Article(id=1322923495113490515, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923011518628427, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.03.042, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339139964, onlineDateStr=2026-10-30, pubDate=1741536000000, pubDateStr=2025-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339139964, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339139964, creator=13701087609, updateTime=1793339139964, updator=13701087609, issue=Issue{id=1322923011518628427, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='3', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1741536000000', pubDateStr='2025-03-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339024666, creator='13701087609', updateTime=1793340602374, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929628976906432, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923011518628427, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929628981100737, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923011518628427, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=219, endPage=222, ext={EN=ArticleExt(id=1322923497181282392, articleId=1322923495113490515, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Effect of Compound Danshen Dropping Pills(复方丹参滴丸)on Changes of Three Dimensional Echocardiogram and White Blood Cell Derived Inflammatory Indicators in Patients with Coronary Heart Disease of Qi Deficiency and Blood Stasis Type, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the effect of Compound Danshen Dropping Pills(复方丹参滴丸)on the changes of threedimensional echocardiography and leukocyte derived inflammation indicators in patients with coronary heart disease of Qi deficiency and blood stasis type.

Method

A total of 122 patients with coronary heart disease and angina pectoris in the hospital from January 2021 to January 2023 divided into a control group(61 cases)and a observation group(61 cases). The control group was treated with atorvastatin calcium tablets and trimetazidine tablets,while the observation group was treated with Compound Danshen Dropping Pills on the basis of control group. The treatment period was 12 weeks. The therapeutic effects,changes in main symptom scores,duration and frequency of angina pectoris,electrocardiogram parameters,three-dimensional echocardiographic indicators and leukocyte derived inflammation indicators before and after treatment and adverse reactions of the two groups were compared.

Result

The effective rate of the observation group was higher than that of the control group(P<0.05). After treatment,the scores of chest tightness and chest pain of two groups were lower than those before treatment(P<0.05). The scores of chest tightness and chest pain of the observation group were lower than those of the control group(P<0.05). After treatment,the duration and frequency of angina pectoris of two groups were lower than those before treatment(P<0.05). The duration and frequency of angina pectoris of the observation group were lower than those of the control group(P<0.05). After treatment,QTc interval and QRStime limit values of two groups were lower than those before treatment(P<0.05). QTc interval and QRStime limit values of the observation group were lower than those of the control group(P<0.05). After treatment,the values of left ventricular ejection fraction(LVEF)and cardiac output(CO)of two groups were higher than those before treatment,while the values of left ventricular end diastolic diameter(LVEDD)and left ventricular end systolic diameter(LVESD)were lower than those before treatment(P<0.05). The values of LVEF and COin the observation group were higher than those of the control group,while the values of LVEDD and LVESD were lower than those of the control group(P<0.05). After treatment,the serum levels of interleukin-6(IL-6)and interleukin-18(IL-18)of two groups were lower than those before treatment,while the levels of interleukin-33(IL-33)were higher than those before treatment(P<0.05). The serum levels of IL-6 and IL-18 in the observation group were lower than those of the control group,while the levels of IL-33 was higher in the control group(P<0.05). The adverse reactions of two groups had no significant difference(P>0.05).

Conclusion

Compound Danshen Dropping Pills have a significant therapeutic effect on patients with coronary heart disease of Qi deficiency and blood stasis type,which can significantly improve their cardiac function and alleviate inflammatory reactions.

, authors=Bin DENG1, Tao TAO2, Hong WANG1, Chaowei TIAN1, Yaobo LONG1, Feng SHEN1, Jibin XIE1, authorsList=Bin DENG, Tao TAO, Hong WANG, Chaowei TIAN, Yaobo LONG, Feng SHEN, Jibin XIE, authorCompany=null, correspAuthors=Hong WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322923510212984945, articleId=1322923495113490515, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=复方丹参滴丸对气虚血瘀型冠心病三维超声心动图变化及白细胞衍生炎症指标的影响, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

探讨复方丹参滴丸对气虚血瘀型冠心病患者三维超声心动图变化及白细胞衍生炎症指标的影响。

方法

选择医院于2021年1月—2023年1月冠心病患者122例,运用随机数字表法将其随机分为对照组61例与观察组61例。对照组给予阿托伐他汀钙片和曲美他嗪缓释片治疗,观察组在对照组基础上结合复方丹参滴丸治疗。两组治疗周期12周。比较两组疗效;治疗前后主要症状积分,心绞痛持续时间和发作次数,心电图参数,三维超声心动图指标和白细胞衍生炎症指标变化及不良反应情况。

结果

观察组总有效率高于对照组(P<0.05)。两组治疗后胸闷和胸痛积分低于治疗前(P<0.05);观察组治疗后胸闷和胸痛积分低于对照组(P<0.05)。两组治疗后心绞痛持续时间和发作次数低于治疗前(P<0.05);观察组治疗后心绞痛持续时间和发作次数低于对照组(P<0.05)。两组治疗后QTc间期和QRS时限值低于治疗前(P<0.05);观察组治疗后QTc间期和QRS时限值低于对照组(P<0.05)。两组治疗后左心室射血分数(LVEF)和心排血量(CO)高于治疗前,而左室舒张末期内径(LVEDD)和左室收缩末期内径LVESD低于治疗前(P<0.05);观察组治疗后LVEF和CO高于对照组,而LVEDD和LVESD低于对照组(P<0.05)。两组治疗后血清白介数(IL)-6和IL-18水平低于治疗前,而IL-33水平高于治疗前(P<0.05);观察组治疗后血清IL-6和IL-18水平低于对照组,而IL-33水平高于对照组(P<0.05)。两组不良反应比较差异无统计学意义(P>0.05)。

结论

复方丹参滴丸对气虚血瘀型冠心病患者疗效显著,可显著改善患者心功能,显著减轻患者炎症反应。

, authors=邓彬1, 陶陶2, 王宏1, 田朝伟1, 龙耀波1, 沈锋1, 谢积斌1, authorsList=邓彬, 陶陶, 王宏, 田朝伟, 龙耀波, 沈锋, 谢积斌, authorCompany=null, correspAuthors=王宏, authorNote=

邓彬(1984-),男,广东韶关人,主治医师,硕士,研究方向:全科医学科。

, correspAuthorsNote=
王宏(1980-),男,湖南人,副主任医师,硕士,研究方向:全科医学科。E-mail:。
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邓彬(1984-),男,广东韶关人,主治医师,硕士,研究方向:全科医学科。

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邓彬(1984-),男,广东韶关人,主治医师,硕士,研究方向:全科医学科。

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组别例数显效有效无效总有效
对照组6125(40.98)22(36.07)14(22.95)47(77.05)
观察组6137(60.65)19(31.15)5(8.20)56(91.80)
χ2值---5.050
P值---0.025
), ArticleFig(id=1322923536599351471, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923495113490515, language=CN, label=表1, caption=

两组气虚血瘀型冠心病患者疗效比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数显效有效无效总有效
对照组6125(40.98)22(36.07)14(22.95)47(77.05)
观察组6137(60.65)19(31.15)5(8.20)56(91.80)
χ2值---5.050
P值---0.025
), ArticleFig(id=1322923537375297712, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923495113490515, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数胸痛胸闷
治疗前治疗后治疗前治疗后
对照组612.26±0.380.82±0.21*2.35±0.410.86±0.18*
观察组612.27±0.310.43±0.14*2.38±0.340.37±0.12*
t值0.15912.0690.44017.690
P值0.874<0.0010.661<0.001
), ArticleFig(id=1322923537874419889, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923495113490515, language=CN, label=表2, caption=

两组气虚血瘀型冠心病患者主要症状积分比较()

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数胸痛胸闷
治疗前治疗后治疗前治疗后
对照组612.26±0.380.82±0.21*2.35±0.410.86±0.18*
观察组612.27±0.310.43±0.14*2.38±0.340.37±0.12*
t值0.15912.0690.44017.690
P值0.874<0.0010.661<0.001
), ArticleFig(id=1322923538650366130, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923495113490515, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数心绞痛持续时间/(min/次)心绞痛发作次数/(次/周)
治疗前治疗后治疗前治疗后
对照组619.62±1.472.92±0.67*7.31±1.572.78±0.57*
观察组619.56±1.321.76±0.43*7.26±1.382.03±0.46*
t值0.23711.3800.1877.997
P值0.813<0.0010.852<0.001
), ArticleFig(id=1322923539078185140, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923495113490515, language=CN, label=表3, caption=

两组气虚血瘀型冠心病患者心绞痛持续时间和发作次数比较()

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组别例数心绞痛持续时间/(min/次)心绞痛发作次数/(次/周)
治疗前治疗后治疗前治疗后
对照组619.62±1.472.92±0.67*7.31±1.572.78±0.57*
观察组619.56±1.321.76±0.43*7.26±1.382.03±0.46*
t值0.23711.3800.1877.997
P值0.813<0.0010.852<0.001
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组别例数QTc间期/(ms)QRS时限值/(ms)
治疗前治疗后治疗前治疗后
对照组61423.76±18.06398.29±20.13*113.17±9.48101.32±8.84*
观察组61425.41±17.43362.47±15.42*112.23±8.5392.09±7.76*
t值-0.51311.0330.5766.129
P值-0.609<0.0010.566<0.001
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两组气虚血瘀型冠心病患者心电图参数比较()

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组别例数QTc间期/(ms)QRS时限值/(ms)
治疗前治疗后治疗前治疗后
对照组61423.76±18.06398.29±20.13*113.17±9.48101.32±8.84*
观察组61425.41±17.43362.47±15.42*112.23±8.5392.09±7.76*
t值-0.51311.0330.5766.129
P值-0.609<0.0010.566<0.001
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组别例数LVEF/(%)CO/(L/min)LVEDD/(mm)LVESD/(mm)
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
对照组6143.41±2.7252.12±3.46*4.29±0.485.35±0.72*62.37±5.6753.42±6.18*54.52±4.4546.82±3.89*
观察组6143.76±2.6457.87±4.23*4.27±0.416.19±0.56*63.21±5.4545.31±4.87*54.21±4.3639.98±4.17*
t值0.7218.2180.2477.1930.8348.0500.3899.368
P值0.472<0.0010.805<0.0010.406<0.0010.698<0.001
), ArticleFig(id=1322923541670265017, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923495113490515, language=CN, label=表5, caption=

两组气虚血瘀型冠心病患者三维超声心动图指标比较()

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组别例数LVEF/(%)CO/(L/min)LVEDD/(mm)LVESD/(mm)
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
对照组6143.41±2.7252.12±3.46*4.29±0.485.35±0.72*62.37±5.6753.42±6.18*54.52±4.4546.82±3.89*
观察组6143.76±2.6457.87±4.23*4.27±0.416.19±0.56*63.21±5.4545.31±4.87*54.21±4.3639.98±4.17*
t值0.7218.2180.2477.1930.8348.0500.3899.368
P值0.472<0.0010.805<0.0010.406<0.0010.698<0.001
), ArticleFig(id=1322923542442016955, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923495113490515, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数IL-6/(ng/L)IL-18/(ng/L)IL-33/(pg/mL)
治疗前治疗后治疗前治疗后治疗前治疗后
对照组6138.21±5.5724.36±4.89*50.45±5.4827.84±5.63*135.26±15.57210.09±21.24*
观察组6137.48±4.5615.45±3.27*51.32±7.2718.94±3.45*134.51±13.42323.32±18.89*
t值0.79211.8300.74610.5270.28531.112
P值0.430<0.0010.457<0.0010.776<0.001
), ArticleFig(id=1322923542886613180, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923495113490515, language=CN, label=表6, caption=

两组气虚血瘀型冠心病患者白细胞衍生炎症指标比较()

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数IL-6/(ng/L)IL-18/(ng/L)IL-33/(pg/mL)
治疗前治疗后治疗前治疗后治疗前治疗后
对照组6138.21±5.5724.36±4.89*50.45±5.4827.84±5.63*135.26±15.57210.09±21.24*
观察组6137.48±4.5615.45±3.27*51.32±7.2718.94±3.45*134.51±13.42323.32±18.89*
t值0.79211.8300.74610.5270.28531.112
P值0.430<0.0010.457<0.0010.776<0.001
), ArticleFig(id=1322923543247323326, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923495113490515, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数胃肠道反应头晕乏力发生率/(%)
对照组6143214.75
观察组612218.20
χ2值----1.291
P值----0.256
), ArticleFig(id=1322923543746445504, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923495113490515, language=CN, label=表7, caption=

两组气虚血瘀型冠心病患者不良反应比较

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组别例数胃肠道反应头晕乏力发生率/(%)
对照组6143214.75
观察组612218.20
χ2值----1.291
P值----0.256
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复方丹参滴丸对气虚血瘀型冠心病三维超声心动图变化及白细胞衍生炎症指标的影响
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邓彬 1 , 陶陶 2 , 王宏 1 , 田朝伟 1 , 龙耀波 1 , 沈锋 1 , 谢积斌 1
中华中医药学刊 | 国家项目点击 2025,43(3): 219-222
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中华中医药学刊 |国家项目点击 2025 , 43 (3) : 219 -222
复方丹参滴丸对气虚血瘀型冠心病三维超声心动图变化及白细胞衍生炎症指标的影响
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邓彬1, 陶陶2, 王宏1 , 田朝伟1, 龙耀波1, 沈锋1, 谢积斌1
作者信息
  • 1.广州医科大学附属第二医院,广东 珠海 510000
  • 2.南方医科大学珠江医院,广东 珠海 510000
通讯作者:
王宏(1980-),男,湖南人,副主任医师,硕士,研究方向:全科医学科。E-mail:。
作者简介:

邓彬(1984-),男,广东韶关人,主治医师,硕士,研究方向:全科医学科。

Effect of Compound Danshen Dropping Pills(复方丹参滴丸)on Changes of Three Dimensional Echocardiogram and White Blood Cell Derived Inflammatory Indicators in Patients with Coronary Heart Disease of Qi Deficiency and Blood Stasis Type
Bin DENG1, Tao TAO2, Hong WANG1 , Chaowei TIAN1, Yaobo LONG1, Feng SHEN1, Jibin XIE1
Affiliations
  • 1.The Second Affiliated Hospital of Guangzhou Medical University,Zhuhai 510000,Guangdong,China
  • 2.Zhujiang Hospital of Southern Medical University,Zhuhai 510000,Guangdong,China
出版时间: 2025-03-10 doi: 10.13193/j.issn.1673-7717.2025.03.042
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目的

探讨复方丹参滴丸对气虚血瘀型冠心病患者三维超声心动图变化及白细胞衍生炎症指标的影响。

方法

选择医院于2021年1月—2023年1月冠心病患者122例,运用随机数字表法将其随机分为对照组61例与观察组61例。对照组给予阿托伐他汀钙片和曲美他嗪缓释片治疗,观察组在对照组基础上结合复方丹参滴丸治疗。两组治疗周期12周。比较两组疗效;治疗前后主要症状积分,心绞痛持续时间和发作次数,心电图参数,三维超声心动图指标和白细胞衍生炎症指标变化及不良反应情况。

结果

观察组总有效率高于对照组(P<0.05)。两组治疗后胸闷和胸痛积分低于治疗前(P<0.05);观察组治疗后胸闷和胸痛积分低于对照组(P<0.05)。两组治疗后心绞痛持续时间和发作次数低于治疗前(P<0.05);观察组治疗后心绞痛持续时间和发作次数低于对照组(P<0.05)。两组治疗后QTc间期和QRS时限值低于治疗前(P<0.05);观察组治疗后QTc间期和QRS时限值低于对照组(P<0.05)。两组治疗后左心室射血分数(LVEF)和心排血量(CO)高于治疗前,而左室舒张末期内径(LVEDD)和左室收缩末期内径LVESD低于治疗前(P<0.05);观察组治疗后LVEF和CO高于对照组,而LVEDD和LVESD低于对照组(P<0.05)。两组治疗后血清白介数(IL)-6和IL-18水平低于治疗前,而IL-33水平高于治疗前(P<0.05);观察组治疗后血清IL-6和IL-18水平低于对照组,而IL-33水平高于对照组(P<0.05)。两组不良反应比较差异无统计学意义(P>0.05)。

结论

复方丹参滴丸对气虚血瘀型冠心病患者疗效显著,可显著改善患者心功能,显著减轻患者炎症反应。

复方丹参滴丸  /  气虚血瘀型  /  冠心病  /  三维超声心动图  /  白细胞衍生指标
Objective

To explore the effect of Compound Danshen Dropping Pills(复方丹参滴丸)on the changes of threedimensional echocardiography and leukocyte derived inflammation indicators in patients with coronary heart disease of Qi deficiency and blood stasis type.

Method

A total of 122 patients with coronary heart disease and angina pectoris in the hospital from January 2021 to January 2023 divided into a control group(61 cases)and a observation group(61 cases). The control group was treated with atorvastatin calcium tablets and trimetazidine tablets,while the observation group was treated with Compound Danshen Dropping Pills on the basis of control group. The treatment period was 12 weeks. The therapeutic effects,changes in main symptom scores,duration and frequency of angina pectoris,electrocardiogram parameters,three-dimensional echocardiographic indicators and leukocyte derived inflammation indicators before and after treatment and adverse reactions of the two groups were compared.

Result

The effective rate of the observation group was higher than that of the control group(P<0.05). After treatment,the scores of chest tightness and chest pain of two groups were lower than those before treatment(P<0.05). The scores of chest tightness and chest pain of the observation group were lower than those of the control group(P<0.05). After treatment,the duration and frequency of angina pectoris of two groups were lower than those before treatment(P<0.05). The duration and frequency of angina pectoris of the observation group were lower than those of the control group(P<0.05). After treatment,QTc interval and QRStime limit values of two groups were lower than those before treatment(P<0.05). QTc interval and QRStime limit values of the observation group were lower than those of the control group(P<0.05). After treatment,the values of left ventricular ejection fraction(LVEF)and cardiac output(CO)of two groups were higher than those before treatment,while the values of left ventricular end diastolic diameter(LVEDD)and left ventricular end systolic diameter(LVESD)were lower than those before treatment(P<0.05). The values of LVEF and COin the observation group were higher than those of the control group,while the values of LVEDD and LVESD were lower than those of the control group(P<0.05). After treatment,the serum levels of interleukin-6(IL-6)and interleukin-18(IL-18)of two groups were lower than those before treatment,while the levels of interleukin-33(IL-33)were higher than those before treatment(P<0.05). The serum levels of IL-6 and IL-18 in the observation group were lower than those of the control group,while the levels of IL-33 was higher in the control group(P<0.05). The adverse reactions of two groups had no significant difference(P>0.05).

Conclusion

Compound Danshen Dropping Pills have a significant therapeutic effect on patients with coronary heart disease of Qi deficiency and blood stasis type,which can significantly improve their cardiac function and alleviate inflammatory reactions.

Compound Danshen Dropping Pills(复方丹参滴丸)  /  Qi deficiency and blood stasis type  /  coronary heart disease  /  three-dimensional echocardiography  /  white blood cell derived indicators
邓彬, 陶陶, 王宏, 田朝伟, 龙耀波, 沈锋, 谢积斌. 复方丹参滴丸对气虚血瘀型冠心病三维超声心动图变化及白细胞衍生炎症指标的影响. 中华中医药学刊, 2025 , 43 (3) : 219 -222 . DOI: 10.13193/j.issn.1673-7717.2025.03.042
Bin DENG, Tao TAO, Hong WANG, Chaowei TIAN, Yaobo LONG, Feng SHEN, Jibin XIE. Effect of Compound Danshen Dropping Pills(复方丹参滴丸)on Changes of Three Dimensional Echocardiogram and White Blood Cell Derived Inflammatory Indicators in Patients with Coronary Heart Disease of Qi Deficiency and Blood Stasis Type[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (3) : 219 -222 . DOI: 10.13193/j.issn.1673-7717.2025.03.042
冠心病主要是由冠状动脉粥样硬化引起管腔狭窄或者闭塞,导致心肌缺血缺氧或者坏死而引起的心脏病,是常见的一种心血管疾病[1]。据统计表明,我国冠心病患病率呈不断上升趋势,而心绞痛是其典型临床特点,严重影响人们身心健康[2]。冠心病心绞痛多由冠状动脉供血不足,造成的心脏前区疼痛症状,多表现出左胸前区疼痛及胸骨后侧疼痛,且呈左肩、左臂区域放射性疼痛[3]。冠心病心绞痛具体发病机制尚未完全明确,病情极为凶险,临床上若不采取及时有效的治疗,则可能会诱发心肌梗死,从而威胁患者生命健康[4]。目前,西医针对冠心病心绞痛患者尚未发现特效治疗药物,临床上仅以缓解胸痛、减少心绞痛发作次数,阻止动脉粥样硬化进展,提高生活质量为治疗原则[5-6]。近年来,随着中医药的深入研究,用于治疗冠心病心绞痛方面取得良好疗效,复方丹参滴丸是一种中成药,具有通络止痛、活血化瘀功效[7]。基于此,本研究选择我院于2021年1月—2023年1月冠心病心绞痛患者122例,旨在探讨复方丹参滴丸对气虚血瘀型冠心病患者三维超声心动图变化及白细胞衍生炎症指标的影响。
依据《慢性稳定性心绞痛诊断与治疗指南》[8]关于冠心病心绞痛标准。
依据《中药新药临床研究指导原则(试行)》[9]标准,辨证属气虚血瘀型。(1)主症:胸痛,胸闷;(2)次症:神疲,乏力,心悸不宁,面色紫黯,身体有瘀斑或瘀点,肢体麻木;(3)舌脉:舌淡胖或有齿痕,脉涩。
选择我院于2021年1月—2023年1月冠心病患者122例,运用随机数字表法将其随机将其分为对照组61例与观察组61例。对照组男37例,女24例;年龄58~74岁,平均(67.43±4.71)岁;病程2~17年,平均(10.56±2.37)年。观察组男38例,女23例;年龄60~76岁,平均(68.13±4.28)岁;病程3~16年,平均(10.71±2.89)年。两组一般资料比较差异无统计学意义(P>0.05)。
(1)符合冠心病心绞痛诊断标准,且辨证属气虚血瘀型;(2)均为稳定型心绞痛;(3)近期未进行冠心病心绞痛相关治疗;(4)签署知情同意书。
(1)合并其他类型心血管疾病,如心肌梗死、心力衰竭、心律失常等;(2)近期有严重外伤史、手术史者;(3)恶性肿瘤者,肝肾功能不全者;(4)严重精神疾病者;(5)合并血液系统、免疫系统疾病者;(6)过敏体质者。
对照组:口服阿托伐他汀钙片(规格:20 mg×7片/盒,乐普制药科技有限公司)20 mg/次,1次/d;口服曲美他嗪缓释片(规格:3520 mg×30片/盒,施维雅制药有限公司)35 mg/次,2次/d。观察组:在对照组基础上口服复方丹参滴丸(规格:27 mg×180丸/瓶,天士力医药集团股份有限公司)10粒/次,3次/d。两组治疗周期12周。
(1)显效:患者心绞痛等症状消失,且患者心电图达到正常心电图或恢复至大致正常;(2)有效:患者心绞痛等症状好转,且患者心电图S-T段回升0.05 mV以上,但未达至正常水平,并且主要导联波倒置T波改变变浅;(3)无效:患者心绞痛等症状无改善,且患者心电图无改善。
(1)观察两组冠心病心绞痛患者主要症状积分变化,包括胸闷和胸痛,根据患者症状严重程度积分0~3分,积分越高症状越严重;(2)观察两组冠心病心绞痛患者心绞痛持续时间和发作次数;(3)观察两组冠心病心绞痛患者心电图参数变化,运用心脏彩色多普勒超声诊断仪测定QTc间期和QRS时限值;(4)观察两组冠心病心绞痛患者三维超声心动图指标变化,运用心脏彩色多普勒超声诊断仪测定左心室射血分数(LVEF)、心排血量(CO)、左室舒张末期内径(LVEDD)和左室收缩末期内径(LVESD);(5)观察两组冠心病心绞痛患者白细胞衍生炎症指标变化,采集患者肘静脉血5 mL,离心6 min,半径10 cm,转速3000 r/min,收集血清,运用ELISA法测定白介素(IL)-6、IL-18和IL-33水平变化;(6)观察两组冠心病心绞痛患者不良反应情况。
运用SPSS25.0软件处理。计量资料用表示,行t检验;计数资料用率表示,行χ2检验。P<0.05差异有统计学意义。
观察组冠心病心绞痛患者总有效率高于对照组(P<0.05)。见表1。
两组治疗后冠心病心绞痛患者胸闷和胸痛积分低于治疗前(P<0.05);观察组治疗后冠心病心绞痛患者胸闷和胸痛积分低于对照组(P<0.05)。见表2。
两组治疗后冠心病心绞痛患者心绞痛持续时间和发作次数低于治疗前(P<0.05);观察组治疗后冠心病心绞痛患者心绞痛持续时间和发作次数低于对照组(P<0.05)。见表3。
两组治疗后冠心病心绞痛患者QTc间期和QRS时限值低于治疗前(P<0.05);观察组治疗后冠心病心绞痛患者QTc间期和QRS时限值低于对照组(P<0.05)。见表4。
两组治疗后冠心病心绞痛患者LVEF和CO高于治疗前,而LVEDD和LVESD低于治疗前(P<0.05);观察组治疗后冠心病心绞痛患者LVEF和CO高于对照组,而LVEDD和LVESD低于对照组(P<0.05)。见表5。
两组治疗后冠心病心绞痛患者血清IL-6和IL-18水平低于治疗前,而IL-33水平高于治疗前(P<0.05);观察组治疗后冠心病心绞痛患者血清IL-6和IL-18水平低于对照组,而IL-33水平高于对照组(P<0.05)。见表6。
两组冠心病心绞痛患者不良反应比较差异无统计学意义(P>0.05)。见表7。
冠心病心绞痛具有反复发作胸痛胸闷等特点,导致患者日常生活和工作效率受到严重影响[10-12]。因此,临床上寻求积极有效地治疗冠心病心绞痛方法具有重要意义。阿托伐他汀是一种羟甲基戊二酸单酰辅酶A(HMG-CoA)还原酶的竞争性、选择性抑制药物,可抑制HMG-CoA转化为甲羟戊酸,以此能够干扰胆固醇合成,且可保护心肌功能,及具有良好的降脂和抗炎作用[13]。曲美他嗪具有增加冠脉和循环血流量,降低血管阻力,促进心肌能量及代谢的产生;曲美他嗪可改善心肌氧的供需平衡,降低心肌耗氧量,并且能够增强对强心苷的耐受性[14]。同时,曲美他嗪可改善心肌缺氧、缺血症状,从而减轻心肌细胞的受损程度,以此能够发挥保护心肌细胞的作用。
中医学认为冠心病心绞痛属“厥心痛”“胸痹”“真心痛”范畴,病证多呈虚实夹杂,以气虚为本,气旺则血行,若出现气虚则血行无力,滞留心脉则血瘀,从而发为胸痹。心气虚者,常由于各种原因造成脾气亏虚所致,脾气虚则脾不升清,子病及母。心主血脉,其能行血,若由于气虚而造成心血不能血运则会引起血脉瘀阻、血流不畅,久而久之,会形成气虚血瘀之证,且由血瘀而造成气虚,使气血失和,心血衰少,久而久之,则会导致血脉瘀阻加重,心脉失养之证而出现胸闷、胸痛等表现[15-16]。因此,应以活通络止痛、活血化瘀为治疗法则。复方丹参滴丸主要是由三七、丹参、冰片组成的一种中成药,其中三七具有消肿止痛、破血散瘀、止血功效;丹参具有通经止痛、活血化瘀功效;冰片具有芳香开窍,通阳定痛功效。诸药合用可奏通络止痛、活血化瘀之功。现代药理研究表明,复方丹参滴丸具有改善心肌缺氧缺血情况,促进血液循环,保护心肌,扩张冠状动脉,改善机体血液流变学,减轻炎症反应[17-18]。本研究表明,观察组总有效率高于对照组,治疗后胸闷和胸痛积分低于对照组,治疗后心绞痛持续时间和发作次数低于对照组,治疗后QTc间期和QRS时限值低于对照组,治疗后LVEF和CO高于对照组而LVEDD和LVESD低于对照组(P<0.05),提示复方丹参滴丸可提高疗效,减轻症状,改善心功能。
白细胞衍生炎症反应参与冠心病心绞痛发生、发展[19]。IL-6作为一种炎症因子,在动脉粥样硬化发生后,可参与动脉粥样硬化过程,从而导致冠心病心绞痛症状加重[20]。IL-18可激活巨噬细胞和免疫细胞,是反应机体炎症状态的一种标志物,可促进炎症反应发展,其水平变化与冠心病心绞痛进展密切相关[21-22]。IL-33主要是由内皮细胞分泌的IL-1家族一员,其水平变化可增强固有免疫和适应性免疫[23-25]。本研究表明,观察组治疗后冠心病心绞痛患者血清IL-6和IL-18水平低于对照组,而IL-33水平高于对照组,提示复方丹参滴丸可通过降低IL-6和IL-18水平及提高IL-33水平而减轻患者炎症反应。
综上所述,复方丹参滴丸对气虚血瘀型冠心病患者疗效显著,可显著改善患者心功能,显著减轻患者炎症反应。
  • 国家中药药管理局全国名老中医药专家传承工作室基金项目(国中医药人教发〔2016〕42号)
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doi: 10.13193/j.issn.1673-7717.2025.03.042
  • 首发时间:2026-10-30
  • 出版时间:2025-03-10
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国家中药药管理局全国名老中医药专家传承工作室基金项目(国中医药人教发〔2016〕42号)
作者信息
    1.广州医科大学附属第二医院,广东 珠海 510000
    2.南方医科大学珠江医院,广东 珠海 510000

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王宏(1980-),男,湖南人,副主任医师,硕士,研究方向:全科医学科。E-mail:。
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
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属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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