麝香保心丸联合美托洛尔治疗冠心病心绞痛对其疗效血清N-末端脑钠肽前体同型半胱氨酸水平及载脂蛋白B/A1值的影响  

Effect of Shexiang Baoxin pill combined with metoprolol in the treatment of angina pectoris of coronary heart disease on its efficacy,and serum NT-proBNP,Hcy level and ApoB/A1 value

作　　者：任蕾蕾 杨莹 Ren Leilei;Yang Ying(Department of Internal Medicine,Fu County People′s Hospital,Yan′an 727500,China)

机构地区：[1]陕西省延安市富县人民医院内科,727500

出　　处：《山西医药杂志》2024年第5期351-356,共6页Shanxi Medical Journal

摘　　要：目的探讨麝香保心丸联合美托洛尔治疗冠心病心绞痛对其疗效、血清N-末端脑钠肽前体(NT-proBNP)、同型半胱氨酸(Hcy)水平及载脂蛋白B/载脂蛋白A1(ApoB/ApoA1)值的影响。方法随机将88例冠心病心绞痛病例分为西医组和中西医结合组,每组44例,西医组给予美托洛尔治疗,中西医结合组基于以上加予麝香保心丸治疗,评定2组治疗前及治疗1个月后的中医症候积分,评估2组疗效,对比2组治疗前及治疗1个月后的心绞痛发作情况、超声心动图指标[左心室舒张末内径(LVDD)、左室射血分数(LVEF)值]、血清血脂水平[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-L)]和其他血清生化指标[NT-proBNP、Hcy及ApoB/A1值]。结果2组治疗1个月后的中医症状积分低于治疗前(P<0.05),其中中西医结合组较西医组降低(P<0.05);中西医结合组临床总有效率高于西医组(89%与70%,P<0.05);2组治疗1个月后的心绞痛发作次数、发作持续时间和心肌耗氧量、LVDD及LVEF较治疗前缩短降低或增加(P<0.05),血清TG、TC、LDL-L和NT-pro BNP、Hcy水平和ApoB/A1比值水平较治疗前降低(P<0.05),HDL-C水平较治疗前提升(P<0.05),其中中西医结合组变化幅度较西医组升高(P<0.05)。结论麝香保心丸用于冠心病心绞痛的美托洛尔治疗中能提高临床疗效,可减轻心绞痛发作情况,有效降低血清HDL-C等血脂指标水平,并提高LDL-C水平,对血清NT-pro BNP、Hcy水平起到抑制作用,有效改善患者预后。Objective To explore the effect of Shexiang Baoxin pill combined with metoprolol in the treatment of angina pectoris of coronary heart disease,and the serum level of N-terminal pro-brain natriuretic peptide(NT-proBNP)and homocysteine(Hcy)level and apolipoprotein B/apolipoprotein A1(ApoB/A1).Methods Total of eighty-eight patients with angina pectoris of coronary heart disease were randomly classified into the Western medicine group(n=44)and integrated Chinese and Western medicine group(n=44).The Western medicine group was treated with metoprolol,and the integrated Chinese and Western medicine group was additionally treated with the Shexiang Baoxin pill on this basis.The scores of Traditional Chinese Medicine(TCM)syndromes of the two groups were evaluated before treatment and after 1 month of treatment,and the efficacy was evaluated in the two groups.The angina pectoris attack,echocardiographic indicators[left ventricular end-diastolic diameter(LVDD),left ventricular ejection fraction(LVEF)],serum blood lipids levels[total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)]and other serum biochemical indicators[NT-proBNP,Hcy,ApoB/A1 value]were compared between the two groups before treatment and after 1 month of treatment.Results Scores of TCM syndromes after 1 month of treatment in both groups were lower than those before treatment(P<0.05),and the scores of the integrated Chinese and Western medicine group were significantly decreased compared to the Western medicine group(P<0.05).The total clinical effective rate was significantly higher in the integrated Chinese and Western medicine group than in the Western medicine group(89%vs 70%,P<0.05).After 1 month of treatment,the frequency of angina pectoris attack,duration of attack,myocardial oxygen consumption,LVDD and LVEF in the two groups were significantly reduced or shortened or increased compared to those before treatment(P<0.05),and the levels of serum TG,TC,LDL-L,NT-proBNP and Hcy and ApoB

关 键 词：心绞痛 冠心病 麝香保心丸 美托洛尔 血脂 载脂蛋白类 

分 类 号：R541.4[医药卫生—心血管疾病]