稳心颗粒长期口服在慢性心绞痛患者中的应用效果及对炎性因子的影响

Long-term effects of the Wenxin granules on chronic angina pectoris and its effect on inflammatory factors

目的:探讨稳心颗粒长期口服在慢性心绞痛患者中的应用效果及对炎性因子的影响。方法:选取2019年9月―2021年8月广州市花都区新街社区卫生服务中心收治的112例慢性心绞痛患者作为研究对象,采用随机数字表法将其分为对照组(56例)及观察组(56例)。对照组患者采用阿托伐他汀钙片联合阿司匹林肠溶片治疗,观察组在对照组给药基础上予以稳心颗粒口服治疗。比较两组患者的临床疗效、心绞痛情况、血清炎性因子水平及不良反应发生情况。结果:观察组总有效率为91.07%(51/56),高于对照组的76.79%(43/56)(P>0.05);治疗前,两组患者心绞痛情况的差异无统计学意义(P>0.05),治疗后,两组心绞痛发作持续时间与频率次数均较治疗前显著降低,差异有统计学意义(P<0.05),并且观察组少于对照组,差异有统计学意义(P<0.05);治疗后,对照组血清白细胞介素-6(Interleukin-6,IL-6)、超敏C反应蛋白(Hypersensitive C-reactive Protein,hs-CRP)、肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)水平分别为(19.46±2.76)pg/mL、(11.47±2.07)mg/L、(17.02±1.99)ng/L,观察组分别(11.32±3.73)pg/mL、(7.28±2.03)mg/L、(9.78±1.40)ng/L。观察组血清IL-6、hs-CRP、TNF-α水平均低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为8.93%(5/56),对照组为5.36%(3/56),两组的差异无统计学意义(P>0.05)。单因素分析结果显示,心血管不良事件与年龄、吸烟、饮酒、高血压病病史、糖尿病病史、稳心颗粒是否服用、IL-6、hs-CRP、TNF-α水平有关(P<0.05)。多因素分析结果显示(OR=-0.705,P=0.042),是稳心颗粒服用为患者随访2年心血管不良事件发生保护因素(P<0.05)。结论:采用稳心颗粒治疗慢性心绞痛患者可取到满意的疗效,减缓心绞痛发作症状,调节机体炎症反应,值得进一步推广。

Objective:To investigate the effect of long-term oral administration of the Wenxin granules(稳心颗粒)in patients with chronic angina pectoris and its effect on inflammatory factors.Methods:A total of 112 patients with chronic angina pectoris admitted to Department of General Practice,Xinjie Community Health Service Center from September 2019 to August 2021 were selected as the research subjects,and they were divided into the control group(56 cases)and the observation group(56 cases)by random number table method.The patients in the control group were treated with atorvastatin calcium tablets combined with aspirin enteric-coated tablets,and the patients in the observation group were treated with the Wenxin granules orally on the basis in the administration in the control group.The clinical efficacy,angina pectoris,serum inflammatory factor levels and adverse reactions were compared between the two groups.Results:The total effective rate in the observation group was 91.07%(51/56),which was higher than 76.79%(43/56)in the control group(P<0.05).Before treatment,there was no significant difference in angina pectoris between the two groups(P>0.05).After treatment,the duration and frequency of angina attack in 2 groups were significantly decreased compared with those before treatment,the difference was statistically significant(P<0.05),the observation group was less than the control group,and the difference was statistically significant(P<0.05).After treatment,the serum levels of interleukin-6(IL-6),hypersensitive C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)in the control group were(19.46±2.76)pg/mL,(11.47±2.07)mg/L and(17.02±1.99)ng/L,respectively.Those in the observation groups were(11.32±3.73)pg/mL,(7.28±2.03)mg/L and(9.78±1.40)ng/L,respectively.The levels of IL-6,hs-CRP and TNF-αin the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Adverse reactions rate was 8.93%(5/56)in the observation group and 5.36%(3/56)in the control group,and there was no statistical significance between the two groups(P>0.05).Univariate analysis showed that adverse cardiovascular events were related to age,smoking,alcohol consumption,history of hypertension,history of diabetes,whether the Wenxin granules was taken,IL-6,hs-CRP,and TNF-αlevels(P<0.05),and multivariate analysis showed that(OR=–0.705,P=0.042).The Wenxin granules was a protective factor for cardiovascular adverse events(MACE)in patients with 2-year follow-up(P<0.05).Conclusion:The use of the Wenxin granules can achieve satisfactory curative effect in the treatment of patients with chronic angina pectoris,it can alleviate the symptoms of angina pectoris,and regulate the body’s inflammatory response,which is worthy of further promotion.