复方丹参滴丸联合氯吡格雷治疗门诊冠心病患者的效果

Effect of Fufang Danshen Diwan combined with clopidogrel in treatment of outpatients with coronary heart disease

目的探讨复方丹参滴丸联合氯吡格雷用于门诊冠心病患者治疗的效果研究。方法选取济南市第二人民医院2018年1月至2020年11月收治的122例门诊冠心病患者作为研究对象,进行前瞻性研究,根据随机数字表法将其分为联合组和对照组。对照组61例,男30例、女31例,年龄32~81(55.67±7.21)岁,予以氯吡格雷治疗;联合组61例,男31例、女30例,年龄39~76(57.36±8.85)岁,在对照组基础上联合复方丹参滴丸治疗。两组患者均于治疗前、治疗1个月后评估临床疗效、血小板功能[血小板膜糖蛋白GpⅡb/Ⅲa复合物(PAC-1)、血小板最大聚集率]、凝血功能[D-二聚体(D-D)水平,抗凝血酶Ⅲ(AT-Ⅲ)水平]。组间比较采用t检验、χ^(2)检验、秩和检验。结果治疗前,两组PAC-1、血小板最大聚集率比较,差异均无统计学意义(均P>0.05)。治疗后,两组PAC-1、血小板最大聚集率较治疗前均降低(均P<0.05),且联合组PAC-1、血小板最大聚集率低于对照组(均P<0.05)。联合组临床疗效(95.08%,58/61)优于对照组(77.05%,47/61),差异有统计学意义(P<0.05)。治疗1个月,两组D-D水平高于治疗前(P<0.05),联合组高于对照组(P<0.05);AT-Ⅲ水平低于治疗前(P<0.05),且联合组低于对照组(P<0.05)。结论复方丹参滴丸联合氯吡格雷能提高门诊冠心病患者的治疗效果,改善患者血小板功能、凝血功能。

Objective To study the efficacy of Fufang Danshen Diwan combined with clopidogrel in the treatment of outpatients with coronary heart disease.Methods A total of 122 outpatients with coronary heart disease admitted to Jinan Second People's Hospital from January 2018 to November 2020 were selected as the research objects for the prospective study.According to the random number table method,they were divided into a combination group and a control group,with 61 cases in each group.There were 30 males and 31 females in the control group;they were 32-81(55.67±7.21)years old.There were 31 males and 30 females in the combination group;they were 39-76 years old.The control group were treated with clopidogrel,and the combination group with clopidogrel and Fufang Danshen Diwan.The clinical efficacies and platelet function[platelet membrane glycoprotein GpⅡb/Ⅲa complex(PAC-1)and maximum platelet aggregation rate]and coagulation function[D-dimer(D-D)and antithrombinⅢ(AT-Ⅲ)]before and one month after the treatment were evaluated.The data were compared between these two groups by t andχ^(2) tests and rank-sum test.Results Before the treatment,there were no statistical differences in PAC-1 and maximum platelet aggregation rate between the two groups(both P>0.05).After the treatment,the PAC-1 and platelet maximum aggregation rates decreased in both group as compared with those before the treatment(all P<0.05);and those in the combined group was lower than those in the control group(both P<0.05).The clinical efficacy of the combined group was better than that of the control group[95.08%(58/61)vs.77.05%(47/61)],with a statistical difference(P<0.05).After 1 month's treatment,the levels of D-D in the 2 groups were higher than those before the treatment(both P<0.05),and that in combination group was higher than that in control group(P<0.05);the AT-Ⅲlevels were lower than those before the treatment(both P<0.05),and that in the combination group was lower than that in the control group(P<0.05).Conclusion Fufang Danshen Diwan combined with clopidogrel in the treatment of outpatients with coronary heart disease can improve the therapeutic effect and their platelet function and coagulation function.