神香苏合丸辅助治疗冠状动脉三支血管病变的临床观察-中国药房

神香苏合丸辅助治疗冠状动脉三支血管病变的临床观察

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篇名：	神香苏合丸辅助治疗冠状动脉三支血管病变的临床观察
TITLE：	Clinical observation of Shenxiang suhe pill in the adjuvant treatment of triple vessel lesion of coronary artery
摘要：	目的探讨神香苏合丸辅助治疗冠状动脉三支血管病变的疗效及安全性。方法将2019年2月至2021年2月哈励逊国际和平医院收治的不稳定型心绞痛冠状动脉三支血管病变（寒凝心脉型胸痹）患者146例按随机数字表法分为观察组和对照组，每组73例。对照组患者给予硝酸异山梨酯片+阿司匹林肠溶片+硫酸氢氯吡格雷片+阿托伐他汀钙片+富马酸比索洛尔片进行西医治疗，观察组在对照组基础上于餐后口服神香苏合丸0.7g/次，每天2次。于持续治疗2个疗程（3周为1个疗程，每疗程间隔1周）时，比较两组患者的疗效及治疗前后心绞痛症状[心绞痛发作频率及持续时间、6min步行试验（6MWT）步行距离]、中医证候积分、心肌标志物[中性粒细胞与淋巴细胞比值（NLR）和内皮素1（ET-1）、一氧化氮（NO）、可溶性生长刺激表达基因2蛋白（sST2）、血管紧张素Ⅱ（Ang-Ⅱ）含量]、生活质量[西雅图心绞痛量表（SAQ）、简明健康状况调查表（SF-36）评分]，并记录治疗期间不良反应和随访期间主要不良心血管事件（MACE）的发生情况。结果观察组患者的总有效率为86.30％，显著高于对照组的71.23％（P＜0.05）。治疗前，两者患者上述各指标比较，差异均无统计学意义（P＞0.05）；治疗后，两组患者的心绞痛发作频率及持续时间、中医证候评分、NLR和sST2、ET-1、Ang-Ⅱ含量均显著降低或缩短，6MWT步行距离、NO含量和SAQ、SF-36各维度评分均显著增加或升高，且观察组上述指标均显著优于对照组（P＜0.05）。两组患者的不良反应发生率比较，差异无统计学意义（P＞0.05）；但观察组患者的MACE发生率显著低于对照组（P＜0.05）。结论神香苏合丸辅助治疗冠状动脉三支血管病变，可改善患者的心绞痛症状和血管内皮功能，降低MACE发生率，提高其生活质量，且安全性较好。
ABSTRACT：	OBJECTIVE To investigate the efficacy and safety of Shenxiang suhe pill in the adjuvant treatment of triple vessel lesion of coronary artery. METHODS From February 2019 to February 2021，146 patients with unstable angina pectoris and triple vessel lesion of coronary artery （chest discomfort of hanning xinmai type ）admitted to Harrison International Peace Hospital were divided into observation group and control group according to random number table ，with 73 cases in each group. Control group was given Isosorbide dinitrate tablets+Aspirin enteric-coated tablets+Clopidogrel bisulfate tablets+Atorvastatin calcium tablets+ Bisoprolol fumarate tablets for western medicine treatment. Observation group was additionally given Shenxiang suhe pill 0.7 g/time orally after meal ，twice a day ，on the basis of control group. After 2 courses of treatment （3 weeks as a course of treatment ，with an interval of 1 week for each course of treatment ），curative effect and symptoms of angina pectoris [frequency and duration of angina pectoris ，walking distance of 6-min walking test （6MWT）]，TCM syndrome score ，cardiac markers [neutrophil to lymphocyte ratio （NLR）and the contents of endothelin-1（ET-1），nitric oxide （NO），soluble suppression of tumorigenicity 2 （sST2），angiotensin Ⅱ（Ang-Ⅱ）] and quality of life [Seattle angina questionnaire （SAQ），36-item short form health survey （SF-36）] before and after treatment were compared between the two groups. Adverse drug reactions （ADR）during treatment and major adverse cardiovascular events （MACE）during follow-up were recorded. RESULTS The total response rate of the observation group was 86.30％，significantly higher than 71.23％ of the control group （P＜0.05）. Before treatment ，there was no statistical difference in the above indexes between 2 groups（P＞0.05）. After treatment ，the frequency and duration of angina pectoris ，TCM syndrome score ，NLR and the contents of sST 2，ET-1 and Ang- Ⅱ in the two groups decreased or shortened significantly ，while the walking distance of 6MWT，NO content ，scores of each dimension in SAQ and SF- 36 increased significantly ；and the above indexes in observation group were significantly better than those in control group （P＜0.05）. There was no significant difference in the inciden ce of ADR between the two groups （P＞0.05）； however，the incidence of MACE in observation group was significantly lower than that in control group （P＜0.05）. CONCLUSIONS In the treatment of adjuvant treatment of triple vessel lesion of coronary artery ，Shenxiang suhe pill can improve the symptoms of angina pectoris and vascular endothelial function ，reduce the incidence of MACE ，improve the quality of life ，and has good safety.
期刊：	2022年第33卷第06期
作者：	李敬，孙红春，豆书梅，张羽
AUTHORS：	LI Jing，SUN Hongchun ，DOU Shumei ，ZHANG Yu
关键字：	神香苏合丸；不稳定型心绞痛；冠状动脉三支血管病变；寒凝心脉型胸痹；中性粒细胞与淋巴细胞比值；血管内皮功能
KEYWORDS：	Shenxiang suhe pill ；unstable angina pectoris ；triple vessel lesion of coronary artery ；chest discomfort of hanning
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