养心氏片改善冠心病稳定性心绞痛患者运动耐量的临床疗效观察  

Clinical efficacy observation of Yangxinshi tablets in improving exercise tolerance in patients with stable angina pectoris in coronary heart disease

作　　者：吴旭东 刘宇 郑颖[1,2] 赵国元 苏全[1,2] 葛昭 任思霖[1,2,3] 王贤良 WU Xudong;LIU Yu;ZHENG Ying;ZHAO Guoyuan;SU Quan;GE Zhao;REN Silin;WANG Xianliang(Department of Cardiology,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China;National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin 300381,China;Graduate School of Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)

机构地区：[1]天津中医药大学第一附属医院心血管科,天津300381 [2]国家中医针灸临床医学研究中心,天津300381 [3]天津中医药大学研究生院,天津301617

出　　处：《天津中医药大学学报》2025年第3期202-207,共6页Journal of Tianjin University of Traditional Chinese Medicine

基　　金：教育部“创新团队发展计划”项目(IRT_16R54);国家中医药管理局中医药创新团队及人才支持计划工作项目(ZYYCXTD-C-202203)。

摘　　要：[目的]观察养心氏片改善冠心病稳定性心绞痛患者运动耐量的临床疗效。[方法]将40例冠心病稳定性心绞痛患者,随机分为对照组和治疗组,每组20例。在西药常规治疗的基础上,对照组加用曲美他嗪片(每次20 mg,每日3次),治疗组加用养心氏片(每次3片,每日3次),两组疗程均为4周,访视点为入组时及治疗后4周。以心肺运动试验峰值公斤摄氧量(Peak VO_(2)/kg)为主要疗效指标,无氧阈代谢当量(METs@AT)、峰值代谢当量(Peak METs)、峰值氧脉搏(Peak VO_(2)/HR)、摄氧量与功率斜率(VO_(2)/WR slope)及中医证候积分、心绞痛改善率、西雅图心绞痛量表评分(SAQ)、焦虑筛选量表评分(GAD-7)、抑郁量表评分(PHQ-9)为次要疗效指标,基本生命体征、血常规、肝肾功能、不良事件等为安全性指标。[结果]两组患者的基线资料比较,差异无统计学意义(P>0.05),具有可比性。与治疗前比较,治疗组和对照组治疗后4周Peak VO_(2)/kg、METs@AT、Peak METs、Peak VO_(2)/HR、VO_(2)/WR slope、SAQ评分升高,中医证候积分、GAD-7评分、PHQ-9评分降低(P<0.01)。与对照组同期比较,治疗组治疗后4周Peak VO_(2)/kg、METs@AT、Peak METs、Peak VO_(2)/HR、VO_(2)/WR slope升高(P<0.05)、SAQ评分中躯体活动受限程度(PL)升高(P<0.01),中医证候积分降低(P<0.01);治疗后4周治疗组和对照组的心绞痛改善率分别为75%和40%,治疗组优于对照组(P<0.05)。[结论]在西药常规治疗基础上加用养心氏片,可进一步提高冠心病稳定性心绞痛患者的运动耐量,改善临床症状,提高生活质量,减轻焦虑抑郁情绪,且安全性良好。[Objective]To explore the clinical efficacy of Yangxinshi tablets in improving exercise tolerance on stable angina pectoris(SAP).[Methods]Forty patients were randomly divided into a control group and a treatment group,20 patients per group.On the basis of Western medicine treatment,the control group was added with trimetazidine(20 mg/Tid),and the treatment group was added with Yangxinshi tablets(3 tablets/Tid),each group had 4 weeks of treatment,the visit points were at the time of enrollment and 4 weeks after treatment.The main therapeutic indicator was the peak VO_(2)/kg oxygen uptake during cardiopulmonary exercise testing,the secondary therapeutic indicators were the METs@AT,Peak METs,Peak VO_(2)/HR,VO_(2)/WR slope,traditional Chinese medicine(TCM)syndrome score,improvement rate of angina pectoris,SAP scale score(SAQ),GAD-7 anxiety screening scale score,and PHQ-9 depression scale score.The safety indicators were the basic vital signs,blood routine,liver and kidney function,adverse events,etc.[Results]Compared with the enrollment,the treatment group and control group had shown an increase in Peak VO_(2)/kg,METs@AT,Peak METs,Peak VO_(2)/HR,VO_(2)/WR slope and SAQ scores;had shown a decrease in TCM syndrome score,GAD-7 anxiety screening scale score,and PHQ-9 depression scale score at 4 weeks after treatment(P<0.01).Compared with the control group,the treatment group had shown an increase in Peak VO_(2)/kg METs@AT,Peak METs,Peak VO_(2)/HR,and VO_(2)/WR slopes(P<0.05),physical activity restriction(PL)in SAQ scores(P<0.01);had shown a decrease in TCM syndrome score(P<0.01)at 4 weeks after treatment.After 4 weeks of treatment,the improvement rates of angina pectoris in the treatment group and the control group were 75%and 40%(P<0.05).[Conclusion]On the basis of conventional Western medicine treatment,the addition of Yangxinshi tablets can effectively improve the exercise tolerance level,clinical symptoms and quality of life,reduce their anxiety and depression,and have good safety.

关 键 词：冠心病稳定性心绞痛 养心氏片 心肺运动试验 运动耐量 心脏康复 

分 类 号：R541.4[医药卫生—心血管疾病]