灯盏花素治疗血瘀型冠心病56例

Treating 56 Cases of Coronary Heart Disease of Blood Stasis Pattern by Breviscapine Injection

目的:研究灯盏花素在血瘀型冠心病中的应用情况。方法:回顾性分析调查灯盏花素在56例血瘀证冠状动脉粥样硬化性心脏病患者中的使用情况,包括剂量、使用时间、溶媒、联合用药等用药情况;观察患者症状积分及临床疗效、心电图改善情况、全血黏度、血浆黏度、纤维蛋白原、血浆凝血酶原时间、药物不良反应发生等情况。结果:灯盏花素日剂量为40~50mg,平均(47.96±4.01)mg。住院期间使用灯盏花素总剂量为240~1450mg,平均(558.57±220.10)mg。灯盏花素溶媒:5%葡萄糖注射液2例,木糖醇注射液3例,0.9%氯化钠注射液51例。灯盏花素使用天数5~29天,平均(11.64±4.45)天。灯盏花素联合前列地尔、低分子肝素、阿司匹林、氯吡格雷分别为17例、3例、24例、4例;联合使用参麦注射液26例;联合使用中药口服汤剂共29例,28例联合活血化瘀中药。中医症状疗效,显效29例,有效25例,无效1例,加重1例,总有效率为96.43%。胸痛、胸闷、气短、心悸、神倦乏力、不寐等症状积分出入院时比较,差异有统计学意义(P<0.05)。入院正常心电图或ST段未见明显异常患者29例,占51.79%;住院前后心电图疗效有效16例(28.57%),无效11例(19.64%)。5例药物不良反应,均为一般药物不良反应。结论:注射用灯盏花素可明显缓解患者临床症状,临床使用安全,溶媒选择合理,目前应深入研究灯盏花素与其他药物的相互作用,以及开发灯盏花素的新剂型。

Objective: To study the application conditions of breviscapine injection to coronary heart disease(CHD) of blood stasis pattern. Methods: The application conditions of breviscapine injection to 56 patients suffering coronary atherosclerotic heart disease of blood stasis pattern were retrospectively analyzed and investigated,including the dose, application time, the solvent, the drug combination and others;to observe the symptoms integrals, Crlrative effects, ECG improvement, whole blood viscosity, plasma viscosity, fibrinogen, plasma prothrombin time, the incidence of adverse reaction and others. Results: Daily dose of breviscapine was 40 ~50 mg,average(47.96 ±4.01)mg. Total dose of using breviscapine during hospitalization period was 240 ~1 450 mg,average(558.57±220.10)mg. Breviscapine solvent: two cases using 5% glucose injection, three cases using xylitol injection, 51 cases using 0.9% sodium chloride injection. Breviscapine injection was used for five to 29 days,average(11.64 ±4.45) days. There were 17 cases combining breviscapine injection with alprostadil, three cases combined with low molecular heparin, 24 cases with aspirin and four cases with clopidogrel respectively;26 cases with ShenMai injection;29 cases with herbal oral decoction, 28 cases with the herbal decoction pieces of promoting blood circulation and eliminating blood stasis. Clinical effects of the symptoms, there were 29 cases markedly effective, 25 cases effective, one case ineffective, one case aggravated, total effective rate was 96.43%. The difference had statistical meaning in the comparisons of the scores of the symptoms including chest pain and stuffiness, panting, palpitation, lassitude and fatigue, insomnia and others(P<0.05). There were 29 cases showing normal ECG or no obvious abnormal changes in ST segments, and they held 51.79%;after hospitalization, there were 16 cases effective in clinical effects of ECG(28.57%), 11 cases ineffective(19.64%). Drug adverse reaction(DAR) happened in five patients, and they were common DAR. Conclusion: Breviscapine injection could gain notable effects in relieving the symptoms, and it shows clinical safety and rational selection of the solvents, currently,the interactions of breviscapine injection with other drugs and the development of new forms of breviscapine should be further studied.