盐酸地尔硫䓬联合心宝丸治疗冠状动脉微血管疾病的临床研究

Clinical study on diltiazem hydrochloride combined with Xinbao pills in the treatment of coronary microvascular disease

目的探讨盐酸地尔硫䓬联合心宝丸对冠状动脉微血管病变(coronary microvascular disease,CMVD)的疗效。方法选择2020年8月至2022年8月河北工程大学附属医院收治的198例CMVD心绞痛患者作为研究对象,随机数表法分为对照组(盐酸地尔硫䓬治疗)和干预组(盐酸地尔硫䓬+心宝丸治疗),每组99例。比较两组的总有效率;比较治疗前后血液流变学、血管内皮功能、血清内皮细胞特异分子(endothelial cell specific molecule,ESM)1、脂肪特异性丝氨酸蛋白酶抑制剂(visceral adipose tissue-derived serine protease inhibitor,Vaspin)水平及不良反应的发生情况。结果干预组的总有效率高于对照组;干预组的全血高切黏度、全血低切黏度、血栓调节蛋白、血管性血友病因子、内皮素-1以及ESM1水平均低于对照组,而纤维蛋白原、红细胞压积以及Vaspin水平均高于对照组,差异均有统计学意义(P<0.05)。两组治疗期间未观察到药物相关性不良反应。结论盐酸地尔硫䓬联合心宝丸可提高对CMVD的疗效,改善血流动力学指标,保护血管内皮功能,调节Vaspin及ESM1表达水平,具有良好的安全性。

Objective To explore the therapeutic effects of diltiazem hydrochloride combined with Xinbao pills on coronary microvascular disease(CMVD).Methods A total of 198 patients with CMVD angina treated in the affiliated hospital of Hebei engineering university from August 2020 to August 2022 were selected as the study objects.They were divided into control group(treated with diltiazem hydrochloride)and intervention group(treated with diltiazem hydrochloride and Xinbao pills)by random number table method,with 99 cases in each group.The total effective rate was compared between the two groups.The blood rheological indexes,vascular endothelial function indexes,serum endothelial cell specific molecule(ESM)1,visceral adipose tissue-derived serine protease inhibitor(Vaspin)and the occurrence of adverse reactions were compared before and after treatment.Results The total effective rate of intervention group was higher than that of control group.After treatment,the levels of whole blood high shear viscosity,whole blood low shear viscosity,thrombomodulin,von Willebrand factor,endothelin-1 and ESM1 in the intervention group were lower than those in the control group.The levels of fibrinogen,hematocrit and Vaspin were higher than those in the control group,and the differences were statistically significant(P<0.05).No drug-related adverse reactions were observed in the two groups during treatment.Conclusion Diltiazem hydrochloride combined with Xinbao pills can improve the efficacy of CMVD patients,improve the hemodynamic indexes of patients,protect vascular endothelial function,regulate the expression levels of Vaspin and ESM1,and have good safety.