麝香保心丸治疗稳定型心绞痛疗效观察

发布时间：2018-05-23 22:22

本文选题：冠心病 + 稳定型心绞痛　；参考：《山西医科大学》2016年硕士论文

【摘要】：目的:通过24个月的临床随访,观察麝香保心丸治疗稳定型心绞痛的疗效和不良反应。方法:选择2012年6月至2013年9月就诊于山西医科大学第一医院、山西医科大学第二医院门诊及住院冠状动脉性心脏病患者114例,符合纳入标准及排除标准的要求,并签署知情同意书。记录所有入选患者的基本资料,同时采用冠心病标准药物治疗,如阿司匹林、硝酸酯剂、β受体阻滞剂、血管紧张素转换酶抑制剂、他汀类药物等,加用试验药物(2粒/次,3次/日),分别于入组后1天、6月、12月、18月、24月进行来院随访,化验肝肾功能等主要生化指标,并记录心绞痛发作次数、硝酸甘油消耗量、心脏事件的发生、药物不良反应等情况。其中心脏相关事件包括:因心绞痛再次住院、心肌梗死、心源性休克及猝死;药物不良反应包括患者临床症状及肝肾功能等生化指标。随访结束后,通过揭盲分为治疗组与安慰剂组,进行数据统计分析。结果:揭盲后治疗组与安慰剂组的患者,在治疗后6月、12月、18月、24月心绞痛发作次数及硝酸甘油消耗量较治疗前均有减少,随时间延长心绞痛发作次数及硝酸甘油消耗量呈递减趋势(P0.05);两组患者在治疗后同期比较治疗组心绞痛发作次数及硝酸甘油消耗量较安慰剂组均有减少,差异有统计学意义(P0.05)。治疗组患者因心绞痛再次住院治疗次数及发生心肌梗死的例数均少于安慰剂组,差异有统计学意义(P0.05);治疗组猝死病例数少于安慰剂组,但差异无统计学意义(P0.05)。治疗组与安慰剂组患者随访期间肝肾功能生化指标与治疗前及治疗后同期相比较,差异均无统计学意义(P0.05);所有入选患者随访期间均无特殊严重不良反应。结论:在冠心病标准药物治疗基础上加用麝香保心丸可以进一步减少稳定型心绞痛患者心绞痛发作次数及硝酸甘油的用量,减少心脏事件的发生,对肝肾功能无明显不良影响,安全性较好。
[Abstract]:Objective: to observe the efficacy and side effects of Shexiang Baoxin Pill in the treatment of stable angina pectoris. Methods: from June 2012 to September 2013, 114 patients with coronary heart disease were selected from the first Hospital of Shanxi Medical University and the second Hospital of Shanxi Medical University. And sign the informed consent. To record the basic data of all patients enrolled, and to use standard drugs for coronary heart disease, such as aspirin, nitrate ester, beta receptor blocker, angiotensin converting enzyme inhibitor, statins, and so on. The patients were followed up for 1 day, 6 days, 12 months, 18 months, 24 months after the trial, and the main biochemical indexes such as liver and kidney function were tested, and the frequency of angina pectoris attack and the consumption of nitroglycerin were recorded. Heart events, adverse drug reactions, etc. Cardiac events include readmission of angina pectoris, myocardial infarction, cardiogenic shock and sudden death, and adverse drug reactions include clinical symptoms, liver and kidney function and other biochemical indicators. After follow-up, the patients were divided into two groups: treatment group and placebo group. Results: the number of angina pectoris attacks and the consumption of nitroglycerin in the treatment group and the placebo group decreased after 6 months, 12 months, 18 months and 24 months after treatment. The times of angina pectoris attack and the consumption of nitroglycerin decreased with time, and the number of angina pectoris attack and the consumption of nitroglycerin in the two groups were lower than those in the placebo group in the same period after treatment, and the difference was statistically significant (P 0.05). The number of times of re-hospitalization for angina pectoris and the incidence of myocardial infarction in the treatment group were less than those in the placebo group (P 0.05), and the number of sudden death cases in the treatment group was less than that in the placebo group, but the difference was not statistically significant (P 0.05). There was no significant difference in the biochemical indexes of liver and kidney function between the treatment group and the placebo group during the follow-up period compared with those before and after treatment (P 0.05). Conclusion: the addition of Shexiang Baoxin Pill on the basis of the standard drug therapy for coronary heart disease can further reduce the number of angina pectoris attacks and the dosage of nitroglycerin in patients with stable angina pectoris, reduce the occurrence of cardiac events, and have no obvious adverse effect on liver and kidney function. The safety is good.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R541.4

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