麝香保心丸治疗难治性女性微血管病变性心绞痛的临床研究

Clinical study on the effect of Shexiang Baoxin Pill in the treatment of refractory female patients with microvascular angina

目的观察麝香保心丸治疗难治性女性微血管病变性心绞痛的疗效、安全性及作用机制。方法将40例微血管病变性心绞痛女性患者,冠脉造影已排除大血管病变,有心肌缺血症状且动态心电图有动态改变,已接受正规冠心病二级预防治疗6月以上,症状不缓解的患者纳入研究。把扩冠药换成麝香保心丸,与其他药物联合治疗6月后比较两组患者的冠状动脉储备能力、心绞痛发作次数、不良反应及患者的依从性。结果 40例患者均完成了6个月的治疗,治疗总有效率为70%。ST段压低最大程度降低。静息冠状动脉血流速度较治疗前明显改善,最大冠状动脉扩张状态较治疗前明显增加,注射腺苷后舒张期最大峰值血流速度与静息状态舒张期峰值血流速度的比值(CFR)明显增高。结论对于女性微血管病变所致的难治性冠心病患者给予麝香保心丸联合治疗可缓解症状、提高疗效,可能与改善冠状动脉血流储备功能有关。且安全性高,依从性好。

Objective： To observe the efficacy and safety of Shexiang Baoxin Pill in the treatment of female patients with refractory microvascular angina and to explore the mechanism. Methods： The female patients with myocardial ischemia symptoms and dynamic ECG changes,excluded large vascular disease,has accepted the formal secondary prevention and treatment of coronary heart disease for six months,40 cases of patients could not be alleviated in symptoms,they received Shexiang Baoxin Pill combination with other drugs for six months,to compare coronary artery reserve capacity,angina attack frequency,adverse reactions and patient compliance. Results： 40 patients completed the treatment for six months,the total efficiency is 70%. The maximum degree ST segment depression was reduced. Resting coronary blood flow velocity was significantly improved than before treatment,maximum coronary artery dilatation state was significantly increased,the ratio of the maximum peak diastolic blood flow velocity and resting diastolic peak flow velocity of injection of adenosine after（ CFR）increased significantly. Conclusions： Shexiang Baoxin Pill can relieve the symptoms of angina pectoris in patients with refractory coronary heart disease and improve the curative effect. High safety and good compliance.