用灯盏花素注射液治疗冠心病所致不稳定型心绞痛的效果分析

用灯盏花素注射液治疗冠心病所致不稳定型心绞痛的效果分析

目的：分析燈盏花素注射液治疗冠心病所致不稳定型心绞痛的临床效果。方法：选取本院2015年6月-2017年7月收治的冠心病所致不稳定型心绞痛患者60例，按随机数字表法分为观察组与对照组，每组各30例。对照组给予常规西药治疗，观察组在对照组基础上加用灯盏花素注射液。比较两组治疗效果，比较两组治疗前后血液流变学参数（全血高切黏度、血浆黏度、红细胞聚集指数、红细胞变形指数）及ADP和COL诱导的血小板聚集率。结果：治疗后，观察组全血高切黏度、血浆黏度值、红细胞聚集指数、红细胞变形指数均低于治疗前和对照组，比较差异均有统计学意义（P＜0.05）；治疗后，两组COL、ADP诱导的血小板聚集率均低于治疗前，且观察组均低于对照组，比较差异均有统计学意义（P＜0.05）；观察组总有效率为93.33%，明显高于对照组的73.33%，比较差异有统计学意义（字2=4.320 0，P=0.037 7）。结论：针对冠心病所致不稳定型心绞痛患者，给予灯盏花素注射液治疗具有满意的效果，能够显著改善患者的凝血指标，促进康复，具有较高的推广价值。

标签：灯盏花素注射液；冠心病；不稳定型心绞痛

【Abstract】Objective：To analyze the clinical effect of Breviscapine Injection in the treatment of unstable angina pectoris caused by coronary heart disease.Method：A total of 60 patients with unstable angina pectoris caused by coronary heart disease were treated in our hospital from June 2015 to July 2017 were selected，according to the random number table method，they were divided into observation group and control group，30 cases in each group.The control group was treated with conventional western medicine，and observation group was treated with Breviscapine Injection on the basis of control group.The treatment effects of two groups was compared，the hemorheological parameters（whole blood viscosity，plasma viscosity，erythrocyte aggregation index，red cell deformation index）and ADP and COL induced platelet aggregation rate before and after treatment between two groups were compared.Result：After treatment，the whole blood viscosity，plasma viscosity，erythrocyte aggregation index and red cell deformation index in observation group were lower than those of before treatment and control group，the differences were statistically significant（P＜0.05）.After treatment，the ADP and COL induced platelet aggregation rate in two groups were all lower than those of before treatment，and observation group were lower than those of control group，the differences were statistically significant（P＜0.05）.The total effective rate of observation group was 93.33%，which was significantly higher than 73.33% of control group，the difference was statistically significant（字2=4.320 0，P=0.037 7）.Conclusion：For patients with unstable angina pectoris caused by coronary heart disease，Breviscapine Injection has satisfactory effect，which can significantly improve coagulation index and promote rehabilitation，and has high popularization value.

【Key words】Breviscapine Injection；Coronary heart disease；Unstable

angina pectoris

First-author’s address：Jiangmen Second People’s Hospital，Jiangmen 529000，Chinadoi：10.3969/j.issn.1674-4985.2018.04.022

临床上，冠心病是一种由冠状动脉粥样硬化或血管痉挛导致心肌缺血、血氧或坏死，进而诱发的一种严重危害人类健康安全的心脏病[1]。不稳定型心绞痛是介于稳定型心绞痛和急性心肌梗死之间的一种不稳定的心肌缺血状态，若未经及时干预，有可能发展为急性心肌梗死，甚至猝死，危险性极高[2]。虽然现阶段给予冠心病所致不稳定型心绞痛患者常规西医治疗具有较为满意的效果，能够显著改善患者的心慌心悸以及胸闷气短等症状，但停药之后心绞痛易复发，因而迫切需要一种更为理想的手段治愈疾病[3]。中医认为，本病属于“胸痹”“心痛”等范畴，病机在于本虚标实、虚实夹杂，而标实以心血瘀阻为主，故多采取活血化瘀法治疗[4]。本院近年来将灯盏花素注射液引入到了本病的治疗中，效果较好，现报道如下。

1 资料与方法

1.1 一般资料选取2015年6月-2017年7月本院收治的冠心病所致不稳定型心绞痛患者60例。（1）纳入标准：①符合《中药新药治疗冠心病心绞痛临床研究指导原则》中对于冠心病心绞痛的相关诊断标准[3]；②患者均对本研究知情并自愿签署知情同意书。（2）排除标准：①合并其他心脏病者，例如先天性心脏病、原发性心肌病以及风湿性心脏病者；②合并严重肝肾功能以及造血功能异常者；③既往有心肌梗死或曾经接受过冠状动脉介入治疗者。按随机数字表法将其分为观察组和对照组，每组各30例。本研究已经院伦理委员会审核批准。

1.2 方法两组均给予常规西药治疗，主要包括：阿司匹林肠溶片（拜耳医药保健有限公司，国药准字J20130078，100 mg/片）口服，100 mg/次，1次/d；低分子肝素钙注射液（深圳赛保尔生物药业有限公司，国药准字H20052319，0.4 mL：4100AXaIU）皮下注射0.4 mL/次，2次/d；硝酸甘油片（上海上药信谊药厂有限公司，国药准字H31021149，

0.5 mg）舌下含服1粒/次，3次/d，饭后服用；酒石酸美托洛尔片（阿斯利康制药有限公司，国药准字H32025391，25 mg/片）口服，12.50 mg/次，2次/d；辛伐他汀片（杭州默沙东制药有限公司，国药准字J20130181，40 mg/片）口服，20 mg/次，1次/d。针对血压及血糖异常者，需在常规西药治疗的基础上行降压、降糖干预。观察组在此基础上增加灯盏花素注射液（昆明龙津药业股份有限公司，国药准字Z53020667，10 mg/支），用法如下：将灯盏花素注射液50 mg溶解于浓度为0.9%的氯化钠注射液250 mL中静脉滴注，1次/d。两组均连续治疗2周。

1.3 观察指标与判定标准测定两组治疗前后的血液流变学参数，包括全血高切黏度、血浆黏度、红细胞聚集指数、红细胞变形指数等；比较两组治疗前后ADP和COL诱导的血小板聚集率；比较两组临床疗效，评定标准：若治疗后心绞痛发作次数较治疗前减少幅度超过70%则评定为显效；若治疗后心绞痛发作次