目的 探討腦心清片聯(lián)合馬來(lái)酸桂哌齊特和丹參酮Ⅱ_A磺酸鈉治療冠心病心絞痛的臨床療效。方法 選取2015年1月-2016年1月在遼寧中醫(yī)藥大學(xué)附屬醫(yī)院心內(nèi)科接受治療的96例冠心病心絞痛患者,隨機(jī)分為對(duì)照組(48例)和治療組(48例)。所有患者均給予低鹽低脂飲食、抗凝、降血脂等基礎(chǔ)治療。對(duì)照組靜脈滴注馬來(lái)酸桂哌齊特注射液,320 mg加入生理鹽水500 mL中,1次/d;同時(shí)靜脈滴注丹參酮Ⅱ_A磺酸鈉注射液,60 mg加入生理鹽水250 mL中,1次/d。治療組在對(duì)照組基礎(chǔ)上口服腦心清片,2片/次,3次/d。兩組患者均連續(xù)治療14 d。觀察兩組的臨床療效,同時(shí)比較兩組血清學(xué)指標(biāo)、癥狀和血液流變學(xué)指標(biāo)改善情況。結(jié)果 治療后,對(duì)照組和治療組總有效率分別為79.17%和93.75%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后兩組血清脂聯(lián)素(APN)、一氧化氮(NO)水平較同組治療前明顯增高(P<0.05),腫瘤壞死因子-α(TNF-α)、高敏C反應(yīng)蛋白(hs-CRP)、內(nèi)皮素(ET)、血栓素B2(TXB2)水平均比同組治療前明顯降低(P<0.05);與對(duì)照組比較,治療組的血清學(xué)指標(biāo)改善更明顯(P<0.05)。治療后兩組心絞痛發(fā)作次數(shù)、持續(xù)時(shí)間以及緩解所需硝酸甘油劑量較同組治療前明顯降低(P<0.05),但治療組降低的更明顯(P<0.05)。治療后兩組全血黏度、FIB、血漿黏度、HCT均較同組治療前明顯降低,差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組比對(duì)照組降低的更明顯,差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 腦心清片聯(lián)合馬來(lái)酸桂哌齊特和丹參酮Ⅱ_A磺酸鈉治療冠心病心絞痛療效顯著,可明顯改善患者血清學(xué)指標(biāo)、臨床癥狀以及降低血液流變學(xué)指標(biāo)。

Objective To explore the clinical efficacies of Naoxinqing Tablets combined with cinepazide maleate and tanshinone Ⅱ_A sodium sulfonate in treatment of coronary heart disease with angina pectoris. Methods Patients (96 cases) with coronary heart disease with angina pectoris from January 2015 to January 2016 in Affiliated Hospital of Liaoning University of TCM were randomly divided into control (48 cases) and treatment (48 cases) groups. All patients were given basic treatment with low salt and low fat diet, anticoagulation, lipid lowering, etc. Patients in the control group were iv administered with Cinepazide Maleate Injection, 320 mg added into normal saline 500 mL, once daily. At the same time, they were iv administered with Tanshinone Ⅱ_A Sodium Sulfonate Injection, 60 mg added into normal saline 250 mL, once daily. The patients in the treatment group were po administered with Naoxinqing Tablets on the basis of control group, 2 tablets/time, three times daily. The patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the improvement of serum indexes, symptoms and hemorheology indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment group were 79.17% and 93.75%, respectively, and there were differences between two groups (P < 0.05). After treatment, serum adiponectin (APN) and nitric oxide (NO) in two groups were significantly increased (P < 0.05), and tumor necrosis factor-α (TNF-α), hypersensitive C-reactive protein (hs-CRP), endothelin (ET) and thromboxane B2 (TXB2) were significantly decreased (P < 0.05). For serum indexes, the treatment group improved more significantly than the control group (P < 0.05). After treatment, frequency and duration of angina pectoris, and also nitroglycerin dosage of two groups were significantly decreased (P < 0.05); Compared with the control group, the serum indexes in the treatment group decreased more obviously (P < 0.05). After treatment, hematocrit, fibrinogen, whole blood viscosity and plasma viscosity of two groups were decreased more than those before treatment with significant difference (P < 0.05). And these hemorheology indexes in treatment group were decreased more than those in the control group, and the difference was significant (P < 0.05). Conclusion Naoxinqing Tablets combined with Cinepazide Maleate Injection and Tanshinone Ⅱ_A Sodium Sulfonate Injection has clinical curative effect in the treatment of coronary heart disease with angina pectoris, can significantly improve the serum indexes, clinical symptoms, and reduce hemorheology indexes.