芪冬颐心颗粒联合曲美他嗪对稳定型冠心病气阴两虚证患者运动耐量的影响

Effects of Qidongyixin Granule Combined with Trimetazidine on Exercise Tolerance in Patients with Stable Coronary Heart Disease with Qi-Yin Deficiency Syndrome

目的 探讨芪冬颐心颗粒联合曲美他嗪对稳定型冠心病气阴两虚证患者临床疗效及运动耐量的影响。方法 选取2019年3月—2020年3月60例稳定型冠心病气阴两虚证患者,根据治疗方法不同分为观察组和对照组,每组30例。2组均给予基础治疗,对照组采用曲美他嗪治疗,观察组采用芪冬颐心颗粒联合曲美他嗪治疗,均治疗8周。对比2组疗效、心血管不良事件发生情况,以及治疗前后中医证候积分,并采用心电图平板运动试验(ETT)评估治疗前后运动耐量改善情况,包括ETT总时间、最大负荷量(METs)、达到METs时心率、出现ST段压低≥0.1 mV时间、ST段压低≥0.1 mV持续时间、心绞痛发作例数。结果 观察组总有效率高于对照组(P<0.05)。观察组治疗4、8周后主症积分、次症积分及总积分低于对照组(P<0.05)。观察组治疗4、8周后ETT总时间、METs、达到METs时心率、出现ST段压低≥0.1 mV时间均长于或高于对照组,ST段压低≥0.1 mV持续时间短于对照组(P<0.05)。2组ETT中心绞痛发作率及心血管不良事件发生率比较差异无统计学意义(P>0.05)。结论 芪冬颐心颗粒联合曲美他嗪治疗能促进稳定型冠心病气阴两虚证患者病情改善,提高运动耐量。

Objective To investigate the effect of Qidongyixin Granules combined with Trimetazidine on the clinical curative effect and exercise tolerance of patients with stable coronary heart disease(CHD) with Qi-Yin deficiency syndrome. Methods A total of 60 patients with stable CHD with Qi-Yin deficiency syndrome treated from March 2019 to March 2020 were selected and divided into observation group(n=30) and control group(n=30) according to different treatment methods. Both groups were given basic treatment, the control group was given Trimetazidine, and the observation group was given Qidongyixin Granules combined with Trimetazidine for 8 weeks. The curative effect, the occurrence of cardiovascular adverse events, and TCM syndrome scores before and after treatment were compared between the two groups. The electrocardiogram treadmill exercise test(ETT) was used to evaluate the improvement of exercise tolerance before and after treatment, including total ETT time, maximum load(METs), heart rate when reaching METs, time to ST-segment depression ≥0.1 mV, duration of ST-segment depression ≥0.1 mV, number of angina attacks. Results The total effective rate in the observation group was higher than that in the control group(P<0.05). At 4 and 8 weeks after treatment, the main symptom score, secondary symptom score and total score in the observation group were lower than those in the control group(P<0.05). At 4 and 8 weeks after treatment, the total time of ETT, METs, heart rate when reaching METs, and the duration of ST-segment depression ≥ 0.1 mV were longer or higher than those in the control group, and the duration of ST-segment depression ≥ 0.1 mV was shorter than that in the control group(P<0.05). There was no significant difference in the incidence of angina pectoris and the incidence of adverse cardiovascular events between the two groups(P>0.05). Conclusion Qidongyixin Granules combined with Trimetazidine can improve the condition of patients with stable CHD with Qi-Yin deficiency syndrome, and improve exercise tolerance.