芪参益气滴丸治疗老年慢性稳定性冠心病长期疗效的临床研究  

Long-term Clinical Effect Study on Qisheng Tonifying Qi Dripping Pills on Elderly Chronic Stable Coronary Heart Disease

作　　者：张建辉 彭雪梅[1] 袁洪伟[1] 余本凯[1] ZHANG Jian-hui;PENG Xue-mei;YUAN Hong-wei;YU Ben-kai(Cardiology Department, Fangshan District the First Hospital of Beijing, Fangshan, Beijing, 102400)

机构地区：[1]北京市房山区第一医院心内科,北京房山102400

出　　处：《智慧健康》2018年第3期89-92,共4页Smart Healthcare

摘　　要：目的对芪参益气滴丸治疗老年慢性稳定型冠心病患者2年的有效性及安全性、依从性研究分析。方法选择我院在2015年2月至2015年4月收治的400例冠心病稳定型心绞痛患者,采用随机数字表法分为治疗组(n=200)和对照组(n=200),参照组予以抗血小板、调脂、抗缺血等常规治疗法,治疗组在此基础上加用芪参益气滴丸进行治疗,共治疗24个月,对二组的用药情况和临床事件进行记录及对比。在随访期中,因两组治疗后心绞痛仍无法控制或有缺血加重的客观证据,可以接受介入治疗(PCI)或旁路移植术(CABG)。比较2组全因死亡率、非致死性心梗及卒中、因病情严重需接受介入治疗、手术治疗以及需要住院治疗等事件比例;比较两组临床症状的改善;同时观察治疗组用药的耐受性及用药前后血常规,肝肾功能,血脂等生化指标。结果两组患者的随访时间为(22.3±2.4)个月,研究发现,芪参益气滴丸治疗组能显著改善心绞痛症状(总有效率91%),慢性冠心病缺血心电图改善(总有效率82%),优于常规用药对照组,P<0.05。芪参益气滴丸治疗组患者随访期内非致死性心肌梗死明显低于对照组(7%:13%,χ2=12.1,P<0.01),治疗组复发性心肌梗死、接受再次血运重建率低于对照组(17%:31%,χ2=16.1,P<0.05)。但两组死亡事件发生率无显著性差异(1.5%:2.5%,χ2=4.1,P>0.05)。入组的400名老年冠心病患者,按研究方案全部完成了用药及随访的所有试验要求,未出现因不耐受芪参益气滴丸口服用药脱落的患者,二组的死亡病例及原因比较无显著差异(P>0.05)。治疗组患者除个别有轻度口麻及腹部不适外,无其他严重药物不良反应。随访期间治疗前、治疗后3个月,6个月,12个月、18个月及24个月患者血常规、肝肾功能、血糖血脂检查各项指标差异无统计学意义(P>0.05)。结论服用芪参益气滴丸(24个月)可明显减少心绞痛事件及其他临床事�Objective To study and analyze effectiveness, safety and compliance of Qishen Tonifying qi dripping pills in treatment of elderly chronic stable coronary heart disease（CHD） for two years. Methods Choose 400 cases stable angina pectoris of coronary heart disease patients in our hospital from February 2015 to April 2015, by random digital table method, divide them into treatment group（n=200） and control group（n=200）. Control group was treated with routine therapy of antiplatelet, lipidlowering, anti ischemia, and treatment group with Qishen Tonifying qi dripping pills based on above treatment for 24 months. Record and compare medication situation and clinical events of two groups. During follow-up period, angina pectoris of two groups was still unable to control or had evidence of ischemia exacerbation, percutaneous coronary intervention（PCI） or coronary artery bypass graft（CABG） could be accepted. Compare proportion of all-cause mortality, non-fatal myocardial infarction and stroke, intervention treatment for severe condition, surgical treatment and hospitalization of two groups. Compare improvement of clinical symptoms of two groups, and observe tolerance, blood routine, liver and kidney function, blood lipids and other biochemical indicators before and after medication of treatment group. Results Follow-up time of two groups was（22.3±2.4） months, study found symptoms of angina pectoris of Qishen Tonifying qi dripping pills group was improved significantly（total effective rate of 91%）, chronic coronary heart disease ECG improved（total effective rate of 82%）, better than control group of routine medicine, P〈0.05. During follow-up period, nonfatal myocardial infarction of treatment group with Qishen Tonifying qi dripping pills was significantly lower than control group,（7%：13%, =12.1, P〈0.01）, recurrent myocardial infarction, revascularization rate of treatment group was lower than control group,（17%：31%, =16.1, P〈0.05）. But death incidence showed no significant di

关 键 词：芪参益气滴丸 冠心病 心血管病 

分 类 号：R259[医药卫生—中西医结合]