麝香保心丸联合单硝酸异山梨酯片对不稳定型心绞痛患者心肌损伤标志物的影响

Effect of Shexiang Baoxin Pills Combined with Isosorbide Mononitrate Tablets on Myocardial Injury Markers in Patients with Unstable Angina Pectoris

目的:观察麝香保心丸联合单硝酸异山梨酯片对不稳定型心绞痛(UAP)患者血管内皮功能及心肌损伤标志物的影响。方法:选取64例气滞血瘀型UAP患者,按随机数字表法分为治疗组及对照组各32例。2组均给予现代医学常规疗法,对照组加用单硝酸异山梨酯片治疗,治疗组在对照组基础上给予麝香保心丸治疗。2组疗程均为4周。观察2组临床疗效,比较2组治疗前后心绞痛发作情况(发作频率、发作时间、心绞痛程度评分)、血脂4项水平[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、血管内皮功能[血清一氧化氮(NO)、内皮素(ET)]及心肌损伤标志物[肌酸激酶同工酶(CK-MB)、氨基末端脑钠肽前体(NT-proBNP)]指标值的变化。结果:治疗组临床疗效总有效率为90.63%,对照组为68.75%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组心绞痛发作频率、发作时间、程度评分均较治疗前下降,治疗组上述3项指标值均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组TC、TG、LDL-C水平均较治疗前下降,HDL-C水平均较治疗前上升,差异均有统计学意义(P<0.05);治疗后,治疗组TC、TG、LDL-C水平均低于对照组,HDL-C水平高于对照组,差异均有统计学意义(P<0.05)。治疗后,2组血清NO水平均较治疗前上升,ET水平均较治疗前下降,差异均有统计学意义(P<0.05);治疗后,治疗组血清NO水平高于对照组,ET水平低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组CK-MB、NT-proBNP指标值均较治疗前下降,治疗组上述2项指标值均低于对照组,差异均有统计学意义(P<0.05)。结论:麝香保心丸联合单硝酸异山梨酯片可改善UAP患者的临床症状,降低血脂水平,改善心肌损伤程度,保护血管内皮细胞,提高临床疗效。

Objective:To observe the effect of Shexiang Baoxin pills combined with isosorbide mononitrate tablets on vascular endothelial function and myocardial injury markers in patients with unstable angina pectoris(UAP).Methods:A total of64 cases of patients with UAP of qi stagnation and blood stasis type were selected and divided into the treatment group and the control group according to the random number table method,with 32 cases in each group.Both groups were given routine therapy of modern medicine,the control group was treated with isosorbide mononitrate tablets,and the treatment group was treated with Shexiang Baoxin pills based on the treatment of the control group.Both groups were treated for four weeks.The clinical effects in the two groups were observed.Before and after treatment,the changes in the condition of angina attacks,including frequency,duration and scores of degree,the four levels of blood lipid including total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)and high-density lipoprotein-cholesterol(HDL-C),the vascular endothelial function including nitric oxide(NO)and endothelin(ET),and myocardial injury markers including creatine kinase muscle-brain(CK-MB)and N-terminal pro-B-type natriuretic peptide(NT-proBNP)before and after treatment in the two groups were compared.Results:The total effective rate of clinical effects was 90.63%in the treatment group and68.75%in the control group,the difference being significant(P<0.05).After treatment,the frequency and duration of angina attacks and the scores of degree in the two groups were decreased when compared with those before treatment,and the above three values in the treatment group were lower than those in the control group,differences being significant(P<0.05).After treatment,the levels of TC,TG and LDL-C in the two groups were decreased when compared with those before treatment,and the HDL-C levels were increased,differences being significant(P<0.05).After treatment,the levels of TC,TG and LDL-C in the treatment group were lower than those in the control group,and HDL-C level was higher,differences being significant(P<0.05).After treatment,the NO levels in serum in the two groups were increased when compared with those before treatment,and ET levels were decreased,differences being significant(P<0.05).After treatment,the NO level in serum in the treatment group was higher than that in the control group,and ET level was lower,differences being significant(P<0.05).After treatment,the values of CK-MB and NT-proBNP in the two groups were decreased when compared with those before treatment,and the above two values in the treatment group were lower than those in the control group,differences being significant(P<0.05).Conclusion:Shexiang Baoxin pills combined with isosorbide mononitrate tablets can improve the clinical symptoms,myocardial injury and clinical effects in UAP patients,reduce the levels of blood lipid,and protect the vascular endothelial cells.