麝香保心丸联合尼可地尔对老年冠心病患者心功能、同型半胱氨酸及血浆内皮素-1水平的影响

Effect of Shexiang Baoxin Pill combined with Nicordil on the cardiac function, Hcy and plasma endothelin-1 levels in elderly patients with coronary atherosclerotic heart disease

目的探讨麝香保心丸联合尼可地尔对老年冠心病患者心功能、同型半胱氨酸(homocysteine,Hcy)及血浆内皮素-1(plasma endothelin-1,ET-1)水平的影响。方法选取2016年1月至2017年4月于山东中医药大学附属医院就诊的老年冠心病患者86例为研究对象,按照随机数表法将入选患者分为观察组和对照组,每组各43例。对照组患者采取常规治疗,观察组患者采取麝香保心丸联合尼可地尔治疗。两组患者均治疗6个月。比较两组患者治疗前后心功能改善情况、Hcy和ET-1水平变化情况、心绞痛发作次数及持续时间。结果治疗后,观察组患者射血分数、心输出量、Hcy及一氧化氮水平均显著高于对照组(P_均<0.01),心率、纽约心脏病协会心功能分级及血清脑钠肽、爱帕琳肽、ET-1水平均显著低于对照组(P_均<0.05),心绞痛周发作次数显著少于对照组(P<0.01),心绞痛发作持续时间显著短于对照组(P<0.05)。结论麝香保心丸联合尼可地尔治疗老年冠心病,可改善患者心功能,提高Hcy水平,降低ET-1水平,减少心绞痛发作次数,缩短心绞痛发作持续时间,值得临床推广。

Objective To investigate the effect of Shexiang Baoxin pill combined with Nicordil on the cardiac function, homocysteine（Hcy） and plasma endothelin-1（ET-1） levels in elderly patients with coronary atherosclerotic heart disease. Method From January 2016 to April 2017, 86 elderly patients with coronary Affiliated Hospital of Shandong University of Traditional Chinese Medicine heart disease in were selected as the subjects. According to the random number table method, they were divided into observation group and control group, 43 cases in each group. Control group patients were treated with routine therapy, observation group patients were treated with Shexiang Baoxin Pill and Nicorandil. The two groups were treated for 6 months. The improvement of cardiac function, the changes of Hcy and plasma ET-1 levels, the frequency and duration of angina pectoris were compared between the two groups before and after treatment. Result After treatment, the levels of ejection fraction, cardiac output, Hcy and nitric oxide in observation group were significantly higher than those in control group（P（all） 0.01）, the heart rate, heart function classification of New York Heart Association, serum brain natriuretic peptide, Apelin and ET-1 levels were significantly lower than those in control group（Pall〈0.05）, and the frequency of angina pectoris perweek was significantly less than that of control group（P〈0.05）, the duration of angina pectoris was significantly shorter than that in control group（P〈0.05）. Conclusion Shexiang Baoxin Pills combined with Nicordil in the treatment of elderly patients with coronary heart disease, can improve their heart function, increase the level of Hcy and reduce the level of ET-1, reduce the frequency of angina pectoris and shorten the duration of angina pectoris, which is worthy of clinical promotion.