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目的:观察中药复方汤剂联合辛伐他汀对老年冠心病患者的疗效及心肌灌注量的影响。方法:选取我院2011年12月至2014年12月老年冠心病患者108例,抽签随机分为观察组与对照组两组,每组54例,对照组患者在常规治疗基础上给予辛伐他汀治疗,观察组患者在对照组治疗基础上联合中药复方汤剂治疗。比较两组患者临床治疗有效率、治疗前后血液流变学指标变化情况、心绞痛发作次数、发作持续时间、心肌灌注缺损(MIA均值)变化及放射性异常分布积分。结果:观察组患者临床治疗有效率为96.29%较对照组83.33%显著较高(P<0.05);观察组患者全血高切粘度、全血低切粘度、血液粘度和纤维蛋白原水平较对照组显著较低(P<0.05);观察组患者治疗后心绞痛发作次数和每次发作持续时间较对照组显著较低(P<0.05);观察组患者治疗后MIA值和放射性异常分布积分较对照组显著较低(P<0.05)。结论:中药复方汤剂联合辛伐他汀治疗老年冠心病疗效显著,患者血液流变学指标水平得到改善,心绞痛发作次数和发作时间显著减少,减少了冠心病心肌缺血面积,改善了心肌灌注,值得临床应用推广。
Objective: To observe the curative effect and myocardial perfusion of traditional Chinese medicine decoction combined with simvastatin in elderly patients with coronary heart disease. Methods: A total of 108 elderly patients with coronary heart disease from December 2011 to December 2014 in our hospital were enrolled. Randomly divided into two groups (observation group and control group), 54 patients in each group. The patients in the control group were given simvastatin Treatment, observation group patients in the control group based on the combination of traditional Chinese medicine decoction treatment. The clinical efficacy, the change of hemorheology index, the number of angina pectoris, the duration of attack, the myocardial perfusion defect (MIA mean) and the distribution of radioactive abnormalities before and after treatment were compared between the two groups. Results: The effective rate of clinical treatment in observation group was significantly higher than that in control group (96.29% vs 83.33%, P <0.05). In the observation group, the whole blood high shear viscosity, whole blood low shear viscosity, blood viscosity and fibrinogen level were significantly higher than those in control group (P <0.05). The number of episodes of angina pectoris and the duration of each episode after treatment in the observation group were significantly lower than those in the control group (P <0.05). The scores of MIA and radioactive abnormalities in the observation group were significantly higher than those in the control group Group was significantly lower (P <0.05). Conclusion: The Chinese herbal compound decoction combined with simvastatin has significant curative effect on elderly patients with coronary heart disease. The indexes of hemorheology are improved, the number of episodes of angina pectoris and the attack time are significantly reduced, the myocardial ischemic area of coronary heart disease is reduced, myocardial perfusion is improved, It is worth to promote clinical application.