丹参舒心胶囊联合硝酸异山梨酯治疗不稳定型心绞痛的临床研究

Clinical study on Danshen Shuxin Capsules combined with isosorbide dinitrate in treatment of unstable angina pectoris

目的探讨丹参舒心胶囊联合硝酸异山梨酯片治疗不稳定型心绞痛的临床疗效。方法选取2017年4月—2018年4月河南省胸科医院治疗的84例不稳定型心绞痛患者作为研究对象,根据住院号的奇偶数将患者分为对照组(42例)和治疗组(42例)。对照组患者口服硝酸异山梨酯片,10 mg/次,3次/d;治疗组患者在对照组治疗的基础上口服丹参舒心胶囊,0.6 g/次,3次/d。两组患者均治疗2周。观察两组患者的临床疗效和心电图疗效,同时比较两组治疗前后的心绞痛发作次数和持续时间、心功能指标和血清学指标。结果治疗后,对照组临床总有效率和心电图疗效分别为80.95%、78.57%,均分别显著低于治疗组95.24%、97.62%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者心绞痛发作次数和持续时间均明显降低(P<0.05);且治疗后治疗组心绞痛发作次数和持续时间显著低于对照组(P<0.05)。治疗后,两组左心室射血分数(LVEF)明显升高,左室舒张末期内径(LVEDD)和左心室收缩末期内径(LVESD)水平均明显降低(P<0.05);且治疗后治疗组心功能指标显著优于对照组(P<0.05)。治疗后,两组血清C反应蛋白(CRP)、白细胞介素-18(IL-18)、可溶性CD40配体(sCD40L)、脂蛋白相关磷脂酶A2(Lp-PLA2)和妊娠相关蛋白-A(PAPP-A)水平均显著降低(P<0.05);且治疗后治疗组血清学指标水平显著低于对照组(P<0.05)。结论丹参舒心胶囊联合硝酸异山梨酯片治疗不稳定型心绞痛可有效改善患者的临床症状和心功能,降低血清细胞因子水平,具有较好的临床推广应用价值。

Objective To investigate the clinical efficacy of Danshen Shuxin Capsules combined with Isosorbide Dinitrate Tablets in treatment of unstable angina pectoris.Methods Patients (84 cases) with unstable angina pectoris in Henan Provincial Chest Hospital from April 2017 to April 2018 were divided into control (42 cases) and treatment (42 cases) groups according to the odd and even number of hospitalization numbers.Patients in the control group were po administered with Isosorbide Dinitrate Tablets,10 mg/time,three times daily.Patients in the treatment group were po administered with Danshen Shuxin Capsules on the basis of control group,0.6 g/time,three times daily.Patients in two groups were treated for 2 weeks.After treatment,the clinical and electrocardiographic (ECG) effects of the two groups were observed,and the frequency and duration of angina attack,cardiac function,and serological indexes in two groups before and after treatment were compared.Results After treatment,the clinical efficacy and ECG efficacy in the control group were 80.95% and 78.57%,which were significantly lower than 95.24% and 97.62% in the treatment group,respectively,and there were differences between two groups (P < 0.05).After treatment,attack frequency and duration of angina pectoris in two groups were significantly reduced (P < 0.05).And the attack frequency and duration of angina pectoris in the treatment group after treatment were significantly lower than those in the control group (P < 0.05).After treatment,the LVEF in two groups were significantly increased,but the LVEDD and LVESD were decreased (P < 0.05).And cardiac function in the treatment group after treatment was significantly better than those in the control group (P < 0.05).After treatment,the levels of CRP,IL-18,sCD40L,Lp-PLA2,and PAPP-A in two groups were significantly decreased (P < 0.05).And the serological indexes in the treatment group after treatment were significantly lower than those in the control group (P < 0.05).Conclusion Danshen Shuxin Capsules combined with Isosorbide Dinitrate Tablets can effectively improve the clinical symptoms and cardiac function of patients with unstable angina pectoris,and reduce the levels of serum cytokines,which has a certain clinical application value.