麝香保心丸联合盐酸曲美他嗪片治疗老年不稳定型心绞痛患者的疗效及对心功能、血脂水平的影响

Effect of Shexiang Baoxin Pill Combined with Trimetazidine Hydrochloride Tablets in the Treatment of Elderly Patients with Unstable Angina Pectoris and Its Influence on Heart Function and Blood Lipid Level

目的探讨与分析麝香保心丸联合盐酸曲美他嗪片治疗不稳定型心绞痛老年患者的疗效及对心功能、血脂水平的影响。方法选取2020年3月—2021年3月甘肃省中医院诊治的不稳定型心绞痛老年患者180例作为研究对象,根据随机数表法把患者分为联合组与传统组,各90例。传统组给予盐酸曲美他嗪治疗,联合组在传统组治疗的基础上给予麝香保心丸治疗。判定两组患者治疗效果与主要心血管不良事件发生情况,检测心功能与血脂水平变化情况。结果治疗后,联合组治疗总有效率高于传统组,差异有统计学意义(P<0.05)。治疗后,联合组与传统组TC、TG与LDL-C水平均明显低于治疗前,HDL-C明显高于治疗前(P<0.05);治疗后联合组TC、TG与LDL-C水平均明显低于传统组,HDL-C明显高于传统组,差异有统计学意义(P<0.05)。联合组与传统组治疗后的心室舒张末期内径与心室收缩末期内径均明显低于治疗前,左心室射血分数均高于治疗前(P<0.05),治疗后联合组心室舒张末期内径与心室收缩末期内径都明显低于传统组,左心室射血分数高于传统组,差异有统计学意义(P<0.05)。治疗后随访1年,联合组的心力衰竭、心源性死亡、心肌梗死、再发心绞痛等主要心血管不良事件发生率低于传统组,但差异无统计学意义(P>0.05)。结论麝香保心丸联合盐酸曲美他嗪片治疗不稳定型心绞痛老年患者能改善患者的心功能,也能改善患者的血脂水平,有利于提高患者的总体治疗效果,且不会增加随访远期心血管不良事件发生率。

Objective To investigate and analysis the effects of Shexiang Baoxin Pill combined with trimetazidine hydrochloride tablets in the treatment of elderly patients with unstable angina pectoris and its influence on heart function and blood lipid level.Methods From March 2020 to March 2021,180 cases of elderly patients with unstable angina pectoris diagnosed and treated in our hospital were selected as the study objects.Accorded to the random number table method,the patients were divided into the combined group and the traditional group with 90 cases in each groups.The traditional group was treated with trimetazidine hydrochloride,and the combined group was treated with Shexiang Baoxin Pill on the basis of the traditional group.All the cases were to determine the treatment effects and cardiovascular adverse events,and to detect the changes of cardiac function and blood lipid levels.Results After treatment,the total effective rates of the combined group were signifi cantly higher than that of the traditional group(P<0.05).The levels of TC,TG and LDL-C in the combined group and the traditional group after treatment were significantly lower than those before treatment(P<0.05),and HDL-C were also signifi cantly higher than those before treatment(P<0.05).There were also signifi cant difference compared between the combined group and the traditional group after treatment(P<0.05).The ventricular end diastolic diameter and ventricular end systolic diameter in the combined group and the traditional group after treatment were significantly lower than those before treatment,left ventricular ejection fraction were all higher than before treatment(P<0.05),and there were also signifi cant difference compared between the combined group and the traditional group after treatment(P<0.05).At 1-year of followup after treatment,the incidence rates of major cardiovascular adverse events such as recurrent angina pectoris,myocardial infarction,cardiac death and heart failure was lower than in the traditional group,and the statistical analysis did not differ(P>0.05).Conclusion The combination of Shexiang Baoxin Pill and Trimetazidine Hydrochloride Tablets in the treatment of elderly patients with unstable angina pectoris can improve the cardiac function,improve the therapeutic effect,improve the blood lipid level of patients,and will not increase the incidence of cardiovascular adverse events.