瓜蒌皮注射液联合磷酸肌酸治疗冠心病稳定型心绞痛的临床研究

目的 探讨瓜蒌皮注射液联合磷酸肌酸治疗冠心病稳定型心绞痛的临床疗效。方法 选取2020年1月—2021年4月在郑州颐和医院诊治的144例冠心病稳定型心绞痛患者，随机分为对照组（72例）和治疗组（72例）。对照组患者静脉滴注注射用磷酸肌酸钠，1 g加入100 mL生理盐水，1次/d。治疗组在对照组的基础上肌内注射瓜蒌皮注射液，4 mL/次，1次/d。两组患者均治疗7 d。观察两组患者临床疗效，比较治疗前后两组患者心绞痛发作次数和持续时间，24 h动态心电图变化，氧化应激指标总抗氧化能力（T-Aoc）、谷胱甘肽过氧化物酶（GSH-Px）和糖基化终末产物（AGEs）水平及血管内皮功能指标一氧化氮（NO）、血管内皮生长因子（VEGF）、内皮素-1（ET-1）和可溶性血栓调节蛋白（sTM）水平。结果 治疗后，对照组总有效率80.56%，治疗组总有效率93.06%，两组总有效率比较差异具有统计学意义（P<0.05）。两组患者心绞痛发作次数、心绞痛每次持续时间较治疗前下降（P<0.05），且治疗组下降幅度更明显（P<0.05）。治疗后，两组患者缺血发作次数、缺血最长持续时间、缺血总时间显著降低（P<0.05），且治疗组缺血发作次数、缺血最长持续时间、缺血总时间显著低于对照组（P<0.05）。治疗后，两组患者T-Aoc、GSH-Px水平均显著升高，AGEs水平显著降低（P<0.05），且治疗组上述指标改善更显著（P<0.05）。治疗后，两组患者NO、VEGF水平显著升高，ET-1、sTM水平显著降低，且治疗组上述指标改善更显著（P<0.05）。结论 瓜蒌皮注射液联合磷酸肌酸可有效改善冠心病稳定型心绞痛患者临床症状，改善冠脉循环，抑制氧化应激反应，减轻血管内皮损伤，具有良好的临床疗效，安全性较高。

Clinical study on Gualoupi Injection combined with phosphocreatine in treatment of stable angina pectoris of coronary heart disease

Objective To investigate the clinical efficacy of Gualoupi Injection combined with phosphocreatine in treatment of stable angina pectoris of coronary heart disease. Methods Patients (144 cases) with stable angina pectoris of coronary heart disease in Zhengzhou Yihe Hospital from January 2020 to April 2021 were randomly divided into control (72 cases) and treatment (72 cases) group. Patients in the control group were iv administered with Creatine Phosphate Sodium for injection, 1 g added into 100 mL normal saline, once daily. Patients in the treatment group were intramuscular injection administered with Gualoupi Injection on the basis of the control group, 4 mL/time, once daily. Patients in two groups were treated for 7 d. After treatment, the clinical evaluation was evaluated, the attack times and duration of angina pectoris, 24 h ambulatory ECG changes, oxidative stress response indexes T-Aoc, GSH-Px and AGEs, and vascular endothelial function indexes NO, VEGF, ET-1 and sTM in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.56%, while the treatment group was 93.06%, respectively, and there were differences between two groups (P < 0.05). After treatment, the frequency of angina attacks and the duration of angina pectoris in two groups were significantly decreased compared with those before treatment (P < 0.05), and the decrease in the treatment group was more obvious (P < 0.05). After treatment, the number of ischemic attacks, the longest duration of ischemia and the total duration of ischemia in the two groups were significantly decreased (P < 0.05), and the number of ischemic attacks, the longest duration of ischemia and the total duration of ischemia in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, T-Aoc and GSH-Px in two groups were significantly increased, while AGEs were significantly decreased (P < 0.05), the improvement degree in treatment group was significantly higher than control group (P < 0.05). The levels of NO and VEGF in two groups were significantly increased, the levels of ET-1 and sTM were significantly decreased (P < 0.05), however, the improvement of the above indicators in the treatment group was more obvious (P < 0.05). Conclusion Gualoupi Injection combined with phosphocreatine can effectively improve the clinical symptoms of patients with stable angina pectoris of coronary heart disease, improve coronary circulation, inhibit oxidative stress response and reduce vascular endothelial injury. It has good clinical efficacy and high safety.