艾灸联合曲美他嗪对老年冠心病稳定型心绞痛患者血小板聚集功能的影响

Effect of moxibustion combined with trimetazidine on platelet aggregation in elderly patients with stable angina pectoris of coronary heart disease

目的 探讨艾灸联合曲美他嗪用于老年冠心病稳定型心绞痛的效果,观察血小板聚集功能变化。方法 选取2020年1月至2022年1月收治的冠心病稳定型心绞痛患者96例,随机数字表法分为观察组和对照组,每组48例。对照组给予曲美他嗪治疗,观察组在对照组基础上加用艾灸治疗。观察2组患者临床疗效,比较2组患者治疗前后中医证候评分、心功能[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)]、血小板聚集功能、心绞痛发作次数、持续时间及西雅图心绞痛量表(SAQ)评分,观察不良反应发生情况。结果 观察组临床总有效率显著高于对照组(P<0.05);观察组胸痛胸闷、面色暗紫、痰多体胖、倦态乏力评分均低于治疗前且低于对照组治疗后(P<0.05);治疗后观察组2.5μmol/L、5μmol/L、300μmol/L诱导剂下的血小板聚集均显著低于治疗前且低于对照组治疗后(P<0.05);观察组LVEF、SAQ量表高于治疗前及对照组,LVEDD、LVESD、心绞痛发作次数、持续时间低于治疗前及对照组(P<0.05);2组患者不良反应差异无统计学意义(P>0.05)。结论 艾灸联合曲美他嗪可改善老年冠心病稳定型心绞痛患者心功能、血小板聚集功能,减少患者心绞痛频率及持续时间,安全性高。

Objective To explore the effect of moxibustion combined with trimetazidine on stable angina pectoris in elderly patients with stable angina pectoris of coronary heart disease and to observe changes in platelet aggregation function.Methods A total of 96 cases of stable angina pectoris combined with coronary heart disease admitted to our hospital from January 2020 to January 2022 were randomly divided into the observation group and the control group,with 48 cases in each group.Patients in both groups were treated with trimetazidine,and those in the observation group were additionally treated with moxibustion.Clinical curative effect,the traditional Chinese medicine(TCM) syndrome score,cardiac function(left ventricular ejection fraction [LVEF],left ventricular end diastolic diameter [LVEDD],left ventricular end systolic diameter [LVESD]),platelet aggregation function,attack times and duration of angina pectoris and the Seattle Angina Questionnaire(SAQ) score before and after treatment were compared.Adverse reactions were recorded.Results The total clinical effective rate in the observation group was significantly higher than that of the control group(P<0.05).After treatment,the scores of chest pain,chest tightness,dark purple complexion,excessive phlegm,fatigue and fatigue in the observation group were significantly lower than those before treatment,which were significantly lower than those of control group(P<0.05).After treatment,the platelet aggregation after the induction of 2.5μmol/L,5μmol/L and 300μmol/L inducers in the observation group was significantly lower than that before treatment,which was significantly lower than that of control group(P<0.05).After treatment,the LVEF and scores of the SAQ in the observation group were significantly higher than those before treatment,which were significantly higher than those of the control group.LVEDD,LVESD,and attack times and duration of angina were significantly lower after treatment in the observation group than those before treatment,which were significantly lower than those of the control group(P<0.05).There was no significant difference in the incidence of adverse events between groups(P>0.05).Conclusion Moxibustion combined with trimetazidine can improve the cardiac function and platelet aggregation function of elderly patients with stable angina pectoris of coronary heart disease,reduce the frequency and duration of angina pectoris with a high safety.