摘要
目的
通心络胶囊是运用中医“络病理论”研制而成的中药复方制剂。现代药理研究表明：通心络胶囊具有改善犬急性心肌缺血程度，缩小心肌梗塞范围；增加正常犬的冠脉血流量；降低食饵性高脂大鼠血清总胆固醇和低密度脂蛋白含量；动物实验还提示本品有一定的降低血粘度，抑制血小板聚集，延长凝血时间的作用。为了进一步观察通心络胶囊对冠心病心绞痛病人的治疗作用，我们进行了本课题的研究。
方法
本课题共收入66例辨证为气虚血瘀型胸痹心痛患者，分为治疗组36例，对照组30例。治疗组给予通心络胶囊口服，每次3粒，每日3次。对照组给予复方丹参片口服，每次4片，每日3次。两组患者治疗期间均停服其他抗心绞痛中西药物，心绞痛发作严重时，可临时予消心痛舌下含服。两组疗程均为4周。对两组病例心绞痛症状，心电图，血脂，血液流变学进行对比观察。
结果
(1)心绞痛改善情况比较，治疗组显效率38.89％，有效率52.78％，总有效率91.67％；对照组显效率23.37％，有效率53.34％，总有效率76.67％。两组疗效有显著性差异(P＜0.05)。(2)心电图疗效比较：治疗组显效率27.78％，有效率50％，总有效率77.78％；对照组显效率13.33％，有效率40％，总有效率53.33％。两组疗效有显著性差异(P＜0.05)。(3)血脂改善情况比较：治疗后组间比较，治疗组血脂改善明显，优于对照组，P＜0.05，有统计学意义；治疗组治疗前后对照，总胆固醇、甘油三脂、低密度脂蛋白降低，高密度脂蛋白升高，P＜0.05，有统计学意义；而对照组治疗前后血脂水平无明显变化，P＞0.05，无统计学意义。(4)血液流变学改善情况：治疗后组间比较，治疗组血液流变学改善情况优于对照组，P＜0.05，有统计学意义；治疗组治疗前后对照，血粘度降低，P＜0.05，有统计学意义；而对照组前后变化不大，P＞0.05，无统计学意义。
结论
通过以上研究，证实通心络胶囊治疗冠心病心绞痛疗效肯定，是治疗冠心病心绞痛的有效药物，可以更加广泛的应用于临床。
Object
TongXinLuo Capsule is developed according as the Collateral Disease Doctrine. The experiment of acute myocardial blood-deficiency on the dog of coronary artery ligation shows that this product can improve the degree of acute myocardial blood-deficiency, narrow the area of myocardial infarction. In addition, it can also increase the normal dog's blood volume of coronary and reduce the content of cholesterol and low-density lipoprotein of bativorous rat's blood serum. Animal experiment also suggested that the capsule could reduce the blood viscosity, inhabit the platelet aggregation and prolong the clotting time. We've carried out this study in order to observe the therapeutic function of TongXinLuo Capsule on coronary angina pectoris. Methods
66 patients were collected and divided into the treated group(36 cases)and the control group(30 cases).All the patients belong to the pattern of Qi deficiency and blood stagnation. The treated group took TongXinLuo Capsule orally 3 pills every time, 3 times a day. The control group took Composite Miltiorrhizae pill orally 4 pills every time,3 times a day. The course was 4 weeks. During the course ,all the patients were asked to stop taking other traditional Chinese and western medicine for treating angina pectoris . The serious one can take Nitroglycerin in need. The symptom, ECG, lipid, lipoprotein and hemorheology of the patients were observed. Results
(1) clinical symptom The treated group: obvious effective rate 38.89%, effective rate 52.78%, total effective rate 91.67%; The control group: obvious effective rate 23. 37%, effective rate 53. 34%, total effective rate 76.67%. The effect of the treated group was better than that of the control group. (P<0.05). (2) Electrocardiogram The treated group: obvious effective rate 27. 78%, effective rate 50%, total effective rate 77.78%; The control group: obvious effective rate 13. 33%,effctive rate 40%,totel effective rate 53. 33%. The effect of treated group were better than that of the control group. (P<0.05). (3) Lipid and lipoprotein After treatment , the
effect of treated group were better than that of the control group. (P<0. 05).Comparing pretreatment with post-treatment , the total cholesterol, LDL-c and the TG of the treated group decreased, the HDL-c stepped-up. (P<0.01). The changes haven't taken place in the control group's. (P>0. 05) (4) Blood viscosity After treatment , the effect of treated group were better than that of the control group. (P<0.05). Comparing pretreatment with post-treatment, the blood viscosity of the treated group decreased. (P<0.01). The changes haven't taken place in the control group's. (P>0, 05). Conclusion
This study proved TongXinLuo Capsule can treat the patients with coronary angina pectoris effectively. The effect of TongXinLuo Capsule is sure. It can be used widely in clinical to rise the effect,
引文
[1] 国际心脏病学会和协会及世界卫生组织临床命名标准化联合专题组．缺血性心脏病命名及诊断标准．中华心血管病杂志，1981，9(1)：75
[2] 冠心病辨证论治研究座谈会．冠心病(心绞痛、心肌梗塞)中医辨证试行标准．中医杂志，1980，21(8)：46
[3] 陈可冀，廖家桢，肖镇祥．心脑血管疾病研究．上海：上海科学技术出版社，1988：319
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[5] 雷燕．络病理论探微．北京中医药大学学报，1998，21(2)：18-23
[6] 吴以岭．虫类通络药何以能治冠心病．解放军健康，1999，(2)：32