冠心宁片联合常规治疗对稳定性冠心病患者的临床疗效

Clinical effects of Guanxinning Tablets combined with conventional treatment on patients with stable coronary heart disease

目的 考察冠心宁片联合常规治疗对稳定性冠心病患者的临床疗效。方法 146例患者随机分为对照组和观察组,每组73例,对照组采用常规治疗(阿司匹林、氯吡格雷、单硝酸异山梨酯等),观察组在对照组基础上加用冠心宁片,疗程3个月。检测临床疗效、心脏自主神经功能指标(SDNN、LF/HF)、颈动脉斑块指标(内-中膜厚度、斑块积分、斑块数目)、血清血管内皮功能指标(NO、ET-1)、TLR4和NF-κB mRNA表达、不良反应发生率变化。结果 观察组总有效率高于对照组(P<0.05)。治疗后,2组SDNN、NO升高(P<0.05),LF/HF、颈动脉斑块指标、ET-1、TLR4和NF-κB mRNA降低(P<0.05),以观察组更明显(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 冠心宁片联合常规治疗可安全有效地改善稳定性冠心病患者心脏自主神经功能、血管内皮功能,抑制TLR4/NF-κB信号通路,减少颈动脉斑块数目。

AIM To investigate the clinical effects of Guanxinning Tablets combined with conventional treatment on patients with stable coronary heart disease.METHODS One hundred and forty-six patients were randomly assigned into control group(73 cases) for 3-month intervention of conventional treatment(aspirin, clopidogrel, isosorbide mononitrate, etc.), and observation group(73 cases) for 3-month intervention of both Guanxinning Tablets and conventional treatment. The changes in clinical efficacy, cardiac autonomic nerve function indices(SDNN, LF/HF), carotid artery plaque indices(intima-media thickness, plaque score, plaque number), serum vascular endothelial function indices(NO, ET-1), mRNA expressions of TLR4 and NF-κB, and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P<0.05). After the treatment, the two groups displayed increased SDNN, NO(P<0.05), and decreased LF/HF, carotid artery plaque indices, ET-1, mRNA expressions of TLR4 and NF-κB(P<0.05), especially for the observation group(P<0.05). No significant difference in incidence of adverse reactions was found between the two groups(P>0.05).CONCLUSION For the patients with stable coronary heart disease, Guanxinning Tablets combined with conventional treatment can safely and effectively improve cardiac autonomic nerve functions and vascular endothelial functions, inhibit TLR4/NF-κB signaling pathway, and reduce carotid plaque number.