灯盏生脉胶囊联合常规西药治...冠心病稳定性心绞痛临床研究_陈王峰.pdf

新中医2023年2月第55卷第4期NEW CHINESE MEDICINEFebruary 2023 Vol.55 No.4收稿日期 2022-02-17修回日期 2022-11-22作者简介陈王峰（1983-），男，主治医师，E-mail：。灯盏生脉胶囊联合常规西药治疗冠心病稳定性心绞痛临床研究陈王峰，金萍台州市第二人民医院老年科，浙江 台州 317200摘要目的：观察灯盏生脉胶囊联合常规西药治疗冠心病（CHD）稳定性心绞痛的临床效果。方法：将104 例气阴两虚型 CHD 稳定性心绞痛患者按随机数字表法分为治疗组 54 例与对照组 50 例，2 组均以常规西药对症治疗，治疗组加予灯盏生脉胶囊治疗，2 组均治疗 3 个月。治疗前后评定中医证候评分，检测心功能指标 心输出量（CO）、左心室射血分数（LVEF）、左心室收缩末期内径（LVESD）、炎症指标血清超敏 C-反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、收缩压（SBP）、心率（HR）、空腹血糖（FBG）、血脂指标 低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、甘油三酯（TG）、总胆固醇（TC）及肝肾功能指标 谷丙转氨酶（ALT）、谷草转氨酶（AST）、尿素（UREA）、肌酐（Cr），评估 2 组的临床疗效，统计心血管不良事件及不良反应的发生率。结果：治疗后，治疗组临床疗效总有效率 94.44%，高于对照组82.00%，差异有统计学意义（P0.05）。2 组中医证候积分均较治疗前降低（P0.05），治疗组中医证候积分低于对照组（P0.05）。2 组 CO、LVEF 值均高于治疗前，LVESD 值均低于治疗前，差异均有统计学意义（P0.05）；治疗组 CO、LVEF 值均高于对照组，LVESD 值低于对照组，差异均有统计学意义（P0.05）。2 组 HR、SBP 水平均低于治疗前（P0.05），治疗组 FBG 水平较治疗前下降并低于对照组（P0.05）。2 组 hs-CRP、IL-6、TG、TC、LDL-C 水平均低于治疗前（P0.05），治疗组以上指标值均低于对照组（P0.05）。2 组 HDL-C 水平均高于治疗前（P0.05），治疗组 HDL-C 水平高于对照组（P0.05）。2 组治疗前后 AST、ALT、Cr、UREA 水平比较，差异均无统计学意义（P0.05）。治疗期间，2 组心血管不良事件、不良反应发生率比较，差异均无统计学意义（P0.05）。结论：采用灯盏生脉胶囊联合常规西药治疗气阴两虚型 CHD 稳定性心绞痛患者，能提高临床治疗效果，有效缓解临床症状，改善心功能，减轻机体炎症反应，调节心率、血压、血糖及血脂水平，从而有效控制病情，且对肝肾功能无明显影响，心血管不良事件及不良反应少，药物安全性高。关键词冠心病；稳定性心绞痛；气阴两虚证；灯盏生脉胶囊；心功能；炎症；心血管不良事件中图分类号R541.4文献标志码A文章编号0256-7415（2023）04-0040-06DOI：10.13457/ki.jncm.2023.04.009Clinical Study on Dengzhan Shengmai Capsules Combined with Routine WesternMedicine for Stable Angina Pectoris of Coronary Heart DiseaseCHEN Wangfeng，JIN PingAbstract：Objective：To observe the clinical effect of Dengzhan Shengmai Capsules combined withroutine western medicine for stable angina pectoris of coronary heart disease(CHD).Methods：A total of104 cases of CHD patients with stable angina pectoris of qi and yin co-deficiency type were divided into thetreatment group and the control group according to the random number table method，with 54 and50 cases in each group respectively.Both groups were treated with routine symptomatic treatment ofwestern medicine，and the treatment group was additionally treated with Dengzhan Shengmai Capsules；40新中医2023年2月第55卷第4期NEW CHINESE MEDICINEFebruary 2023 Vol.55 No.4冠状动脉粥样硬化性心脏病（CHD）是冠状动脉粥样硬化致血管腔狭窄或阻塞，引起心肌缺血、缺氧或坏死的一种心脏病，好发于中老年人群。心绞痛是 CHD 的一种常见类型，是在冠状动脉狭窄基础上，因血管痉挛或心肌负荷增加导致心肌急剧或暂时缺血、缺氧的临床综合征，分为稳定性和不稳定性心绞痛。稳定性心绞痛是指心绞痛发作程度、频率及诱发因素均较稳定，规范治疗对病情具有较好both groups were treated for 3 months.Before and after treatment，the traditional Chinese medicine(TCM)syndrome scores were evaluated，and the heart function indexes including cardiac output(CO)，leftventricular ejection fraction(LVEF)and left ventricular end systolic diameter(LVESD)，inflammatory indexesincluding serum high-sensitivity C-reactive protein(hs-CRP)and interleukin-6(IL-6)，systolic bloodpressure(SBP)，heart rate(HR)，fasting blood glucose(FBG)，blood lipid indexes including low-densitylipoprotein cholesterol(LDL-C)，high-density lipoprotein cholesterol(HDL-C)，triglycerides(TG)and totalcholesterol(TC)，and liver and kidney function indexes including alanine aminotransferase(ALT)，aspartatetransaminase(AST)，urea，and creatinine(Cr)were measured.Clinical effects were evaluated in the twogroups.The incidence of cardiovascular adverse events and adverse reactions were calculated.Results：After treatment，the total effective rate of clinical effect was 94.44%in the treatment group，higher thanthat of 82.00%in the control group，the difference being significant(P0.05).TCM syndrome scores in thetwo groups were decreased when compared with those before treatment(P0.05)，and TCM syndromescores in the treatment group were lower than those in the control group(P0.05).The values of CO andLVEF in the two groups were higher than those before treatment，and LVESD values were lower than thosebefore treatment，differences being significant(P0.05)；the values of CO and LVEF in the treatmentgroup were higher than those in the control group，and LVESD value in the treatment group was lower thanthat in the control group，differences being significant(P0.05).The levels of HR and SBP in the twogroups were lower than those before treatment(P0.05)，and FBG level in the treatment group was lowerthan that before treatment and that in the control group after treatment(P0.05).The levels of hs-CRP，IL-6，TG，TC，and LDL-C in the two groups were lower than those before treatment(P0.05)，and theabove indexes in the treatment group were lower than those in the control group in average(P0.05).Thelevels of HDL-C in the two groups were higher than those before treatment(P0.05)，and the level ofHDL-C in the treatment group was high than that in the control group(P0.05).There was no significantdifference being found in the comparison of levels of AST，ALT，Cr，and UREA in the two groups beforeand after treatment(P0.05).During treatment，there was no significant difference being found in thecomparison of the incidence of cardiovascular adverse events and adverse drug reactions between the twogroups(P0.05).Conclusion：For CHD patients with stable angina pectoris，Dengzhan ShengmaiCapsules combined with routine symptomatic treatment of