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目的探讨降脂通络软胶囊治疗冠心病心绞痛的疗效及作用机制。方法将98例冠心病心绞痛患者经过2周导入期后,随机分为观察组50例和对照组48例。两组患者均给予抗栓、稳定斑块、钙通道拮抗剂及β受体阻滞剂等常规治疗。观察组加用降脂通络软胶囊,每次2粒,每日3次,口服;对照组加用单硝酸异山梨酯缓释片60mg,每日1次,两组仍有心绞痛发作者,临时含服硝酸甘油片1片。两组疗程均为12周。治疗期间记录患者每天心绞痛或胸闷发作次数以及硝酸甘油用量,并检测治疗前后两组患者血清脂联素(APN)和丙二醛(MDA)水平。结果治疗后两组患者心绞痛或胸闷发作次数和硝酸甘油用量均明显减少,与本组治疗前比较差异均有统计学意义(P<0.01),但组间比较差异无统计学意义(P>0.05)。治疗后,观察组血清APN较治疗前和对照组明显升高(P<0.01),对照组治疗后血清APN水平有所上升,但与本组治疗前比较差异无统计学意义(P>0.05)。治疗后,观察组血清MDA较本组治疗前及对照组均明显降低(P<0.01),对照组治疗后血清MDA亦有下降,但差异无统计学意义(P>0.05)。治疗后观察组患者甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)均较治疗前显著下降(P<0.01);治疗后观察组的TG和高密度脂蛋白胆固醇(HDL-C)较对照组差异有统计学意义(P<0.01)。结论常规治疗的基础上,联合降脂通络软胶囊具有良好的抗心绞痛作用,其作用机制可能与抑制体内炎性反应和氧化应激有关。
Objective To investigate the therapeutic effect and mechanism of Jiangzhi Tongluo soft capsules on angina pectoris of coronary heart disease. Methods A total of 98 patients with coronary heart disease and angina pectoris were randomly divided into observation group (n = 50) and control group (n = 48) after 2 weeks of induction period. Both groups were given antithrombotic, stable plaques, calcium channel blockers and β-blockers and other conventional treatment. The observation group plus Jiangzhi Tongluo soft capsules, 2 capsules each time, 3 times a day orally; control group with isosorbide mononitrate sustained-release tablets 60mg, 1 day, there are still two groups of patients with angina pectoris, Temporarily containing nitroglycerin tablets 1. The two groups were treated for 12 weeks. The number of patients with angina pectoris or chest tightness and the amount of nitroglycerin were recorded during treatment. Serum levels of adiponectin (APN) and malondialdehyde (MDA) were measured before and after treatment. Results After treatment, the number of episodes of angina pectoris or chest tightness and the amount of nitroglycerin in both groups were significantly decreased (P <0.01), but there was no significant difference between the two groups (P> 0.05 ). After treatment, serum APN in observation group was significantly higher than that before treatment and in control group (P <0.01), while APN level in control group increased after treatment, but there was no significant difference compared with before treatment (P> 0.05) . After treatment, the level of serum MDA in observation group was significantly lower than that before treatment and in control group (P <0.01). The serum MDA in control group also decreased after treatment, but the difference was not statistically significant (P> 0.05). After treatment, the triglyceride (TG), total cholesterol (TC), and low density lipoprotein cholesterol (LDL-C) in the observation group were significantly lower than those before treatment (P <0.01) Protein cholesterol (HDL-C) than the control group difference was statistically significant (P <0.01). Conclusion On the basis of routine treatment, combined with Jiangzhi Tongluo Soft Capsule has a good anti-anginal effect, and its mechanism may be related to inhibition of inflammatory reaction and oxidative stress in vivo.