2023 年第 9 期 第 18 卷

灯盏生脉胶囊联合硝酸酯类药物治疗老年气虚血瘀型不稳定型心绞痛患者的临床效果

Effect of Dengzhan Shengmai capsules combined with nitrate ester drugs on elderly patients of unstable angina pectoris with Qi deficiency and blood stasis syndrome

作者：贾韩静蒋闻弢余瑞杭黄哲华曾凯徐文婷

英文作者：Jia Hanjing Jiang Wentao Yu Ruihang Huang Zhehua Zeng Kai Xu Wenting

单位：浙江中医药大学附属第一医院急诊外科，杭州310000

英文单位：Department of Emergency Surgery the First Affiliated Hospital of Zhejiang Chinese Medical University Hangzhou 310000 China

关键词：不稳定型心绞痛；灯盏生脉胶囊；单硝酸异山梨酯片；气虚血瘀型

英文关键词：Unstableanginapectoris;DengzhanShengmaicapsules;Isosorbidemononitratetablets;Qideficiencyandbloodstasissyndrome

• 摘要：

• 目的  探讨灯盏生脉胶囊联合硝酸酯类药物治疗老年气虚血瘀型不稳定型心绞痛（UAP）患者的临床效果。方法 选取2020年12月至2021年12月浙江中医药大学附属第一医院收治的104例老年气虚血瘀型UAP患者，按随机数字表法分为对照组和观察组，各52例。对照组在常规治疗基础上予单硝酸异山梨酯片，观察组在对照组的基础上加用灯盏生脉胶囊，均连续治疗28 d。记录治疗前后患者心绞痛发作频率、持续时间以及心电图ST段下移幅度，比较2组临床疗效及治疗前后血液流变学指标、脂代谢指标水平。记录患者不良反应发生情况。结果 治疗后，2组心绞痛发作频率、持续时间及心电图ST段下移幅度低于/短于/小于治疗前，且观察组低于/短于/小于对照组，差异均有统计学意义（均P<0.05）。观察组总有效率高于对照组［90.4%（47/52）比73.1%（38/52）］，差异有统计学意义（P=0.022）。治疗后，2组血细胞比容、红细胞沉降率、血浆黏度及低密度脂蛋白胆固醇水平均低于治疗前，且观察组均低于对照组；2组高密度脂蛋白胆固醇、脂联素、脂肪特异性丝氨酸蛋白酶抑制剂水平均高于治疗前，且观察组均高于对照组［（1.32±0.20）mmol/L比（1.21±0.23）mmol/L、（7.6±1.2）mg/L比（6.2±1.1）mg/L、（1.85±0.46）μg/L比（1.60±0.37）μg/L］，差异均有统计学意义（均P<0.05）。2组不良反应发生率比较差异无统计学意义（P=0.402）。结论 灯盏生脉胶囊联合单硝酸异山梨酯片治疗老年气虚血瘀型UAP患者效果显著，能够明显缓解患者临床症状，改善机体血液流变学以及脂代谢，且安全性较好。

• Objective To investigate the effect of Dengzhan Shengmai capsules combined with nitrate ester drugs on elderly patients of unstable angina pectoris (UAP) with Qi deficiency and blood stasis syndrome. Methods From December 2020 to December 2021, 104 elderly patients of UAP with Qi deficiency and blood stasis syndrome admitted to the First Affiliated Hospital of Zhejiang Chinese Medical University were selected. They were divided into the control group and the observation group according to the random number table method, with 52 cases in each group. The control group received isosorbide mononitrate tablets based on conventional treatment, and the observation group received Dengzhan Shengmai capsules based on the control group, both treated for 28 d. The frequency and duration of angina pectoris and downward distance of electrocardiogram ST-segment were recorded. The clinical efficacy was compared between the two groups, as well as levels of hemorheology index and lipid metabolism index before and after treatment. The occurrence of adverse reactions was recorded. Results After treatment, the frequency and duration of angina pectoris and downward distance of electrocardiogram ST-segment in both groups were lower/shorter/less than those before treatment, and the above parameters in the observation group were lower/shorter/less than those in the control group (all P<0.05). The total effective rate in the observation group was higher than that in the control group ［90.4%（47/52）vs 73.1%（38/52）］(P=0.022). After treatment, levels of hematocrit, erythrocyte sedimentation rate, plasma viscosity, and low-density lipoprotein cholesterol in both groups were lower than those before treatment, and the levels in the observation group were lower than those in the control group; levels of high-density lipoprotein cholesterol, adiponectin and visceral adipose tissue-derived serine protease inhibitor in both groups were higher than those before treatment, and the levels in the observation group were higher than those in the control group ［（1.32±0.20）mmol/L vs （1.21±0.23）mmol/L,（7.6±1.2）mg/L vs （6.2±1.1）mg/L,（1.85±0.46）μg/L vs （1.60±0.37）μg/L］ (all P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P=0.402). Conclusions  sDengzhan Shengmai capsules combined with isosorbide mononitrate tablets has a significant effect on elderly patients of UAP with Qi deficiency and blood stasis syndrome, which can relieve the clinical symptoms of patients, improve the body′s hemorheology and lipid metabolism, and has good safety.