稳心颗粒联合地尔硫卓治疗不稳定型心绞痛的临床研究

Clinical study on Wenxin Granules combined with diltiazem in treatment of unstable angina pectoris

目的探讨稳心颗粒联合地尔硫卓治疗不稳定型心绞痛的临床效果。方法选取2015年9月-2017年12月北京怡德医院和北京阜外医院收治的不稳定型心绞痛患者132例,随机分成对照组(66例)和治疗组(66例)。对照组餐前30 min口服盐酸地尔硫卓片,1片/次,3次/d。治疗组在对照组基础上口服稳心颗粒,1袋/次,3次/d。两组患者连续治疗4周。观察两组患者临床疗效和心电图疗效,同时比较治疗前后两组患者临床症状改善情况、心肌缺血总负荷(TIB)值和血清C反应蛋白(CRP)水平及血液高凝指标。结果治疗后,对照组患临床疗效和心电图疗效的总有效率分别为75.8%、81.8%,均显著低于治疗组的89.4%、93.9%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者疼痛发作次数、VAS评分、持续时间、发作时硝酸甘油用量和ST段下移幅度均显著降低(P<0.05),且治疗组患者临床症状改善情况明显优于对照组(P<0.05)。治疗后,两组患者TIB值、血浆CRP含量、血小板最大聚集率(PAGM)、全血高切黏度(WBHV)、全血低切黏度(WBLV)及血浆黏度(PV)值和血浆D-二聚体(D-D)浓度显著降低(P<0.05),且治疗组这些指标明显低于对照组(P<0.05)。结论稳心颗粒联合地尔硫卓治疗不稳定型心绞痛,能有效控制患者心绞痛症状,改善心肌缺血状况,纠正体内血液高凝状态,抑制血栓形成。

Objective To investigate the clinical efficacy of Wenxin Granules combined with diltiazem in treatment of unstable angina pectoris. Methods Patients(132 cases) with unstable angina pectoris in Beijing EDEN Hospital and Fuwai Hospital, CAMS&PUMC from September 2015 to December 2017 were randomly divided into control(66 cases) and treatment(66 cases) groups. Patients in the control group were po administered with Ditiazem Hydrochloride Tablets 30 min before meals, 1 tablet/time, three times daily. Patients in the treatment group were po administered with Wenxin Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical and electrocardiogram efficacy were evaluated, and the improvement of clinical symptoms, TIB value, CRP levels, and blood hypercoagulability indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and electrocardiogram efficacy in the control group were 75.8% and 81.8%, which were significantly lower than 89.4% and 93.9% in the treatment group, respectively, and there were differences between two groups(P < 0.05). After treatment, the frequency of pain attacks, VAS, duration of pain, nitroglycerin dosage during pain and downward shift distance of ST in two groups were significantly reduced(P < 0.05), and the improvement of clinical symptoms in the treatment group was significantly better than that in the control group(P < 0.05). After treatment, the TIB value, CRP levels, PAGM, WBHV, WBLV, PV value and plasma concentration of D-D in two groups were significantly decreased(P < 0.05), and these indexes in the treatment group were significantly lower than those in the control group(P < 0.05). Conclusion Wenxin Granules combined with diltiazem in treatment of unstable angina pectoris, can effectively control the angina pectoris symptoms, improve the condition of myocardial ischemia, correct the blood hypercoagulability state and inhibit thrombosis.