养心氏片联合比索洛尔治疗冠心病心绞痛的临床研究

Clinical study on Yangxinshi Tablets combined with bisoprolol in treatment of coronary heart disease angina pectoris

目的探讨养心氏片联合比索洛尔治疗冠心病心绞痛的临床疗效。方法选取2018年2月-2019年2月在解放军联勤保障部队第940医院治疗的冠心病心绞痛患者96例,随机分成对照组(48例)和治疗组(48例)。对照组口服富马酸比索洛尔片,5 mg/次,2次/d;治疗组在对照组基础上口服养心氏片,1.8 g/次,3次/d。两组患者均经4周治疗。观察两组患者临床疗效,同时比较治疗前后两组患者临床症状改善时间、心电图改善情况、心功能指标、血清白细胞介素-6(IL-6)、IL-18、脂蛋白磷脂酶A2(Lp-PLA2)、核因子抑制蛋白-κB(NF-κB)、髓过氧化物酶(MPO)、可溶性细胞间黏附分子-1(s ICAM-1)水平及全血黏度(WBV)、血浆黏度(PV)、纤维蛋白原(FIB)和血小板黏附率(PAR)。结果治疗后,对照组心电图和临床有效率分别为81.25%和83.33%,均分别显著低于治疗组的95.83%和97.92%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者心绞痛发作次数及持续时间均显著减少(P<0.05),且治疗组患者心绞痛发作次数及持续时间明显少于对照组(P<0.05)。治疗后,两组患者左心室射血分数(LVEF)、心排血量(CO)均明显升高(P<0.05),左室收缩末期内径(LVESD)明显降低(P<0.05),且治疗组患者心功能明显好于对照组患者(P<0.05)。治疗后,两组患者血清IL-6、IL-18、Lp-PLA2、NF-κB、MPO、sICAM-1水平均显著降低(P<0.05),且治疗组患者的血清学指标明显低于对照组患者(P<0.05)。治疗后,两组患者WBV、PV、FIB、PAR水平均显著降低(P<0.05),且治疗组患者WBV、PV、FIB、PAR水平显低于对照组患者(P<0.05)。结论养心氏片联合比索洛尔治疗冠心病心绞痛可明显改善患者临床症状,有利于患者心功能及血液流变学指标的改善。

Objective To explore the clinical efficacy of Yangxinshi Tablets combined with bisoprolol in treatment of coronary heart disease angina pectoris. Methods Patients(96 cases) with coronary heart disease angina pectoris in 940 Hospital of PLA Joint Logistics Support Force from February 2018 to February 2019 were randomly divided into control(48 cases) and treatment(48 cases) groups. Patients in the control group were po administered with Bisoprolol Fumarate Tablets, 5 mg/time, twice daily. Patients in the treatment group were po administered with Yangxinshi Tablets on the basis of the control group, 1.8 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the improvement time of clinical symptoms, ECG improvement, cardiac function indexes, IL-6, IL-18, Lp-PLA2, NF-κB, MPO, sICAM-1, WBV, PV, FIB, and PAR in two groups before and after treatment were compared. Results After treatment, the electrocardiogram and clinical efficacy in the control group were 81.25% and 83.33%, which were significantly lower than 95.83% and 97.92% in the treatment group, respectively, and there were differences between two groups(P < 0.05). After treatment, the frequency and duration of angina attack in two groups were significantly decreased(P < 0.05), and which in the treatment group was significantly lower than that in the control group(P < 0.05). After treatment, the LVEF and CO in two groups were significantly increased(P < 0.05), but LVESD was significantly decreased(P < 0.05), and the cardiac function in the treatment group were significantly better than that in the control group(P < 0.05). After treatment, the serum levels of IL-6, IL-18, Lp-PLA2, NF-κB, MPO sICAM-1 in two groups were significantly decreased(P < 0.05), and these serological indexes in the treatment group were significantly lower than those in the control group(P < 0.05). After treatment, the WBV, PV, FIB and PAR levels 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 Yangxinshi Tablets combined with bisoprolol in treatment of coronary heart disease angina pectoris can significantly improve the clinical symptoms, cardiac function and hemorheological indicators.