心可舒治疗冠心病心绞痛的疗效及对血液流变学及炎症因子的影响——一项多中心、随机、双盲、安慰剂对照临床研究  

Efficacy of Xinkeshu in treating angina pectoris of coronary heart disease and its effects on hemorheology and inflammatory factors

作　　者：白丽娜[1] 张虹[1] 严萍[2] 张云霞[3] 赵玉兰[4] 关怀敏[5] 王显[6] BAI Li-na;ZHANG Hong;YAN Ping;ZHANG Yun-xia;ZHAO Yu-lan;GUAN Huai-min;WANG Xian(Department of Cardiology,Tianjin Nankai Hospital,Tianjin 300193,China;the Second Affiliated Hospital of Fujian Traditional Chinese Medical University,Fuzhou 350000,China;Wenzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Traditional Chinese Medical University,Wenzhou 325000,China;the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China;Dongzhimen Hospital Beijing University of Chinese Medicine,Beijing 100000,China)

机构地区：[1]天津市南开医院心内科,天津300193 [2]福建中医药大学附属第二人民医院,福建福州350000 [3]温州市中医院,浙江温州325000 [4]郑州大学第二附属医院,河南郑州450000 [5]河南中医药大学第一附属医院,河南郑州450000 [6]北京中医药大学东直门医院,北京100000

出　　处：《实用药物与临床》2021年第8期678-683,共6页Practical Pharmacy and Clinical Remedies

基　　金：山东省科技厅省技术创新专项(201541907016)。

摘　　要：目的探讨心可舒治疗冠心病心绞痛的疗效及对血液流变学及炎症因子的影响。方法本研究选取2016年6月至2019年10月多中心收治的冠心病心绞痛患者120例,观察心可舒片对慢性稳定型心绞痛患者心绞痛症状的疗效,其中60例做运动平板心电图,以考察基础治疗合并应用心可舒片对于改善患者运动耐量的疗效,按1∶1分配为观察组(心可舒片治疗)和对照组(心可舒片模拟剂治疗)。治疗过程中观察组脱落5例(其中3例为运动平板心电图者),对照组脱落4例(其中2例为运动平板心电图者)。比较两组治疗前后心绞痛发作次数及持续时间、心绞痛治疗疗效、中医证候疗效、运动平板实验结果及安全性。120例患者中92例具有血液流变学及炎症因子检测数据,观察组43例,对照组49例,比较治疗前后两组血液流变学指标及炎症因子水平变化。结果治疗后,观察组发作次数少于对照组,持续时间短于对照组,心绞痛治疗总有效率及中医证候治疗总有效率高于对照组,差异均有统计学意义(P<0.05);治疗后,观察组ST段压低最大幅度小于对照组,平板实验评分均高于对照组,差异有统计学意义(P<0.05),两组总运动时间、代谢当量、心绞痛出现时间、血压心率乘积、ST段压低1.0 mm时间比较,差异无统计学意义(P>0.05);治疗后,观察组血浆黏度、红细胞集聚度指数、血小板聚集率、血清白介素-6(Interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)水平均低于对照组,差异均有统计学意义(P<0.05)。两组治疗期间均未出现明显不良反应,治疗前后的肝肾功能无明显变化。结论心可舒治疗冠心病心绞痛能有效改善心绞痛症状,提高运动耐量,改善患者血液流变学及炎症状态,且安全性高。Objective To explore the efficacy of Xinkeshu on angina pectoris of coronary heart disease and its effects on hemorheology and inflammatory factors.Methods Totally 120 patients with angina pectoris of coronary heart disease treated in the multicenter hospitals from June 2016 to October 2019 were selected to observe the efficacy of Xinkeshu tablets on improving the angina symptoms in patients with chronic stable angina,in which,60 patients were selected for treadmill exercise electrocardiogram in order to investigate the efficacy of basic treatment combined with Xinkeshu tablets on improving exercise tolerance of patients,and they were assigned as observation group(Xinkeshu tablet treatment)and control group(Xinkeshu tablet analog agent treatment)according to the ratio of 1∶1.During the treatment,there were 5 cases of shedding in observation group(3 of them were with treadmill exercise electrocardiogram)and 4 cases of shedding in control group(2 of them were with treadmill exercise electrocardiogram).The frequency and duration of angina pectoris before and after treatment,efficacy of angina pectoris treatment and symptoms of traditional Chinese medicine,treadmill exercise test results and safety were compared between the two groups.Among 120 patients,92 patients(43 patients in observation group and 49 patients in control group)had hemorheology indexes and inflammatory factors which were compared between the two groups before and after treatment.Results After treatment,the frequency of attacks in observation group was less than that in control group,and the duration was shorter than that in control group,and the total effective rates of angina pectoris treatment and symptoms of traditional Chinese medicine were higher than those in control group(P<0.05).After treatment,the maximum extent of ST segment depression was smaller than that in control group(P<0.05),while the score of treadmill exercise electrocardiogram in observation group was higher;there were no significant difference in the total exercise time,metab

关 键 词：心可舒 冠心病心绞痛 运动平板心电图 血液流变学 炎症因子 

分 类 号：R285.6[医药卫生—中药学]