[1]曾建勇,王小玲,范小虹,等.复方丹参滴丸联合阿托伐他汀治疗冠心病合并心绞痛疗效及对患者氧化应激指标的影响[J].陕西中医,2023,(1):55-59.[doi:DOI:10.3969/j.issn.1000-7369.2023.01.013]
 ZENG Jianyong,WANG Xiaoling,FAN Xiaohong,et al.Efficacy of compound Danshen dripping pills combined with atorvastatin in the treatment of coronary heart disease with angina pectoris and its influence on oxidative stress indicators of patients[J].,2023,(1):55-59.[doi:DOI:10.3969/j.issn.1000-7369.2023.01.013]
点击复制

复方丹参滴丸联合阿托伐他汀治疗冠心病合并心绞痛疗效及对患者氧化应激指标的影响
分享到:

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2023年1期
页码:
55-59
栏目:
临床研究
出版日期:
2023-01-05

文章信息/Info

Title:
Efficacy of compound Danshen dripping pills combined with atorvastatin in the treatment of coronary heart disease with angina pectoris and its influence on oxidative stress indicators of patients
作者:
曾建勇1王小玲2范小虹1魏京霞1
(1.成都市第六人民医院药剂科,四川 成都 610051; 2.四川省骨科医院药剂科,四川 成都 610051)
Author(s):
ZENG JianyongWANG XiaolingFAN XiaohongWEI Jingxia
(Department of Pharmacy,the Sixth People's Hospital of Chengdu,Chengdu 610051,China)
关键词:
冠心病 心绞痛 复方丹参滴丸 阿托伐他汀 氧化应激 血液流变学
Keywords:
Coronary heart disease Angina pectoris Compound Danshen dripping pills Atorvastatin Oxidative stress Hemorheology
分类号:
R 541.4
DOI:
DOI:10.3969/j.issn.1000-7369.2023.01.013
文献标志码:
A
摘要:
目的:研究复方丹参滴丸联合阿托伐他汀用于冠心病合并心绞痛患者的治疗疗效及对患者氧化应激指标的影响。方法:选择114例冠心病合并心绞痛患者作为研究对象,按单双号法随机分配到联合组(n=57)和单一组(n=57),均给予常规治疗,其中单一组加以阿托伐他汀治疗,联合组加用复方丹参滴丸,比较两组患者治疗前及治疗2个月后临床疗效、心绞痛改善情况、心功能指标、血液流变学指标、血清氧化应激指标,并比较治疗期间两组患者不良心血管事件总发生率。结果:治疗2个月后,联合组总有效率为92.98%,显著高于单一组的82.46%(P<0.05); 两组患者心绞痛发作频率、发作时间较治疗前显著降低(P<0.05),联合组显著低于单一组(P<0.05); 治疗2个月后,两组患者左心室射血分数(LVEF)、6分钟步行距离(6MWD)均较治疗前显著提高(P<0.05),左心室收缩末内径(LVESD)、左心室舒张末期内径(LVEDD)均较治疗前显著降低(P<0.05),联合组治疗后比较差异有统计学意义(P<0.05); 治疗2个月后,两组患者全血高切黏度、全血低切黏度、血浆黏度较治疗前显著降低(P<0.05),两组患者血清总超氧化物歧化酶(T-SOD)、谷胱甘肽过氧化物酶(GSH-Px)活力较治疗前显著提高(P<0.05),联合组显著高于单一组(P<0.05); 丙二醛(MDA)、乳酸(LD)含量较治疗前显著降低(P<0.05),联合组显著低于单一组(P<0.05); 治疗期间,联合组和单一组不良心血管事件总发生率分别为3.51%和1.76%,比较差异无统计学意义(P>0.05)。结论:复方丹参滴丸联合阿托伐他汀治疗冠心病合并心绞痛效果良好,能明显降低心绞痛的发生情况、改善患者心功能和血液流变学,同时缓解氧化应激状态,药物方案安全性良好,值得临床应用。
Abstract:
Objective:To study the therapeutic efficacy of compound Danshen dripping pills combined with atorvastatin on patients with coronary heart disease complicated with angina pectoris and its influence on oxidative stress indicators of patients.Methods:114 patients with coronary heart disease complicated with angina pectoris were selected as the research subjects,and they were randomly assigned to combined group(n=57)and single group(n=57)according to the odd and even number method.All the patients were given conventional treatment,and single group was additionally treated with atorvastatin,and the combined group was additionally given compound Danshen dripping pills.The clinical efficacy,improvement of angina pectoris,cardiac function indicators,hemorheological indicators and serum oxidative stress indicators were compared between the two groups before treatment and after 2 months of treatment.The total incidence rate of adverse cardiovascular events of the two groups of patients was compared during treatment.Results:After 2 months of treatment,the total effective rate with 92.98% of combined group was significantly higher than 82.46% of single group(P<0.05).The frequency and duration of angina pectoris in the two groups of patients were significantly decreased compared with those before treatment(P<0.05),and the frequency and duration of combined group were significantly lower than those in single group(P<0.05).After 2 months of treatment,the left ventricular ejection fraction(LVEF)and 6-minute walking distance(6MWD)of the two groups were significantly improved compared to before treatment(P<0.05),while the left ventricular end-systolic diameter(LVESD)and left ventricular end-diastolic diameter(LVEDD)were significantly reduced compared to before treatment(P<0.05),and the indicators in combined group were significantly different from those in single group after treatment(P<0.05).After 2 months of treatment,the whole blood high-shear viscosity,whole blood low-shear viscosity and plasma viscosity of the two groups were significantly lower than those before treatment(P<0.05),while the serum total superoxide dismutase(T-SOD)and glutathione peroxidase(GSH-Px)activity of the two groups were significantly higher than those before treatment(P<0.05),and the above indicators of combined group were significantly higher than those in single group(P<0.05).The levels of malondialdehyde(MDA)and lactic acid(LD)were significantly lower than those before treatment(P<0.05),and the levels were significantly lower in combined group than those in single group(P<0.05).During treatment,the total incidence rate of adverse cardiovascular events was 3.51% in combined group and was 1.76% in single group(P>0.05).Conclusion:Compound Danshen dripping pills combined with atorvastatin has a good effect in the treatment of coronary heart disease with angina pectoris.It can significantly reduce the occurrence of angina pectoris,improve the cardiac function and hemorheology,and relieve the oxidative stress status.The drug regimen has a good safety and is worthy of clinical promotion.

参考文献/References:

[1] 吴玉杰,石小平,孙丽曼.针灸联合黄芪对冠心病心绞痛患者血清正五聚蛋白-3、可溶性CD40L水平的影响[J].陕西中医,2022,43(5):644-647.
[2] 董 昕,杨朋康.单硝酸异山梨酯联合维拉帕米对冠心病稳定型心绞痛患者血脂水平及血清同型半胱氨酸、高敏C反应蛋白的影响[J].陕西医学杂志,2020,49(4):485-488.
[3] Zhang H,Chang R.Effects of exercise after percutaneous coronary intervention on cardiac function and cardiovascular adverse events in patients with coronary heart disease:Systematic review and meta-analysis[J].J Sports Sci Med,2019,18(2):213-222.
[4] Jiang R,Zhao S,Wang R,et al.Safety and efficacy of atorvastatin for chronic subdural hematoma in chinese patients:A randomized clinicaltrial[J].JAMA Neurol,2018,75(11):1338-1346.
[5] Zhang Y,Zhao J,Ding R,et al.Pre-treatment with compound Danshen dripping pills prevents lipid infusion-induced microvascular dysfunction in mice[J].Pharm Biol,2020,58(1):701-706.
[6] Yao D,Wang C,Han L,et al.Compound Danshen dripping pills combined with trimetazidine in treating unstable angina pectoris:Protocol for a systematic review of randomized controlled trials[J].Medicine(Baltimore),2019,98(49):e18238.
[7] 葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2013:526-527.
[8] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会.慢性稳定性心绞痛诊断与治疗指南[J].中华心血管病杂志,2007,35(3):195-206.
[9] Li K,Liu MM,Yang X,et al.Evaluation of efficacy and safety of combined rosuvastatin and atorvastatin in treating with coronary heart disease:A protocol for systematic review and meta-analysis[J].Medicine(Baltimore),2021,100(24):e26340.
[10] Meng L,Li Y,Xue C,et al.Compound Danshen dripping pills affect the pharmacokinetics of azisartan by regulating the expression of cytochrome P450 2B1,2C6,and 2C11 in rats[J].J Pharm Biomed Anal,2021,195:113887.
[11] Jin T,Liu Z,Chu Y,et al.UFLC-MS/MS determination and population pharmacokinetic study of tanshinol,ginsenoside Rb1 and Rg1 in rat plasma after oral administration of compound Danshen dripping pills[J].Eur J Drug Metab Pharmacokinet,2020,45(4):523-533.
[12] 张 敏,张科林.复方丹参滴丸联合曲美他嗪对冠心病合并左心功能不全患者血液流变学影响及疗效观察[J].陕西中医,2016,37(10):1327-1329.
[13] Beck JD,Moss KL,Morelli T,et al.Periodontal profile class is associated with prevalent diabetes,coronary heart disease,stroke,and systemic markers of c-reactive protein and interleukin-6[J].Periodontol,2018,89(2):157-165.
[14] 肖 铃.复方丹参滴丸药理作用及临床应用的研究进展[J].世界中医药,2015,10(7):1117-1119.
[15] 李付兵,吴 萱.复方丹参滴丸联合马来酸桂哌齐特对冠心病稳定型心绞痛患者的临床疗效[J].中成药,2020,42(7):1764-1768.
[16] 叶 莎,金爱萍,高 洁,等.复方丹参滴丸联合曲美他嗪对冠心病合并高脂血症患者血液流变学及血脂的影响[J].现代生物医学进展,2019,19(5):868-871.
[17] 张鞠华,赵志宏,李海霞,等.丹蒌片对冠心病合并高脂血症病人血脂、血液流变学的影响[J].中西医结合心脑血管病杂志,2018,16(10):1319-1323.
[18] Zhang WX,Xiao XY,Peng CG,et al.Sodium tanshinone ⅡA sulfate protects myocardium against paraquat-induced toxicity through activating the Nrf2 signaling pathway in rats[J].Hum Exp Toxicol,2019,38(2):247-254.
[19] 牛慧君.不同剂量阿托伐他汀降脂治疗对冠心病稳定型心绞痛患者血脂相关指标及氧化应激的影响[J].中国药物与临床,2021,21(10):1754-1756.
[20] 王晓芳,蒙 婷,马 伶.丹参多酚注射液联合尼可地尔治疗冠心病不稳定型心绞痛(痰瘀互结型)临床疗效及对血清学指标的影响[J].湖北中医药大学学报,2021,23(1):18-21.
[21] 张芳芹.丹红注射液联合针灸治疗气虚血瘀型冠心病心绞痛患者的疗效[J].心血管康复医学杂志,2020,29(2):235-240.
[22] 杨 芳,段洪涛,童安荣,等.复方龙血竭胶囊联合曲美他嗪对冠心病稳定型心绞痛心血瘀阻证的疗效及对氧化应激指标水平的影响[J].医学临床研究,2019,36(11):2220-2222.
[23] 任 莹,杨 蕾,赵平凡,等.益气复脉通络方加减对不稳定型心绞痛心肌酶谱、sICAM-1和MMPs-9水平影响[J].中华中医药学刊,2019,37(11):2719-2722.
[24] Yan R,Chen R,Wang J,et al.Jingshu Keli and its components notoginsenoside R1 and ginsenoside Rb1 alleviate the symptoms of cervical myelopathy through Kir3.1 mediated mechanisms[J].CNS Neurol Disord Drug Targets,2019,18(8):631-642.

相似文献/References:

[1]朱 薇.通脉调脂方治疗冠心病稳定性心绞痛疗效及对患者血流变、VCAM1〖JZ〗及ICAM1影响的研究*[J].陕西中医,2019,(3):290.
 ZHU Wei..Effect of Tongmai Tiaozhi recipe on the efficacy, Hemorheology, VCAM1 and ICAM1 〖JZ〗in patients with stable angina pectoris of coronary heart disease[J].,2019,(1):290.
[2]时晓华.丹参多酚酸盐注射液辅助介入治疗冠心病 及对患者心、肾功能和心肌损伤的影响*[J].陕西中医,2019,(5):568.
 SHI Xiaohua..Effects of salvianolate injection on cardiac function, renal function, myocardial injury in percutaneous coronary intervention postoperative patients with coronary heart disease[J].,2019,(1):568.
[3]刘 红,张玲燕,杨 玲.血府逐瘀汤治疗冠心病介入术后心绞痛临床研究[J].陕西中医,2019,(5):594.
 LIU Hong,ZHANG Lingyan,YANG Ling..Clinical observation of Xuefu Zhuyu decoction in the treatment of angina pectoris after PCI for coronary heart disease[J].,2019,(1):594.
[4]吕永飞,陈爱莲.益心康泰胶囊治疗冠心病经皮冠状动脉介入术术后疗效及对患者血流变、血管内皮功能的影响*[J].陕西中医,2019,(6):714.
 LV Yongfei,CHEN Ailian..Effect of Yixin Kangtai capsule on the curative effect hemorheology and vascular endothelial function after coronary artery disease PCI[J].,2019,(1):714.
[5]贺建涛,胡宇才,刘 磊.活血通络散治疗冠心病PCI术后心绞痛疗效研究*[J].陕西中医,2019,(7):854.
 HE Jiantao,HU Yucai,LIU Lei..Efficacy observation of Huoxue Tongluo powder in the treatment of angina pectoris after coronary heart disease PCI[J].,2019,(1):854.
[6]解洪涛,张 顺△,曾广伟.当归补血方联合西药治疗冠脉搭桥术后疗效及对患者血瘀证证候评分和凝血功能的影响*[J].陕西中医,2019,(10):1341.
 XIE Hongtao,ZHANG Shun,ZENG Guangwei..Effects of Danggui Buxue prescription combined with western medicine on blood stasis and coagulation function after coronary artery bypass grafting[J].,2019,(1):1341.
[7]索晓菲,王亚红△,王居新,等.软坚通脉汤治疗冠心病PCI术后Ⅱ期心脏康复疗效〖JZ〗及对患者生活质量的影响*[J].陕西中医,2020,(1):29.
[8]尹 毅,李小兰△.益气活血汤联合尼可地尔治疗稳定性心绞痛疗效及对患者T淋巴细胞亚群的影响[J].陕西中医,2020,(7):888.[doi:DOI:10.3969/j.issn.10007369.2020.07.014]
[9]季学清,刘 萍△,陈宝瑾,等.冠心康方加减联合西药治疗冠心病合并2型糖尿病气虚痰瘀证疗效研究*[J].陕西中医,2020,(9):1208.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.008]
 JI Xueqing,LIU Ping,CHEN Baojin,et al.Efficacy of Guanxinkang preparation combined with western medicine in the treatment of coronary heart disease and type 2 diabetes mellitus with syndrome of Qixu Tanyu[J].,2020,(1):1208.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.008]
[10]肖 进,张新莉.醒脾祛湿汤治疗湿浊痹阻型胸痹心痛临床研究[J].陕西中医,2021,(4):463.[doi:DOI:10.3969/j.issn.1000-7369.2020.04.015]
 XIAO Jin,ZHANG Xinli.Clinical study on chest pain patients with Shizhuo Bizu type treated by Xingpi Qushi decoction[J].,2021,(1):463.[doi:DOI:10.3969/j.issn.1000-7369.2020.04.015]
[11]龚显田,陈丽梅,李子才,等.瓜蒌薤白半夏汤合失笑散加减治疗冠心病心绞痛临床研究[J].陕西中医,2021,(7):886.[doi:DOI:10.3969/j.issn.1000-7369.2020.07.019]
 GONG Xiantian,CHEN Limei,LI Zicai,et al.Clinical Study on Gualou Xiebai Banxia decoction and Shixiao powder modified in treating coronary heart disease angina pectoris[J].,2021,(1):886.[doi:DOI:10.3969/j.issn.1000-7369.2020.07.019]
[12]汪思慧,沈 雁.从“络以辛为泄”论治冠心病心绞痛研究进展[J].陕西中医,2022,(12):1822.[doi:DOI:10.3969/j.issn.1000-7369.2022.12.043]

备注/Memo

备注/Memo:
基金项目:四川省医学会科研课题(2019HR36)
更新日期/Last Update: 2022-12-28