心达康滴丸联合地尔硫卓治疗冠心病心绞痛的临床研究

目的探讨心达康滴丸联合盐酸地尔硫卓片治疗冠心病心绞痛的临床疗效。方法选择2018年7月—2019年7月在武汉市江夏区中医医院治疗的冠心病心绞痛患者94例,根据用药的差别分成对照组(47例)和治疗组(47例)。对照组口服盐酸地尔硫卓片,30mg/次,3次/d;治疗组在对照组基础上口服心达康滴丸,18粒/次,3次/d。两组患者均经4周治疗。观察两组患者临床疗效,同时比较治疗前后两组患者心绞痛发作次数和持续时间,临床症状积分、SAQ和GQOLI-74评分,血清C反应蛋白(CRP)、S100钙结合蛋白A12(S100A12)、白细胞介素-18(IL-18)、妊娠相关血清蛋白A(PAPP-A)、内皮素-1(ET-1)和肌钙蛋白I(CTnI)水平及心功能。结果治疗后,对照组和治疗组临床有效率分别为80.85%和97.87%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者心绞痛发作次数及持续时间都显著改善降低(P0.05),且治疗组比对照组改善更显著(P0.05)。治疗后,两组患者SAQ积分和GQOLI-74评分均明显升高,而临床症状积分明显降低(P0.05),且治疗组这些评分明显好于对照组(P0.05)。治疗后,两组患者血清CRP、S100A12、IL-18、PAPP-A、ET-1、CTnI水平均明显降低(P0.05),且治疗组明显低于对照组(P0.05)。治疗后,两组患者左心室射血分数(LVEF)和心排血量(CO)均升高,而左室收缩末期内径(LVESD)明显降低(P0.05),且治疗组LVEF、CO和LVESD比对照组改善更明显(P0.05)。结论心达康滴丸联合盐酸地尔硫卓片治疗冠心病心绞痛可明显改善患者临床症状,改善生活质量,具有一定的临床推广应用价值。

Clinical study on Xindakang Dropping Pills combined with diltiazem in treatment of angina pectoris of coronary heart disease

Objective To explore the clinical efficacy of Xindakang Dropping Pills combined with diltiazem in treatment of angina pectoris of coronary heart disease. Methods Patients (94 cases) with angina pectoris of coronary heart disease in Wuhan Jiangxia District Hospital of TCM from July 2018 to Juny 2019 were divided into control (47 cases) and treatment (47 cases) groups based on different treatments. Patients in the control group were po administered with Diltiazem Hydrochloride Tablets, 30 mg/time, three times daily. Patients in the treatment group were po administered with Xindakang Dropping Pills on the basis of the control group, 18 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the frequency and duration of angina pectoris, clinical symptom scores, SAQ and GQOLI-74 scores, the serum levels of CRP, S100A12, IL-18, PAPP-A, ET-1 and CTnI, and cardiac function indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 80.85% and 97.87% respectively, and there were differences between two groups (P<0.05). After treatment, the frequency and duration of angina pectoris in two groups was significantly decreased (P<0.05), and which in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the SAQ and GQOLI-74 scores in two groups were significantly increased (P<0.05), but the clinical symptom scores were significantly decreased (P<0.05), and these scores in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the serum levels of CRP, S100A12, IL-18, PAPP-A, ET-1 and CTnI in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the LVEF and CO levels in two groups were significantly increased (P<0.05), but the LVESD levels were significantly decreased (P<0.05), and the LVEF, CO and LVESD in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Xindakang Dropping Pills combined with diltiazem in treatment of angina pectoris of coronary heart disease can significantly improve the clinical symptoms, the quality of life, which has a certain clinical application value.