Advances in Research of Treatment of Angina Pectoris in Coronary Heart Disease from the Method of Dredging Collaterals with Pungent

The angina pectoris in coronary heart disease belongs to the category of"chest impediment"in traditional Chinese medicine,and belongs to the syndrome of root deficiency with tip excess.Its main pathogenesis is obstruction of the heart collaterals,and treatment mainly adopts dredging collaterals and relieving pain.Based on the treatment principles of dredging collaterals with pungent,aiming at the etiology,pathogenesis and disease characteristics of angina pectoris in coronary heart disease,this article systematically analyzes the Method of Dredging Collaterals with Pungent including the methods of dredging collaterals with pungent moisture,dredging collaterals with pungent warm,dredging collaterals with pungent aroma,and dredging collaterals with insect type drugs,to provide ideas for the treatment of angina pectoris in coronary heart disease.

A systematic review and meta-analysis of Dengzhanxixin injection for coronary heart disease with angina pectoris patients

Background:Dengzhanxixin Injection(DZXXI)has been widely used to treat Coronary heart disease with angina pectoris patients.Therefore,the study aimed to evaluate the therapeutic efficacy and safety of DZXXI in treating Coronary heart disease with angina pectoris.Methods:The Cochrane Library,the China National Knowledge Infrastructure database,the Wanfang database,the VIP database,the PubMed database,the Medline database,the EMBASE database,and Clinical Trial were used to search literatures up to August 2022.Results:The results showed that DZXXI combined with conventional therapy were significant in clinical efficacy(relative risk(RR)=1.23,95%cerebral infarction(CI):1.18,1.29;P<0.01)and electrocardiogram curative effect(RR=1.35,95%CI:1.24-1.47;P<0.01),even the subgroup of the DZXXI≤20 ml showed the largest difference.In addition,DZXXI combined with conventional therapy could lower the level of triacylglycerol(mean difference(MD)=−0.63,95%CI:−0.72,−0.55;P<0.01),total cholesterol(MD=−1.18,95%CI:−1.28,−1.09;P<0.01)and low density lipoprotein-cholesterol(MD=−0.98,95%CI:−1.08,−0.88;P<0.01),improve the level of high density lipoprotein-cholesterol(MD=0.41,95%CI:0.33,0.49;P<0.01),blood viscosity(MD=−1.09,95%CI:−1.32,−1.86,P<0.01),plasma viscosity(MD=−0.11,95%CI:−0.11,−0.11,P<0.01)and fibrin(MD=−1.50,95%CI:−1.53,−1.47,P<0.01).Conclusion:These findings revealed that there was more efficacious in DZXXI combined with conventional therapy than that in conventional therapy for the Coronary heart disease with angina pectoris and low dose of DZXXI might be suggested.

A Clinical Study of Safflower Yellow Injection in Treating Coronary Heart Disease Angina Pectoris with Xin-Blood Stagnation Syndrome

Objective： To evaluate the clinical effect and safety of Safflower Yellow injection （SYI） in treating coronary heart disease angina pectoris （OHD-AP） with Xin-blood stagnation syndrome （XBSS）. Methods： Adopted was the multi-centered, randomized, positive parallel controlled method, 448 patients with CHD-AP-XBSS were enrolled and divided into two groups, 336 in the tested group treated with SYI and 112 in the control group treated with Salvia injection by intravenous dripping once a day for 14 days, so as to observe the conditions of angina, electrocardiogram, and therapeutic effect on traditinal Chinese medicine （TCM） symptoms as well as the safety of the treatment. Results： The significantly effective rate and total effective rate in the tested group were 60.06% （194/323） and 91.02 % （294/323） respectively; those in improvement of TOM symptoms were 40. 18% （129/321） and 75.23% （243/323） respectively, which were better than those in the control group （P〈0.01）. Conclusion： SYI Injection is effective and safe in treating OHD-AP-XBSS.

Clinical Non-inferiority Trial on Treatment of Coronary Heart Disease Angina Pectoris of Xin-blood Stasis Syndrome Type with Lyophilized Salvia Salt of Lithospermic Acid Powder for Injection

Objective： To evaluate the effectiveness and safety of lyophilized Salvia salt of lithospermic acid powder for injection （SSLA） in treating coronary heart diseases angina pectoris （CHD-AP） of Xin-blood stasis syndrome type, and to conduct the non-inferiority trial with Danshen injection （丹参注射液, DSI） as positive control. Methods： An non-inferiority clinical layered, segmented, randomized, and blinded trial on three parallel and multiple centered groups was conducted in 480 patients with stable effort angina grade Ⅰ , Ⅱand Ⅲ, who had two or more times of attack every week. The 240 patients in test group A were treated with SSLA 200 mg added in 250 ml of 5% glucose solution for intravenous dripping every day; the 120 patients in test group B were treated with SSLA but the dosage doubled; and the 120 patients in the control group were treated with DSI 20 ml daily in the same method as SSLA was given. The clinical effectiveness and safety were evaluated after the patients were treated for 14 days. Results： The results showed that the markedly effective rate in test groups A, B and control group was 37.45 %, 36.75 % and 30.09 % respectively, while the total effective rate in them was 88.09%, 89.74% and 67.26% respectively. Statistical significance was shown in comparisons of the therapeutic effect between control group with test group A and test group B, with that in the two test groups superior to that in the control group, and non-inferiority trial showed eligibility （P〈0.01）. Adverse reaction appeared in 8 patients in the test groups and 2 in the control group. Conclusion： SSLA has definite therapeutic effect in treating patients with CHD-AP, with its effect not inferior to that of DSI, and no evident toxic-adverse reaction.

Optimal scheme of Shengmai Injection in the treatment of angina pectoris of coronary heart disease based on Louvain algorithm: A real world study

Objective:To explore the optimal scheme of Shengmai Injection combined with other drugs for clinical doctors.Methods:Based on the large-scale data warehouse established by the institute of Clinical Basic Medicine,Chinese Academy of Traditional Chinese Medicine,the hospital information system of 22 large-scale tertiary hospitals in China was collected and 1751 patients with angina pectoris who were treated with Shengmai Injection were selected.Louvain algorithm and complex network analysis are used to build the model to summarize the rule of Shengmai Injection in the treatment of angina pectoris of coronary heart disease.Results:On the basis of Shengmai Injection,according to the symptom treatment of angina pectoris of coronary heart disease,nitrates or Suxiao Jiuxin Pill was used to dilate coronary artery;for the treatment of risk factors of angina pectoris,a combination of"insulin+acarbose+bisoprolol+nifedipine+captopril+estazolam"was used to control blood glucose and blood pressure;"Ganmao Qingre Granule+levofloxacin"to treat upper respiratory tract infection and other medication regimens were used as well.For the complications of angina pectoris of coronary heart disease,"furosemide+spironolactone+potassium chloride+magnesium sulfate"was used to reduce edema and“isosorbide nitrate+metoprolol+Shenmai injection+Wenxin Granule"was used to improve symptom of heart failure of qi and yin deficiency type.Conclusion:The therapeutic regimen of Shengmai Injection combined with traditional chinese medicine and western medicine is basically consistent with the current guidelines,but more clinical studies are still needed to explore more effective combination therapy.

Effects of adjuvant Chinese patent medicine therapy on major adverse cardiovascular events in patients with coronary heart disease angina pectoris:a population-based retrospective cohort study

Objective: This study aimed to explore the effects of Chinese patent medicine(CPM) in reducing the incidence of major adverse cardiovascular events(MACE) in patients with coronary heart disease(CHD) angina pectoris and improving clinical effectiveness and provide evidence for its use as clinical adjuvant therapy.Methods: Twenty-eight thousand five hundred and seventeen patients hospitalized with CHD angina pectoris from 6 hospitals were divided into CPM group(n = 11,374) and non-CPM group(n = 17,143) to evaluate the incidence of MACE, including myocardial infarction, percutaneous coronary intervention, and coronary artery bypass grafting.Results: The incidence of MACE in the CPM group was lower than that in the non-CPM group. CPM therapy was an independent protective factor that reduced the overall risk of MACE [adjusted hazard ratio = 0.40, 95% confidence interval(0.33;0.49)]. Patients in the CPM group who received one, two, or three types of CPM could benefit from adjuvant treatment with CPM, and taking more types of CPM was associated with a lower risk of MACE. In addition, the male population was better than the female population at taking CPM, and middle-aged people aged 55 to 64 were more suited to take CPM based on Western medicine.Conclusions: The use of CPM as adjuvant therapy can decrease the occurrence of MACE in patients with CHD angina pectoris,especially in men and middle-aged people, and the drug treatment plan should be optimized accordingly. However, this conclusion needs further verification by prospective cohort studies in the future.

Network-meta analysis of 9 kinds of patent Chinese medicine for nourishing qi and activating blood in the treatment of angina pectoris of coronary heart disease

Objective:To evaluate the efficacy and safety of Yiqi Huoxue oral Chinese patent medicine in the treatment of angina pectoris.Methods:the databases of EMBASE,PubMed,CNKI,Wanfang and VIP were searched by computer,and the randomized controlled trial(RCT)of Yiqi Huoxue Chinese patent medicine in the treatment of angina pectoris of coronary heart disease(CHD)was searched until December 2019.By using stata15.1 software,the total clinical effective rate,the improvement rate of ECG,the improvement rate of angina pectoris,the attack frequency and duration of angina pectoris were taken as the outcome indicators for network meta analysis and mapping.Results:51 RCTs were included,including 9 kinds of traditional Chinese medicine.The results of network meta analysis showed that:in terms of clinical total effective rate,the order was Shexiang Baoxin Pill(78.2%)>xueshuanxinming tablet>Dengzhan Shengmai capsule>Shengui Capsule>Tongxinluo capsule>Tongmai Yangxin pill>Yangxin tablet>Shexiang Tongxin drop pill>Naoxintong capsule;the improvement of ECG was Tongmai Yangxin pill(85.2%)>Yangxin tablet>Dengzhan Shengmai capsule>Shexiang Tongxin drop pill>Shexiang Baoxin Pill>Tongxinluo gum Capsule>Shengui Capsule>Naoxintong capsule;in order to reduce the frequency and duration of angina pectoris,they are conventional Naoxintong capsule(88.6%)>Shengui Capsule>Tongmai Yangxin pill>Shexiang Baoxin Pill>xueshuanxinmingpian>Tongxinluo capsule>Shexiang Tongxin drop pill>Dengzhan Shengmai capsule;Shexiang Baoxin Pill(66.9%)>Dengzhan Shengmai capsule>Shexiang Tongxin drop pill>Tongxinluo capsule>xueshuanxinmingning capsule Tablet>Tongmai Yangxin pill.Conclusion:Traditional Chinese medicine combined with western medicine has obvious advantages in the treatment of angina pectoris.Shexiang Baoxin Pill,Dengzhan Shengmai capsule and Tongmai Yangxin pill can be given priority.

Sixty-one Cases of Angina Pectoris due to Coronary Heart Disease Treated by External Use of the Paste of Nitrum and Realgar Powder on Zhiyang(GV 9)

In order to inquire into the therapeutic effects of Xiao Shi Xiong Huang San (硝石雄黄散the Nitrum and Realgar Powder), one of the Dunhuang Prescription, on angina pectoris due to coronary heart disease (APCHD), the authors have treated 61 cases of APCHD by externally applying paste of the powder on Zhiyang (GV 9), with another 30 cases of APCHD treated with the nitroglycerin paste on Zhiyang as the controls. The results showed that the total effective rate was 82% and markedly effective rate 31.2% in the treatment group (the Paste of Nitrum and Realgar Powder), and the total effective rate was 46.6% and markedly effective rate 23.2% in the control group (the nitroglycerin paste). The difference in therapeutic effects between the two groups was very significant (P<0.01), indicating that the therapeutic effect of the former was significantly superior to that of the latter.

The efficacy and safety of clopidogrel and aspirin in coronary heart disease with angina pectoris: a systematic review and meta-analysis

Background:To assess the efficacy and safety of clopidogrel combined with aspirin for angina pectoris.Methods:Randomized controlled trials were searched in PubMed,Excerpta Medica Database,the Cochrane Library,China National Knowledge Infrastructure,WANFANG databases and VIP databases from inception to February,2020.Methodological quality was evaluated by the tool of Cochrane collaboration.The meta-analysis was performed in the RevMan 5.3.Results:Fourteen randomized controlled trials with a total of 1,130 participants were included.Meta-analysis showed that for patients with angina pectoris,clopidogrel combined with aspirin had better clinical efficacy than aspirin alone(RR=1.26,95%CI:1.19-1.32,P<0.00001);on the interval time,duration and frequency of angina attack,clopidogrel and aspirin had better effect than aspirin alone(MD=2.09,95%CI:2.07-2.11,P<0.00001;MD=−2.48,95%CI:−3.12 to−1.84,P<0.00001;MD=−1.47,95%CI:−2.59 to−0.35,P=0.01,respectively).Moreover,the available data showed that aspirin and clopidogrel for patients with coronary heart disease with angina pectoris were safer than aspirin alone(RR=0.41,95%CI:0.27-0.61,P<0.0001).Conclusion:Clopidogrel combined with aspirin could be effective for patients with angina pectoris,meanwhile,it is important to be aware of the potential side effects.

Effect of action research-based exercise training guidance on exercise endurance and readmission rate in patients with stable angina pectoris due to coronary heart disease

Background Stable angina pectoris is a common subtype of coronary heart disease.Patients suffer from chest tightness,chest pain and crushing pain under the inducement of fatigue and emotional agitation.This study aims to investigate the effect of exercise training guidance based on action research on exercise endurance and readmission rate of patients with stable angina pectoris.Methods A retrospective study was conducted on 60 patients with stable angina pectoris due to coronary heart disease admitted to our hospital from February 2020 to November 2023.Patients were divided into a control group of 29 cases(receiving conventional exercise training guidance)and a guidance group of 31 cases(receiving action research-based exercise training guidance).Both groups received continuous training for one month.A comparison was made between the exercise endurance indicators[6-minute walk test distance(6MWT),peak oxygen consumption(peak VO2),anaerobic threshold(AT),exercise duration(ED)],quality of life,and readmission rate within 6 months after intervention in both groups.Results After 1 month of intervention,6MWT,peak VO2,AT and ED were increased in both groups,and those in the guidance group were higher than those in the conventional group(P<0.05).The score of quality of life(The 36-item shot-form health status survey,SF-36)in both groups was increased,and the guidance group scored higher than the conventional group(P<0.05).The readmission rate of patients in the guidance group was 6.45%,which was lower than that in the conventional group(27.59%)(P<0.05).Conclusions The application of action research-based exercise training guidance in patients with stable angina pectoris due to coronary heart disease has significant effects,improving exercise endurance,significantly improving quality of life,and reducing readmission rate,thus having practical value.[S Chin J Cardiol 2024;25(3):162-168]

Efficacy and prognostic impact of Pericarpium Trichosanthis injection combined with nicorandil for intractable angina pectoris in elderly patients: A retrospective study

BACKGROUND Coronary artery disease(CAD)is a leading cause of global cardiovascular morta-lity.Refractory angina pectoris,a manifestation of CAD,requires effective drug treatments.Pericarpium Trichosanthis injection,a traditional Chinese medicine,improves cardiovascular symptoms,while nicorandil alleviates spasms and angina.Both have potential in treating CAD.AIM To investigate the therapeutic effects of combining Pericarpium Trichosanthis injection and nicorandil in elderly patients suffering from refractory angina caused by coronary heart disease.METHODS A retrospective analysis was conducted on the data of 130 patients diagnosed with refractory coronary heart disease.Based on the different treatment regimens administered during hospitalization,the patients were divided into a control group(58 cases)and a study group(72 cases).The control group received conven-tional treatment,which included aspirin,statins,and nitrate vasodilators.In addition to the conventional medication,the study group received a combination treatment of Pericarpium Trichosanthis injection and nicorandil.RESULTS After treatment,the study group showed significantly higher left ventricular ejection fraction and cardiac output,and lower brain natriuretic peptide and C-reactive protein levels compared to the control group.The study group also exhibited improvements in angina,quality of life,exercise endurance,and lipid profiles.Multivariate logistic regression analysis revealed a relationship of lipid levels and heart function with the combined treatment.Some patients in the study group experienced headaches during treatment,but no significant adverse reactions were observed.Follow-up showed that the treatment was well-tolerated,with no drug-related adverse reactions detected.CONCLUSION Combination of Pericarpium Trichosanthis injection and nicorandil is more effective than conventional treatment in improving symptoms and heart function in elderly patients with refractory angina pectoris.

Plasma levels of omentin-1 and visfatin in senile patients with coronary heart disease and heart failure

Objective:To investigate the alteration of plasma levels of omentin-1 and visfatin in elderly patients with coronary heart disease(CHD)and heart failure.Methods:Plasma omentin-1 and visfatin levels were measured in 90 subjects(29 stable angina pectoris(SAP)cases,30 unstable angina pectoris(UAP)cases and 31 age-and sex-matched healthy controls(age≥60 years)by enzyme-linked immunosorbent assay methods.According to the New York Heart Association classification.59 CHDs were divided into three groups:functional I class,11 cases;functional II/III class,36 cases;and functional IV class,12 cases.Results:The plasma level of omentin-1in CHO patients was significantly lower than thai of the control group.Otnenlin-lin SAP group and UAP group were significantly lower compared to the control group(there was no statistical significance between UAP group and SAP group;P>0.05).The plasma level of visfatin in CHD patients was significandy higher than that of the control group.Similarly,visfatin in SAP group and UAP group were all significantly higher compared to the control group,while there was no statistical significance between UAP group,and SAP group.The plasma omentin-1 level was negatively correlated with SBP(r=-0.264,P<0.05),positively correlated with HDL-c level(r=0.271,P<0.05);the plasma visfatin level was positively correlated with TC(r=0.292,P<0.05),negatively correlated with HDL-c level(r=-0.266,P<0.05).There was a negative correlation between plasma omentin-1 and visfatin levels(r=-0.280,P<0.05).Moreover,multiple linear stepwise regression analysis showed that omentin-1 and visfatin levels might be affected by HDL-c level.Logistic regression analysis showed that visfatin could be an independent risk factor of CHD.Conclusions:Decreased levels of omentin-1 and increased levels of visfatin may be involved in the occurrence and development of CHD.Omentin-1 and visfatin,independently,may be protective and pro-inflammatory cytokines.Additionally,both omentin-1 and visfatin may be related to lipid metabolism.Visfatin may be an independent risk factor of CHD.

Trial Study on DENG Tie-tao's Coronary Heart Disease Capsules in Improving Patients' Quality of Life

Objective： To assess the efficacy of the Coronary Heart Disease （CHD） Capsules worked out by Prof. Deng -- in improving quality of life of CHD patients of qi deficiency with phlegm and blood stasis syndrome. Method： According to the WHO＇s diagnosis criteria of CHD, a total of 93 stable angina patients were divided into 3 groups using the single blinded method. The groups were evenly distributed into CHD Capsule treated group （CHDC）, isosorbide dinitrate control group （ID）, and Compound Prescription Danshen Droplet Pills control group （CPDDP）. Two courses of treatment lasting for 6 months were given. During the courses of treatment, the following parameters were observed： clinical symptoms of angina pectoris, ECG change, treadmill exercise test, 36 items in short form of health survey （SF-36） and Seattle Angina Questionnaire （SAQ） scale. Results： After 6 months of treatment, all the three groups showed good curative effect in angina pectoris, ECG and treadmill exercise test, differences between them had no statistical significance. The CHDC group showed a better result in nitro-glycerine stopping or alleviation rate and in improving symptoms than the other groups （P〈0.05）. The general health, vitality, role-emotional, mental health and reported health transition in the CHDC group were significantly better than those in the control groups （P〈 0.05）. The scores in physiological functioningrole, physiological function and pain alleviation were not different among the three groups. Conclusion. Prof. DENG Tie-tao＇s CHDC is effective in treating CHD with qi deficiency, phlegm and blood stasis and also in improving the quality of life. CHDC is more suitable to be used in long-term treatment than isosorbide dinitrate. The SF-36 and SAQ can be used to appraise the curative effect of traditional Chinese medicine agents for CHD angina pectoris.

CLINICAL OBSERVATION AND STUDY OF MECHANISMSOF ACUPUNCTURE TREATMENT OFCORONARY HEART DISEASE

In the present paper, 80 in-patients with coronary heart disease were randomly assignedto acupuncture group, Western medicine group and acupuncture transient effect group, and 30 healthyblood donors were served as control group. At the same time of further observation on clinical therapeutic effects of acupuncture, effects of acupuncture on contents of blood monoamine, serotonin(5-HT), noradrenaline(NE) and dopamine(DA) for analyzing mechanisms of acupuncture treatment. Results indicated that 1. Therapeutic effects of acupuncture on angina pectoris and changes of ST-T segment of ischemic electrocardiogram (ECG) in patients of coronary heart disease were superior to thosein the Western medicine group, suggesting that acupuncture improves markedly left ventricular function; 2. The contents of blood 5-HT, 5-hydroxyindol acetic acid (5-HIAA ) and NE in patients ofcoronary heart disease were significantly higher than those in the healthy blood-donors; 3. After onetherapeutic course, the contents of blood 5-HT, 5-HIAA and NE in the acupuncture group were obviously lower than those before treatment and in the Western medicine respectively, indicating that themechanism of acupuncture treating coronary heart disease is related with regulatory effects of acupuncture on blood contents of 5-HT and NE.

Application progress of cognitive behavioral therapy in coronary heart disease

To As one of the most common cardiovascular diseases,coronary heart disease has a high morbidity and mortality.In recent years,non-drug therapy has been put on equal importance with drug therapy due to its simple operation and fast onset.Cognitive behavioral therapy,as a kind of non-drug therapy,has been widely used to improve the physical and mental symptoms of patients with coronary heart disease.This article reviews the origin,concept,theoretical basis,characteristics,technology,and current research status of cognitive behavioral therapy in patients with coronary heart disease,in order to provide a reference for the clinical development of cognitive behavioral therapy.

Effect of St. John＇s wort extract on depressive disorder in elderly patients with unstable angina

The elderly patients with coronary heart disease （CHD） are often accompanied with depression. This study aimed to assess the effect of St. John＇s wort extract （SWE） on depressive disorder in elderly patients with unstable angina pectoris. Altogether 170 patients who met the set criteria were enrolled in this prospective study. They were randomly divided into SWE group （44 patients）, Deanxit group （44）, psychotherapy group （42）, and control group （40）. The effectiveness of SWE was evaluated by reduced percentage of Hamilton depression （HAMD） scale and reduced frequency of angina pectoris attack, which were measured before and at 12 weeks after the treatment with SWE. The reduced percentages of HAMD scale were 79.5%, 56.8% and 57.1% in the SWE, Deanxit and psychotherapy groups, respectively. Compared with the control, the three groups had significant differences in the percentages （P〈0.001）. The improvement after the treatment was more significant in the SWE group than in the Deanxit or psychotherapy group （P〈0,05）. The improvement of angina pectoris evaluated by the Canadian Cardiac Society Classification was significantly better in the treatment groups （88.7%, 65.9%, 57.1%） than in the control group, and it was marked in the SWE group （P〈0.001）. Angina pectoris attack, its frequencies, durations and electrocardiographic changes were significantly improved in the treatment groups than in the control group （F=6.05, 4.58, 5.12, P〈0.01）. They are markedly improved in the SWE group （P〈0.05）. SWE can improve depressive symptoms more significantly in elderly patients with unstable angina pectoris than Deanxit or psychotherapy, proving that SWE contributes to better treatment of angina attack as well.

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

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。

夏橘化瘀胶囊治疗气虚血瘀型冠状动脉旁路移植术后再发心绞痛的临床效果

目的 探讨夏橘化瘀胶囊治疗气虚血瘀型冠状动脉旁路移植术后再发心绞痛的临床效果。方法 选取2021年1月至12月山东省潍坊市中医院收治的70例行冠状动脉旁路移植术后再发心绞痛患者为研究对象,采用随机数字表法将其分为对照组和观察组,各35例。对照组采用西医常规治疗,观察组采用西医常规治疗+夏橘化瘀胶囊,两组均连续治疗3个月。比较两组中医证候疗效,比较两组治疗前后心绞痛发病频率、持续时间、西雅图心绞痛量表评分、N-末端B型利钠肽前体(NT-pro BNP)、超敏C反应蛋白(hs-CRP)水平,同时记录患者相关安全性指标。结果 观察组中医证候疗效优于对照组(P<0.05)。治疗后,两组心绞痛发病频率少于治疗前、持续时间短于治疗前,且观察组心绞痛发病频率少于对照组、持续时间短于对照组(P<0.05)。治疗后,两组西雅图心绞痛量表各项评分均高于治疗前,且观察组高于对照组(P<0.05)。治疗后,两组血清NT-pro BNP、hs-CRP水平低于治疗前,且观察组低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 夏橘化瘀胶囊对冠状动脉旁路移植术后再发心绞痛有明显改善作用,且安全性较高,具有重要的临床应用价值。

瑞舒伐他汀联合氯吡格雷治疗冠心病不稳定型心绞痛的有效性探讨

目的探讨对于冠状动脉粥样硬化性心脏病(简称冠心病)不稳定心绞痛患者实施瑞舒伐他汀联合氯吡格雷治疗的有效性及安全性。方法选取2021年3月—2022年12月东台市中医院收治的116例冠心病不稳定心绞痛患者为研究对象,均实施常规药物(如阿司匹林肠溶片+酒石酸美托洛尔+低分子肝素)治疗,以随机摸球法将其分为两组,各58例。对照组在常规处理后联合辛伐他汀,治疗组在常规处理后给予瑞舒伐他汀联合氯吡格雷治疗。对比两组治疗有效性、心绞痛发作情况、血脂指标和安全性。结果治疗组治疗总有效率(96.55%)高于对照组(86.21%),差异有统计学意义(χ^(2)=3.940,P<0.05)。经过6周治疗后,治疗组心绞痛发作频率及持续时间均少于对照组,差异有统计学意义(P均<0.05);治疗组血脂指标中三酰甘油、总胆固醇及低密度脂蛋白胆固醇水平明显低于对照组低,高密度脂蛋白胆固醇水平显著高于对照组,差异有统计学意义(P均<0.05)。治疗组不良反应发生率显著低于对照组,差异有统计学意义(P<0.05)。结论对冠心病不稳定型心绞痛患者以瑞舒伐他汀联合氯吡格雷进行治疗,能减少心绞痛发作情况,缩短发作持续时间,控制血脂水平,同时也具有一定的安全性,可减少不良反应。

阿司匹林联合替格瑞洛治疗冠心病不稳定型心绞痛的疗效及对患者心室重塑、氧化应激的影响

目的 观察阿司匹林联合替格瑞洛治疗冠心病不稳定心绞痛的疗效,并评估其对患者心室重塑、氧化应激等指标的影响。方法 选取2021年10月至2023年10月期间新乡市中心医院收治的186例冠心病不稳定心绞痛患者纳入研究,采用随机数表法分为观察组和对照组,每组93例。对照组患者采用阿司匹林联合氢氯吡格雷片治疗,观察组患者采用阿司匹林联合替格瑞洛治疗,均连续治疗3个月。比较两组患者的临床疗效,以及治疗前后的心室重塑[基质金属蛋白酶-9 (MMP-9)、半乳凝素-3 (Gal-3)]、血管内皮功能[血清细胞间黏附分子-1 (ICAM-1)、血管紧张素Ⅱ(AngⅡ)、内皮素-1 (ET-1)、血流介导舒张功能(FMD)水平]和氧化应激[一氧化氮(NO)、丙二醛(MDA)、超氧化物歧化酶(SOD)]水平。结果 观察组患者的治疗总有效率为96.77%,明显高于对照组的86.02%,差异有统计学意义(P<0.05);观察组患者治疗后的MMP-9水平为(141.28±19.33)μg/L,明显低于对照组的(164.72±19.86)μg/L,而Gal-3水平为(6.87±0.92) ng/mL,明显高于对照组的(5.36±0.84) ng/mL,差异均有统计学意义(P<0.05);观察组患者治疗后的ICAM-1、AngⅡ和ET-1水平分别为(56.87±9.70) pg/mL、(0.70±0.14) ng/mL和(43.15±5.83) pg/mL,明显低于对照组的(81.35±10.31) pg/mL、(0.96±0.15) ng/mL和(52.37±6.37) pg/mL,而FMD水平为(14.82±1.93)%,明显高于对照组的(11.27±2.33)%,差异均有统计学意义(P<0.05);观察组患者治疗后的NO、SOD水平分别为(77.95±9.60) mol/L、(112.69±11.47) U/L,明显高于对照组的(62.49±9.37) mol/L、(107.34±10.63) U/L,而MDA水平为(12.45±2.26) mmol/L,明显低于对照组的(15.38±2.35) mmol/L,差异均有统计学意义(P<0.05)。结论 阿司匹林联合替格瑞洛治疗不稳定型冠心病疗效确切,且能促进患者的心室重塑、改善血管内皮功能及氧化应激指标。