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目的探究活血通脉片联合曲美他嗪治疗冠心病的临床效果。方法选取2015年5月—2016年2月在临高县人民医院心内科进行治疗的冠心病患者60例,根据治疗方案的差别分成对照组与治疗组,每组各30例。所有患者均给予常规治疗。对照组口服盐酸曲美他嗪片,20 mg/次,3次/d。治疗组在对照组基础上口服活血通脉片,5片/次,3次/d。两组患者均连续治疗4周。观察两组的临床疗效,比较两组患者治疗前后血清炎性因子、血管内皮功能因子和心功能指标改善情况。结果治疗后,对照组和治疗组总有效率分别为80.00%、96.67%,两组总有效率比较差异具有统计学意义(P<0.05)。治疗后,两组患者超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)和丙二醛(MDA)水平较治疗前明显下降,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组上述血清炎性因子水平降低更明显,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者内皮素-1(ET-1)水平均较治疗前明显下降,NO、降钙素基因相关肽(CGRP)水平较治疗前明显升高,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组这些观察指标的改善程度优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者左心室舒张末期内径(LVEDD)和左室后壁舒张期直径(LVPWd)明显降低,左心室射血分数(LVEF)指标升高,同组比较差异具有统计学意义(P<0.05);且治疗组这些心功能指标改善程度优于对照组的,两组比较差异具有统计学意义(P<0.05)。结论活血通脉片联合曲美他嗪治疗冠心病疗效显著,可明显改善患者心脏功能和血管内皮功能,降低炎性因子水平,具有一定的临床推广应用价值。
Objective To investigate the clinical effect of Huoxue Tongmai tablet combined with trimetazidine in treatment of coronary heart disease. Methods From May 2015 to February 2016, 60 patients with coronary heart disease were treated in Department of Cardiology, Lingao People’s Hospital, and divided into control group and treatment group according to the difference of treatment regimen, 30 cases in each group. All patients were given routine treatment. The control group oral trimetazidine hydrochloride tablets, 20 mg / time, 3 times / d. The treatment group was given oral Huoxuetongmai tablets on the basis of the control group, 5 tablets / time, 3 times / d. Two groups of patients were treated for 4 weeks. The clinical efficacy of the two groups was observed. The serum inflammatory factors, vascular endothelial function factors and cardiac function were compared before and after treatment. Results After treatment, the total effective rates of the control group and the treatment group were 80.00% and 96.67%, respectively. The total effective rate of the two groups was statistically significant (P <0.05). After treatment, the levels of hs-CRP, TNF-αand malondialdehyde (MDA) in both groups were significantly lower than those before treatment, and there were statistically significant differences between the two groups before and after treatment (P <0.05). The level of serum inflammatory cytokines in the treatment group decreased more obviously, and there was significant difference between the two groups (P <0.05). After treatment, the levels of endothelin-1 (ET-1) in both groups were significantly lower than those before treatment, and the levels of NO and CGRP were significantly higher than those before treatment, with statistical difference before and after treatment (P <0.05). The improvement of these indexes in the treatment group was better than that in the control group, and the difference between the two groups was statistically significant (P <0.05). After treatment, left ventricular end-diastolic diameter (LVEDD) and left ventricular diastolic diameter (LVPWd) and left ventricular ejection fraction (LVEF) increased significantly in both groups, with statistical significance (P <0.05). The improvement of these cardiac function indexes in the treatment group was better than that in the control group. The difference between the two groups was statistically significant (P <0.05). Conclusion Huoxue Tongmai tablet combined with trimetazidine treatment of coronary heart disease significant effect, can significantly improve the patient’s cardiac function and endothelial function, reduce the level of inflammatory cytokines, with a certain clinical application value.