益心舒片联合地尔硫卓治疗稳定型劳力性心绞痛疗效观察

Clinical observation of Yixinshu Tablets combine with diltiazem in treatment of stable exertional angina pectoris

目的探讨益心舒片联合盐酸地尔硫卓片治疗稳定型劳力性心绞痛的临床疗效。方法选取2017年1月—2018年1月新乡医学院第二附属医院收治的94例稳定型劳力性心绞痛患者为研究对象,采用随机数字表法将患者分为对照组和治疗组,每组各47例。对照组餐前、睡前口服盐酸地尔硫卓片,起始剂量为1片/次,4次/d。治疗组患者在对照组的基础上口服益心舒片,3粒/次,3次/d。两组患者均连续治疗12周。观察两组患者的心绞痛症状疗效、心电图疗效和中医证候疗效,比较两组治疗前后的症状缓解情况和心功能指标。结果治疗后,治疗组的心绞痛症状疗效的有效率为91.5%,高于对照组的72.3%,两组比较差异具有统计学意义(P<0.05)。治疗后,治疗组的心电图疗效的总有效率为95.7%,高于对照组的80.8%,两组比较差异具有统计学意义(P<0.05)。治疗后,对照组和治疗组的中医证候有效率分别为68.1%、85.1%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组心绞痛发作次数、持续时间和硝酸甘油使用量均明显降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组心绞痛情况和硝酸甘油使用量明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组左室舒张末期内径(LVEDD)和舒张早期流速峰值/舒张晚期流速峰值(E/A值)均显著降低,心排血量(CO)、左室射血分数(LVEF)水平均明显升高,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组心功能指标明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论益心舒片联合盐酸地尔硫卓片治疗稳定型劳力性心绞痛具有较好的临床疗效,可缓解患者临床症状,改善心功能,具有一定的临床推广应用价值。

Objective To explore the clinical effect of Yixinshu Tablets combined with Diltiazem Hydrochloride Tablets in treatment of stable exertional angina pectoris. Methods Patients(94 cases) with stable exertional angina pectoris in The Second Affiliated Hospital of Xinxiang Medical University from January 2017 to January 2018 were randomly divided into control and treatment groups,and each group had 47 cases. Patients in the control group were po administered with Diltiazem Hydrochloride Tablets before meals or bedtime, and the initial dose was 1 tablet/time, four times daily. Patients in the treatment group were po administered with Yixinshu Tablets on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the angina symptoms efficacy, electrocardiogram efficacy, and TCM syndrome efficacy were evaluated, the symptom relief and the cardiac function indexes in two groups before and after treatment were compared. Results After treatment, the angina symptoms efficacies in the treatment group was 91.5%, which was significantly higher than 72.3% in the control group, and there were differences between two groups(P < 0.05). After treatment, the electrocardiogram efficacies in the treatment group was 95.7%, which was significantly higher than 80.8% in the control group, and there were differences between two groups(P < 0.05). After treatment,the TCM syndrome efficacies in the control and treatment group were 68.1% and 85.1%, and there were differences between two groups(P < 0.05). After treatment, frequency and duration of angina pectoris, and nitroglycerin dosage were significantly decreased in two groups, and there were differences in the same group(P < 0.05). And the angina attack and nitroglycerin dosage in the treatment group were significantly lower than those in the control group, and there were differences between two groups(P < 0.05). After treatment, LVEDD and E/A value were significantly decreased in two groups, but CO and LVEF were significantly increased, and there were differences in the same group(P < 0.05). And the cardiac function indexes in the treatment group were significantly better than those in the control group, and there were differences between two groups(P < 0.05). Conclusion Yixinshu Tablets combined with Diltiazem Hydrochloride Tablets has good clinical effect in treatment of stable exertional angina pectoris, can alleviate the clinical symptoms and improve the cardiac function of patients, which has a certain clinical application value.