脉络通颗粒联合美托洛尔对冠心病不稳定心绞痛患者运动耐力、炎症反应的影响

Inflammatory Reaction in Patients with unstable Angina Pectoris of Coronary Heart Disease

目的评价脉络通颗粒联合美托洛尔对冠心病不稳定心绞痛患者运动耐力、炎症反应的影响。方法按照随机对照原则将郑州市第七人民医院2019年8月至2022年3月收治的88例冠心病不稳定心绞痛患者分为两组,单用组(44例)口服美托洛尔治疗,联合组(44例)口服脉络通颗粒联合美托洛尔治疗。统计两组疗效、观察治疗前后心绞痛症状、6 min步行距离、心率变异性(HRV)、炎症反应、不良反应发生率。结果联合组治疗有效率(93.18%)比单用组(77.27%)高,差异有统计学意义(P<0.05)。联合组治疗后心绞痛持续时间、发作次数、VAS评分比单用组低,6 min步行距离比单用组高,差异有统计学意义(P<0.05)。联合组治疗后24 h内每5 min一段的平均正常R-R间期值的标准差(SDANN)、24 h平均R-R间期标准差(SDNN)、连续24 h R-R间期差值大于50 ms的百分比(PNN50)、连续正常R-R间期差值的均方根(RMMSD)比单用组高。血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)水平比单用组低,差异有统计学意义(P<0.05)。联合组治疗期间不良反应发生率(15.91%)与单用组(13.64%)相比,差异无统计学意义(P>0.05)。结论冠心病不稳定心绞痛患者接受脉络通颗粒联合美托洛尔治疗的效果明显,可减轻心绞痛症状、缩短持续时间,提高HRV,改善运动耐力,降低炎症反应,且安全可靠。

Objective To evaluate the effects of Mailuotong Granule and metoprolol on exercise tolerance and inflammatory reaction in patients with unstable angina pectoris.Methods According to the principle of random control,88 patients with unstable angina pectoris of coronary heart disease admitted to Zhengzhou Seventh People's Hospital from August 2019 to March 2022 were divided into two groups:the single group(44 cases)was treated with metoprolol orally,and the combined group(44 cases)was treated with Mailuotong granules and metoprolol orally.The curative effects of the two groups were counted,and the symptoms of angina pectoris,6-minute walking distance,heart rate variability(HRV),inflammatory reaction and adverse reaction rate were observed before and after treatment.Results The effective rate of combined group(93.18%)was higher than that of single group(77.27%),the difference was statistically significant(P<0.05).After treatment,the duration of angina pectoris,the number of attacks and VAS scores in the combined group were lower than those in the single group,and the 6-minute walking distance was higher than those in the single group,with statistically significant differences(P<0.05).The standard deviation(SDANN),standard deviation(SDNN),percentage of continuous 24-hour R-R interval difference greater than 50 ms(PNN50),and root mean square of continuous normal R-R interval difference(RMMSD)of the combined group were higher than those of the single group within 24 hours after treatment.Serum tumor necrosis factor-α(TNF-α),the levels of interleukin-6(IL-6)and high-sensitivity C-reactive protein(hs-CRP)were significantly lower than those in the single group(P<0.05).There was no significant difference in the incidence of adverse reactions between the combined group(15.91%)and the single group(13.64%)(P>0.05).Conclusion Mailuotong granule combined with metoprolol has obvious effect on patients with unstable angina pectoris of coronary heart disease,which can reduce the symptoms of angina pectoris,shorten the duration,increase HRV,improve exercise endurance,reduce inflammatory reaction,and is safe and reliable.