胸痹通胶囊联合尼可地尔对不稳定型心绞痛患者炎性因子及血小板功能的影响
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摘要
目的探讨医院自制胸痹通胶囊联合尼可地尔对不稳定型心绞痛患者炎性因子及血小板功能的影响。方法选择医院2014年2月至2016年5月收治的不稳定型心绞痛患者110例,按随机数字表法分为观察组和对照组,各55例。所有患者均给予他汀类药物稳定斑块,口服拜阿司匹林抑制血小板聚集,盐酸曲美他嗪改善心肌供血,美托洛尔片降低心肌耗氧量,尼可地尔片每次5 mg,1日3次;观察组患者在此基础上口服胸痹通胶囊,每次4粒,1日3次。两组患者疗程均为6个月。结果治疗后,两组患者躯体活动受限程度、心绞痛稳定状态、心绞痛发作情况、治疗满意程度、疾病认识程度评分及总分均较治疗前显著升高(P<0.05),观察组各项评分均高于对照组(P<0.05);两组患者血清中肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)、超敏C反应蛋白(hs-CRP)、血小板聚集率(MPAR)、血小板α-膜蛋白(GMP-140)、血浆内皮素(ET)的表达水平均下降,且观察组下降程度均大于对照组(P<0.05);两组患者治疗过程中不良反应发生率相当(P>0.05)。结论胸痹通胶囊联合尼可地尔片可显著降低患者心绞痛评分,降低血清炎性因子表达水平及血小板活化程度,无严重不良反应发生,值得临床推广。
Objective To investigate the effect of Xiongbitong Capsules combined with nicorandil on inflammatory factors and platelet function in patients with unstable angina pectoris. Methods Totally 110 patients with unstable angina pectoris admitted to our hospital from February 2014 to May 2016 were selected and divided into the observation group and the control group according to the random number table method,55 cases in each group. All patients were given statins to stabilize plaque,oral administration of aspirin to inhibit platelet aggregation,trimetazidine hydrochloride to improve myocardial blood supply,Metoprolol Tablets to reduce myocardial oxygen consumption,Nicorandil Tablets 5 mg/time,3 times a day,on the basis,the observation group was given Xiongbitong Capsules,4 capsules/time,3 times a day. The course of treatment for the two groups was 6 months. Results After treatment,the scores of degree of physical activity,the steady state of angina pectoris,the angina pectoris,the degree of satisfaction,the degree of disease awareness and the total scores in the two groups were significantly higher than those before treatment( P < 0. 05),and those in the observation group were significantly higher than those in the control group( P < 0. 05). The levels of TNF-α,IL-6,hs-CRP,MPAR,GMP-140 and ET in the two groups were significantly lower than those before treatment( P < 0. 05),and those in the observation group were significantly lower than those in the control group( P < 0. 05). There was no significant difference in the incidence rate of adverse reactions between the two groups( P > 0. 05). Conclusion Xiongbitong Capsules combined with Nicorandil Tablets can significantly reduce the SAQ score of patients with angina pectoris,reduce the expression level of serum inflammatory factors and the degree of platelet activation without serious adverse reactions,it is worthy of clinical promotion.
Objective To investigate the effect of Xiongbitong Capsules combined with nicorandil on inflammatory factors and platelet function in patients with unstable angina pectoris. Methods Totally 110 patients with unstable angina pectoris admitted to our hospital from February 2014 to May 2016 were selected and divided into the observation group and the control group according to the random number table method,55 cases in each group. All patients were given statins to stabilize plaque,oral administration of aspirin to inhibit platelet aggregation,trimetazidine hydrochloride to improve myocardial blood supply,Metoprolol Tablets to reduce myocardial oxygen consumption,Nicorandil Tablets 5 mg/time,3 times a day,on the basis,the observation group was given Xiongbitong Capsules,4 capsules/time,3 times a day. The course of treatment for the two groups was 6 months. Results After treatment,the scores of degree of physical activity,the steady state of angina pectoris,the angina pectoris,the degree of satisfaction,the degree of disease awareness and the total scores in the two groups were significantly higher than those before treatment( P < 0. 05),and those in the observation group were significantly higher than those in the control group( P < 0. 05). The levels of TNF-α,IL-6,hs-CRP,MPAR,GMP-140 and ET in the two groups were significantly lower than those before treatment( P < 0. 05),and those in the observation group were significantly lower than those in the control group( P < 0. 05). There was no significant difference in the incidence rate of adverse reactions between the two groups( P > 0. 05). Conclusion Xiongbitong Capsules combined with Nicorandil Tablets can significantly reduce the SAQ score of patients with angina pectoris,reduce the expression level of serum inflammatory factors and the degree of platelet activation without serious adverse reactions,it is worthy of clinical promotion.
引文
[1]李淑玲,朱成朔,刘国安,等.不稳定型心绞痛的发病机制及药物治疗进展[J].世界中西医结合杂志,2013,8(2):210-212.
[2]高方,宾建平,肖文星,等.不稳定型心绞痛的病因和发病机制[J].新医学,2004,35(9):520-521.
[3]金小辉,徐凯,王丽,等.瑞舒伐他汀治疗不稳定型心绞痛的临床效果及对血脂、hs-CRP、Hcy、c Tn I水平的影响[J].中国生化药物杂志,2017,37(4):364-366.
[4]赵明明,王海蓉,熊峰,等.尼可地尔治疗不稳定型心绞痛疗效和安全性的Meta分析[J].中国循证心血管医学杂志,2014,6(2):131-135.
[5]徐珠屏.中西医结合治疗冠心病不稳定型心绞痛的临床研究[J].中国现代医学杂志,2015,25(19):91-94.
[6]蔡洪滨,姚朱华,高仪,等.复方丹参滴丸联合氯吡格雷片对不稳定型心绞痛患者血小板功能的影响[J].中医杂志,2013,54(6):500-502.
[7]吉苗苗.不稳定型心绞痛伴胰岛素抵抗患者血小板CD62P、PAC-1的变化及意义研究[D].大连:大连医科大学,2016.
[8]陈比特.不稳定型心绞痛患者血清内脏脂肪素水平的变化及与血管内皮细胞黏附分子的相关性[J].实用临床医药杂志,2017,21(13):1-4.
[9]李华政.PCI对不稳定型心绞痛患者血清肌钙蛋白、超敏C反应蛋白、白介素-6影响的研究[D].新乡:新乡医学院,2015.
[10]石玉国,李康,林扬眉,等.胸痹通胶囊对颈动脉粥样硬化斑块的临床疗效[J].医药前沿,2015,5(9):35-36.
[11]张文秀.胸痹通胶囊对冠心病炎症因子hs-CRP、IL-6血清水平的影响[D].济南:山东中医药大学,2012.
[12]傅桂清,钟思干.盐酸替罗非班对不稳定型心绞痛患者血小板CD62P和PAC-1的影响及安全性[J].广东医学,2013,34(10):1606-1607.
[13]黄震华,朱雅琴.221例不稳定型心绞痛病人强化抗血小板治疗的疗效[J].中国新药与临床杂志,2008,27(8):566-569.
[14]郎永军,魏建军,刘存英,等.盐酸川芎嗪联合辅酶Q10对不稳定型心绞痛患者炎症反应和免疫功能的影响[J].现代中西医结合杂志,2014,23(34):3790-3792.
[15]吴钟伟,王圣,李斌,等.短期大剂量阿托伐他汀对PCI治疗不稳定型心绞痛患者炎症反应和心肌损伤的影响[J].山西医科大学学报,2015,46(4):293-296.
[2]高方,宾建平,肖文星,等.不稳定型心绞痛的病因和发病机制[J].新医学,2004,35(9):520-521.
[3]金小辉,徐凯,王丽,等.瑞舒伐他汀治疗不稳定型心绞痛的临床效果及对血脂、hs-CRP、Hcy、c Tn I水平的影响[J].中国生化药物杂志,2017,37(4):364-366.
[4]赵明明,王海蓉,熊峰,等.尼可地尔治疗不稳定型心绞痛疗效和安全性的Meta分析[J].中国循证心血管医学杂志,2014,6(2):131-135.
[5]徐珠屏.中西医结合治疗冠心病不稳定型心绞痛的临床研究[J].中国现代医学杂志,2015,25(19):91-94.
[6]蔡洪滨,姚朱华,高仪,等.复方丹参滴丸联合氯吡格雷片对不稳定型心绞痛患者血小板功能的影响[J].中医杂志,2013,54(6):500-502.
[7]吉苗苗.不稳定型心绞痛伴胰岛素抵抗患者血小板CD62P、PAC-1的变化及意义研究[D].大连:大连医科大学,2016.
[8]陈比特.不稳定型心绞痛患者血清内脏脂肪素水平的变化及与血管内皮细胞黏附分子的相关性[J].实用临床医药杂志,2017,21(13):1-4.
[9]李华政.PCI对不稳定型心绞痛患者血清肌钙蛋白、超敏C反应蛋白、白介素-6影响的研究[D].新乡:新乡医学院,2015.
[10]石玉国,李康,林扬眉,等.胸痹通胶囊对颈动脉粥样硬化斑块的临床疗效[J].医药前沿,2015,5(9):35-36.
[11]张文秀.胸痹通胶囊对冠心病炎症因子hs-CRP、IL-6血清水平的影响[D].济南:山东中医药大学,2012.
[12]傅桂清,钟思干.盐酸替罗非班对不稳定型心绞痛患者血小板CD62P和PAC-1的影响及安全性[J].广东医学,2013,34(10):1606-1607.
[13]黄震华,朱雅琴.221例不稳定型心绞痛病人强化抗血小板治疗的疗效[J].中国新药与临床杂志,2008,27(8):566-569.
[14]郎永军,魏建军,刘存英,等.盐酸川芎嗪联合辅酶Q10对不稳定型心绞痛患者炎症反应和免疫功能的影响[J].现代中西医结合杂志,2014,23(34):3790-3792.
[15]吴钟伟,王圣,李斌,等.短期大剂量阿托伐他汀对PCI治疗不稳定型心绞痛患者炎症反应和心肌损伤的影响[J].山西医科大学学报,2015,46(4):293-296.