愈心痛胶囊联合尼可地尔治疗微血管性心绞痛的临床研究

Clinical study on Yuxintong Capsules combined with nicorandil in treatment of microvascular angina

目的探讨愈心痛胶囊联合尼可地尔片治疗微血管性心绞痛的临床疗效。方法选取2017年2月—2018年2月在大连市第三人民医院治疗的微血管性心绞痛患者82例,根据用药的差别分为对照组(41例)和治疗组(41例)。对照组口服尼可地尔片,5mg/次,3次/d;治疗组在对照组基础上口服愈心痛胶囊,4粒/次,3次/d。两组患者均治疗4周。观察两组患者临床疗效,同时比较治疗前后两组患者心绞痛发作次数和持续时间及心电图指标、血管内皮功能和炎症指标。结果治疗后,对照组临床有效率为80.49%,显著低于治疗组的97.56%,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都显著降低(P<0.05),且治疗组心绞痛发作次数和持续时间明显少于对照组(P<0.05)。治疗后,两组运动平板试验的总运动时间和ST段压低0.1 mV时间明显延长(P<0.05),ST段最大压低幅度显著减小(P<0.05),且治疗组心电图相关指标明显优于对照组(P<0.05)。治疗后,两组内皮素-1(ET-1)水平显著降低(P<0.05),一氧化氮(NO)水平显著升高(P<0.05),且治疗组ET-1和NO水平明显优于对照组(P<0.05)。治疗后,两组血清C反应蛋白(CRP)、白细胞介素-1(IL-1)、脂蛋白相关磷脂酶A2(Lp-PLA2)、IL-6水平均显著降低(P<0.05),且治疗组上述炎症指标水平明显低于对照组(P<0.05)。结论愈心痛胶囊联合尼可地尔片治疗微血管性心绞痛可有效降低心绞痛发作次数,提高运动耐量,减轻炎症反应,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Yuxintong Capsules combined with nicorandil in treatment of microvascular angina. Methods Patients（82 cases） with microvascular angina in the third people＇s Hospital of Dalian from February 2017 to February 2018 were divided into control（41 cases） and treatment（41 cases） groups based on different treatments. Patients in the control group were po administered with Nicorandil Tablets, 5 mg/time, three times daily. Patients in the treatment group were po administered with Yuxintong Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the frequency and duration of angina pectoris, the electrocardiogram indexes, the vascular endothelial function, and the inflammatory markers in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.49%, which was significantly lower than 97.56% in the treatment group, and there were differences between two groups（P〈0.05）. After treatment, the frequency and duration of angina pectoris in two groups was significantly decreased（P〈0.05）, and which in the treatment group was significantly less than that in the control group（P〈0.05）. After treatment, the time of treadmill exercise test and ST segment lowered by 0.1 mV in two groups was significantly prolonged（P〈0.05）, but the maximum amplitude of ST segment depression was significantly decreased（P〈0.05）, and the electrocardiogram indexes in the treatment group were significantly better than those in the control group（P〈0.05）. After treatment, the ET-1 levels in two groups were significantly decreased（P〈0.05）, but NO levels were significantly increased（P〈0.05）, and the ET-1 and NO levels in the treatment group were significantly better than those in the control group（P〈0.05）. After treatment, the CRP, IL-1, Lp-PLA2, and IL-6 levels in two groups were significantly decreased（P〈0.05）, and the inflammatory markers levels in the treatment group were significantly lower than those in the control group（P〈0.05）. Conclusion Yuxintong Capsules combined with nicorandil in treatment of microvascular angina can effectively reduce the frequency of angina pectoris, improve the exercise tolerance and reduce the inflammatory response, which has a certain clinical application value.