替格瑞洛联合复方血栓通胶囊治疗不稳定型心绞痛的临床观察
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篇名: 替格瑞洛联合复方血栓通胶囊治疗不稳定型心绞痛的临床观察
TITLE: Clinical observation of ticagrelor combined with Compound xueshuantong capsule in the treatment of unstable angina pectoris
摘要: 目的 观察替格瑞洛联合复方血栓通胶囊治疗不稳定型心绞痛的疗效及安全性。方法将2021年1月-2022年12月三门峡市中医院收治的120例不稳定型心绞痛气阴两虚兼血瘀型患者随机分为氯吡格雷组(A组)、替格瑞洛组(B组)和联合用药组(C组),每组40例。A组患者在常规治疗基础上加用氯吡格雷口服;B组患者在常规治疗基础上加用替格瑞洛口服;C组患者在常规治疗基础上加用替格瑞洛和复方血栓通胶囊口服。治疗12周后评价3组患者的临床疗效、心绞痛发作情况、凝血功能指标、心功能指标、中医证候疗效、不良心血管事件和出血事件发生情况。结果A、B、C组患者的总有效率分别为77.5%、85.0%、90.0%,不良心血管事件和出血事件总发生率分别为7.5%、7.5%、5.0%,差异均无统计学意义(P>0.05)。3组患者治疗后的心绞痛发作次数、心绞痛持续时间、气短持续时间均较治疗前显著减少或缩短(P<0.05);C组患者治疗后的心绞痛发作次数显著少于A、B组(P<0.05)。3组患者治疗后的纤维蛋白原(FBG)、D-二聚体水平均显著低于治疗前(P<0.05);A组患者的FBG、D-二聚体水平显著高于B、C组(P<0.05)。3组患者治疗后的左室收缩末期内径、左室舒张末期内径均显著短于治疗前,左室射血分数均显著高于治疗前(P<0.05),但组间比较差异无统计学意义(P>0.05)。A、B、C组患者的中医证候疗效总有效率分别为67.5%、80.0%、87.5%,其中C组显著高于A组(P<0.05)。结论替格瑞洛联合复方血栓通胶囊可显著减少不稳定型心绞痛患者的心绞痛发作次数,降低FBG、D-二聚体水平,改善中医证候疗效,且不增加出血风险。
ABSTRACT: OBJECTIVE To observe the efficacy and safety of ticagrelor combined with Compound xueshuantong capsules in the treatment of unstable angina pectoris. METHODS Totally 120 patients with unstable angina pectoris with deficiency of Qi and Yin combined admitted to Sanmenxia Hospital of Traditional Chinese Medicine from January 2021 to December 2022 were randomly divided into clopidogrel group (group A), ticagrelor group (group B) and combined medication group (group C), with 40 patients in each group. In addition to conventional treatment, group A was given clopidogrel orally; group B was given ticagrelor orally; group C was given ticagrelor and Compound xueshuantong capsule orally. After 12 weeks of treatment, the clinical efficacy, frequency of angina attacks, coagulation function indicators, cardiac function indicators, traditional Chinese medicine syndrome efficacy, and the incidence of adverse cardiovascular events and bleeding incidence were evaluated in the 3 groups. RESULTS The total effective rates of group A, group B and group C were 77.5%, 85.0% and 90.0%, respectively. The incidence of adverse cardiovascular events and bleeding events were 7.5%, 7.5% and 5.0% in the respective groups, with no statistically significant difference (P>0.05). The frequency of angina attacks, duration of angina attacks and duration of dyspnea were significantly reduced or shortened in all 3 groups after treatment compared to before treatment (P<0.05). The frequency of angina attacks in group C was significantly lower than that in groups A and B after treatment (P<0.05). The levels of fibrinogen (FBG) and D-dimer in all 3 groups were significantly lower after treatment compared to before treatment (P<0.05); group A had significantly higher levels of FBG and D-dimer compared to group B and C (P<0.05). The left ventricular end-diastolic diameter and left ventricular end-systolic diameter in all three groups were significantly shorter after treatment, and the left ventricular ejection fraction was significantly higher compared to before treatment (P<0.05), but there were no statistically significant differences among those groups (P>0.05). The total effective rates of traditional Chinese medicine syndrome efficacy in groups A, B and C were 67.5%, 80.0% and 87.5%, respectively, with group C being significantly higher than group A (P<0.05). CONCLUSIONS In addition to conventional treatment, ticagrelor combined with Compound xueguantong capsules can more significantly reduce the frequency of angina attacks in patients with unstable angina pectoris, reduce the levels of FBG and D- dimer, improve traditional Chinese medicine syndrome efficacy, and do not increase the risk of bleeding.
期刊: 2023年第34卷第23期
作者: 柴松波;杜亚康;张淑娟;兀江波;张伟萍;王晓飞
AUTHORS: CHAI Songbo,DU Yakang,ZHANG Shujuan,WU Jiangbo,ZHANG Weiping,WANG Xiaofei
关键字: 不稳定型心绞痛;替格瑞洛;复方血栓通胶囊;心绞痛发作次数
KEYWORDS: unstable angina pectoris; ticagrelor; Compound xueshuantong capsule; frequency of angina attacks
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