胞比容(Hct)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、血清载脂蛋白(Apo)B/Apo A1比值、同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)、脂联素(APN)、白细胞介素(IL)-35和颈动脉超声参数变化。结果治疗后,对照组心绞痛症状和心电图总有效率分别为81.0%和76.2%,均分别显著低于治疗组的93.7%和90.5%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组E/A、LVEF值均显著增加(P<0.05),PV、HCT值和血清LDH、CK-MB浓度均显著降低(P<0.05),且治疗后治疗组这些指标明显优于对照组(P<0.05)。治疗后,两组颈总动脉IMT和内径值均显著缩小(P<0.05),且治疗组IMT和内径值明显小于对照组(P<0.05)。治疗后,两组血清Apo B/Apo A1比值和Hcy、hs-CRP浓度均显著降低(P<0.05),APN、IL-35含量显著上升(P<0.05),且治疗后治疗组上述指标明显优于对照组(P<0.05)。结论应用大株红景天注射液联合尼可地尔治疗冠心病可明显改善心电图和心功能,调节血液流变学状态,延缓病情进展,具有一定的临床推广应用价值。

objective To explore the clinical effect of Sofren Injection combined with nicorandil in treatment of coronary disease. Methods Patients（126 cases） with coronary disease in Longhua District People＇s Hospital from June 2016 to January 2018 were randomly divided into control（63 cases） and treatment（63 cases） groups. Patients in the control group were po administered with Nicorandil Tablets, 5 mg/time, three times daily. Patients in the treatment group were iv administered with Sofren Injection on the basis of the control group, 10 mL added into 5% glucose solution 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the angina curative effect and the ECG efficacy was evaluated, and the changes of E/A, LVEF, PV, Hct, LDH, CK-MB, Apo B/Apo A1, Hcy, hs-CRP, APN, IL-35, and the carotid ultrasound parameters in two groups before and after treatment were compared. Results After treatment, the angina curative effect in the control group was 81%, and the ECG efficacy was 76.2%, which were significantly lower than 93.7% and 90.5% in the treatment group, respectively, and there were differences between two groups（P〈0.05）. After treatment, the E/A and LVEF levels in two groups were significantly increased（P〈0.05）, but PV, HCT, LDH and CK-MB levels were significantly decreased（P〈0.05）, and these indicators in the treatment group after treatment were significantly better than those in the control group（P〈0.05）. After treatment, the IMT and internal diameter of common carotid artery in two groups were significantly reduced（P〈0.05）, and the IMT and internal diameter in the treatment group after treatment were significantly smaller than those in the control group（P〈0.05）. After treatment, the Apo B/Apo A1, Hcy and hs-CRP levels in two groups were significantly decreased（P〈0.05）, but APN and IL-35 levels were significantly increased（P〈0.05）, and these indicators in the treatment group after treatment were significantly better than those in the control group（P〈0.05）. Conclusion Sofren Injection combined with nicorandil in treatment of coronary disease can obviously improve the electrocardiogram and heart function, regulate the blood rheology and delay disease progress, which has a certain clinical application value.