摘要
【目的】观察注射用丹参多酚酸盐对冠心病心绞痛心血瘀阻型患者的疗效及对患者血脂、炎症因子、血液流变学、心功能指标的影响。【方法】将100例冠心病心绞痛心血瘀阻型住院患者随机分为治疗组和对照组,每组各50例。对照组给予西医常规治疗,治疗组在对照组的基础上给予静脉滴注注射用丹参多酚酸盐治疗,疗程为2周。观察2组患者治疗前后西雅图心绞痛量表(SAQ)评分及血清炎症因子、血脂、血液流变学、心功能指标的变化情况,并评价2组患者的心绞痛疗效和安全性。【结果】(1)心绞痛疗效方面:治疗2周后,治疗组的总有效率为86.0%(43/50),对照组为72.0%(36/50),组间比较,治疗组的心绞痛疗效明显优于对照组(P<0.05)。(2)SAQ评分方面:治疗后,2组患者SAQ量表各项评分均较治疗前明显提高(P<0.05),且治疗组对SAQ量表各项评分的提高作用均明显优于对照组(P<0.05)。(3)炎症因子方面:治疗后,2组患者血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)水平均较治疗前明显降低(P<0.05),且治疗组对血清hs-CRP、TNF-α水平的降低作用均明显优于对照组(P<0.05)。(4)血脂方面:治疗后,2组患者的总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平均较治疗前降低(P<0.05),高密度脂蛋白胆固醇(HDL-C)水平均较治疗前升高(P<0.05),且治疗组对TC、TG、LDL-C水平的降低作用和对HDL-C水平的升高作用均明显优于对照组,差异均有统计学意义(P<0.05)。(5)血液流变学方面:治疗后,2组患者的全血高切黏度、全血低切黏度和血浆黏度均较治疗前明显降低(P<0.05),且治疗组对各项血液流变学指标的降低作用均明显优于对照组(P<0.05)。(6)心功能方面:治疗后,2组患者的左室射血分数(LEVF)、左室舒张早期快速充盈的充盈峰(E峰)、左室舒张早期快速充盈的充盈峰与舒张晚期充盈的充盈峰的比值(E/A值)均较治疗前明显改善(P<0.05),且治疗组对各项心功能指标的改善作用均明显优于对照组(P<0.05)。(7)安全性方面:治疗过程中,2组患者均未发生严重不良反应。【结论】注射用丹参多酚酸盐对冠心病心绞痛心血瘀阻型患者的治疗有效,能有效改善患者的心功能、血液流变学、血脂及炎症因子水平。
Objective To observe the clinical efficacy of salvianolate for injection in treating coronary heart disease(CHD)patients with angina pectoris(AP)differentiated as heart-blood stasis obstruction syndrome and to observe its effects on blood lipids,inflammatory factors,blood rheology and cardiac function indexes.Methods A total of 100 CHD-AP inpatients with heart-blood stasis obstruction syndrome were randomly divided into the treatment group and the control group,with 50 cases in each group.The control group was given conventional western medical treatment,while the treatment group was given intravenous injection of salvianolate on the basis of treatment for the control group for a period of 2 weeks.Before and after treatment,we observed the changes in the Seattle Angina Questionnaire(SAQ)scores and serum inflammatory factors,blood lipids,blood rheology and cardiac function indexes of the patients in the two groups.After treatment,the clinical efficacy and safety for angina pectoris in the two groups were evaluated.Results(1)After 2 weeks of treatment,the overall effective rate for angina pectoris in the treatment group was 86.0%(43/50)and that in the control group was 72.0%(36/50),and the intergroup comparison showed that the angina pectoris efficacy of the treatment group was significantly superior to that of the control group(P<0.05).(2)After treatment,the scores of all the items of SAQ in the two groups were significantly improved compared with those before treatment(P<0.05),and the effect on the improving the scores of all the items of SAQ in the treatment group was significantly superior to that in the control group(P<0.05).(3)After treatment,the levels of serum hypersensitive C-reactive protein(hs-CRP)and tumor necrosis factorα(TNF-α)were significantly decreased in both groups compared with those before treatment(P<0.05),and the treatment group had a significantly stronger effect on decreasing serum hs-CRP and TNF-ɑlevels than the control group(P<0.05).(4)After treatment,the levels of total cholesterol(TC),triglycerides(TG)and low-density lipoprotein cholesterol(LDL-C)in both groups were decreased compared with those before treatment(P<0.05),and the level of high-density lipoprotein cholesterol(HDL-C)was increased compared that before treatment(P<0.05).The treatment group had stronger effect on lowering TC,TG and LDL-C levels and on increasing HDL-C level than the control group,and the differences were statistically significant(P<0.05).(5)After treatment,the whole blood high-shear viscosity,whole blood low-shear viscosity and plasma viscosity of the two groups were significantly decreased compared with those before treatment(P<0.05),and the decrease of hemorheology indexes in the treatment group was significantly superior to that in the control group(P<0.05).(6)After treatment,the left ventricular ejection fraction(LEVF),the peak value at early-diastolic fast filling period of the left ventricle(peak E),and the ratio of peak E to the peak value at late-diastolic filling period of the left ventricle(E/A value)in both groups were significantly improved compared with those before treatment(P<0.05),and the improvement of cardiac function indexes in the treatment group was significantly superior to that in the control group(P<0.05).(7)No serious adverse reactions occurred in the two groups during the treatment.Conclusion Salvianolate for injection is effective in treating CHD patients with angina pectoris differentiated as heart-blood stasis obstruction syndrome,which can effectively improve patients’cardiac function,blood rheology,blood lipids and inflammatory factor levels.
作者
陈静
陶永
戴小华
张国梁
许祖建
袁良
侯勇
CHEN Jing;TAO Yong;DAI Xiao-Hua;ZHANG Guo-Liang;XU Zu-Jian;YUAN Liang;HOU Yong(The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031 Anhui,China;Branch of National Clinical Research Center for Chinese Medicine Cardiology,Institute of Cardiovascular Disease of Anhui Academy of Traditional Chinese Medicine,Hefei 230031 Anhui,China)
出处
《广州中医药大学学报》
CAS
2023年第5期1070-1076,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
国家重点研发计划项目(编号:2017YFC1700306)
安徽省高校探索性科研项目(编号:2021zxts30)。
关键词
冠心病心绞痛
心血瘀阻
注射用丹参多酚酸盐
心功能
血脂
炎症因子
血液流变学
angina pectoris in coronary heart disease
heart-blood stasis obstruction
salvianolic for injection
cardiac function
blood lipids
inflammatory factors
blood rheology
