冠心平片治疗老年稳定性冠心病合并颈动脉斑块患者的临床研究

The clinical research on Guanxinping tablets in the treatment of elderly patients of stable coronary artery disease with carotid plaque

目的观察冠心平片治疗老年稳定性冠心病(SCAD)合并颈动脉斑块气阴亏虚、痰瘀痹阻证患者的临床疗效及安全性。方法选择符合诊断标准的老年SCAD合并颈动脉斑块患者60例,采用随机数字法分为两组,在常规西药干预的基础上,治疗组联合冠心平片,对照组联合益心舒片,疗程为3个月。记录并分析患者治疗前后中医证候积分、心绞痛发作情况、心电图变化、颈动脉内膜中层厚度(C-IMT)、Crouse积分以及血清血管内皮细胞生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)的变化。结果治疗组中医证候总有效率、心电图有效率、SCAD综合疗效高于对照组(P<0.05)。治疗后两组心绞痛发作次数和发作时长、C-IMT、Crouse积分以及血清VEGF、bFGF水平均较治疗前改善(P<0.01),治疗组优于对照组(P<0.05~0.01)。治疗期间两组未出现不良反应。结论冠心平片可以改善老年SCAD合并颈动脉斑块气阴亏虚、痰瘀痹阻证患者的心绞痛严重程度、心电图异常情况,降低中医证候积分、C-IMT和Crouse积分以及血清VEGF、bFGF水平,疗效显著且安全性高。

Objective To observe the clinical efficacy and safety of Guanxinping in treatment of elderly patients of stable coronary artery disease(SCAD)with carotid plaque combined with deficiency of Qi-Yin and Phlegm-Blood stasis syndrome.Methods 60 elderly patients of SCAD with carotid plaque combined with deficiency of Qi-Yin and Phlegm-Blood stasis syndrome were bringed to the study.They were all given orally basic western medicine and randly divided into the treatment group(combined with Guanxinping tablets)and the control group(combined with Yixinshu tablets).The course of treatment was 3 months.before and after treatment,the TCM syndrome scores,the angina symptoms,ECG,carotid intima-media thickness(C-IMT)and Crouse scores,vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(bFGF)contents in serum of the above-mentioned groups were recorded and analyzed.Results The total effective rate of TCM syndromes the efficacy of ECG and the comprehensive efficacy of SCAD in the treatment group were higher than that of the control group(P<0.05).In terms of frequency of attack and duration of angina pectoris,C-IMT and Crouse scores,TCM syndrome scores VEGF and bFGF contents in serum,both groups improved after treatment compared before treatment(P<0.01),and the treatment group was better than that of in the control group(P<0.05,0.01).No adverse reaction occurs during the course of treatment.Conclusion Guanxinping tablets can improve the severity of angina pectoris and abnormal ECG,decrese C-IMT,Crouse scores,VEGF and bFGF contents in serum of elderly patients of SCAD with carotid plaque combined with deficiency of Qi-Yin and Phlegm-Blood stasis syndrome.It is effective,safe and reliable.