血栓通注射液对冠状动脉粥样硬化性心脏病患者血流变学及血小板活化功能的影响

刘超

摘要 目的：探究血栓通注射液治療冠状动脉粥样硬化性心脏病（CHD）的临床疗效，分析其对患者血流变学及血小板活化功能的影响。方法：选取2014年9月至2017年1月急诊病区收治的冠状动脉粥样硬化性心脏病患者95例，按照随机数字表法分为对照组（47例）及观察组（48例），2组患者入院后均给予CHD常规基础治疗及对症治疗，观察组患者同时联合血栓通注射液治疗，2组均连续治疗1个月。治疗后统计2组患者临床疗效及心电图变化情况;检测并比较治疗前后2组患者血液流变学及血小板活化功能。结果：与对照组比较，治疗后观察组临床疗效及心电图疗效显效率均升高，无效率均降低（P<0.05），且观察组临床疗效及心电图疗效总有效率分别为91.67%及87.50%，显著高于对照组的68.09%及53.19%（P<0.05）;与治疗前比较，治疗后2组全血高切黏度、全血低切黏度、红细胞聚集指数及观察组血浆黏度、红细胞比容均显著降低（P<0.05），且观察组均显著低于对照组（P<0.05）;与治疗前比较，治疗后2组GMP-140及观察组MAR显著降低，且观察组均显著低于对照组（P<0.05）。结论：血栓通注射液有助于改善CHD患者血流变，调节其血小板活化功能，有效改善CHD患者临床症状，疗效显著优于常规治疗。

关键词 冠状动脉粥样硬化;心脏病;血栓通注射液;血流变学;血小板活化;治疗;心电图;临床疗效

Effects of Xueshuantong Injection on the Hemorheology and Platelet Activation Function

in the Treatment of Coronary Atherosclerotic Heart Disease

Liu Chao

（Beijing Chinese Medicine Hospital Shunyi Hospital， Beijing 101300， China）

Abstract Objective：To explore the clinical efficacy of Xueshuantong injection in the treatment of coronary atherosclerotic heart disease （CHD） and analyze the effects on the hemorheology and platelet activation function. Methods：A total of 95 cases of CHD patients in cardiology department of our hospital from Sep. 2014 to Jan. 2017 were selected and divided into control group （n=47） and expriment group （n=48） according to the random number table. The control group was treated with conventional foundation treatment and symptomatic treatment， and experiment group was treated with Xueshuantong injection on the basis of control group. Both groups were treated for 1 month continuously. The clinical efficacy and electrocardiogram efficacy of 2 groups after treatment was statisticsed; the changes of hemorheology indexes and platelet activation function indexes of 2 groups before and after treatment were detected and compared. Results：Compared with control group， the marked effective rates of clinical efficacy and electrocardiogram efficacy in 2 groups increased significantly， and the inefficiency decreased significantly （P<0.01）. The total effective rates of clinical efficacy and electrocardiogram efficacy in experiment group were 91.67% and 87.50% respectively， which were higher than 91.67% and 87.50% in control group （P<0.01）; Compared with before treatment， the whole blood high/low shear viscosity， red blood cell aggregation index of 2 groups and the plasma viscosity， hematokrit of experiment group decreased significantly （P<0.01）， and experiment group was lower than control group （P<0.01）; Compared with that before treatment， the GMP-140 of 2 groups and the MAR of experiment group decreased significantly， and experiment group was lower than control group （P<0.01）. Conclusion：Xueshuantong injection can contribute to improve the hemorheology of CHD patients， adjust the platelet activation function， improve the clinical symptoms effectively， and the efficacy is better significantly than conventional treatment.

Key Words Coronary atherosclerotic; Heart disease; Xueshuantong injection; Hemorheology; Platelet activation function; Treatment; Electrocardiograph; Clinical efficacy

中图分类号：R283;R541文献标识码：Adoi：10.3969/j.issn.1673-7202.2018.03.032

冠状动脉粥样硬化性心脏病（Coronary Heart Disease，CHD），简称冠心病，是指冠状动脉粥样硬化后，冠状动脉狭窄或阻塞导致的患者心肌血供不足，造成缺血、缺氧等，继而引发心脏结构及功能的改变，并伴有一系列临床症状，属全身动脉粥样硬化在心脏的局部病理表现[1-2]。CHD的常规治疗药物有血管紧张素转换酶抑制剂、硝酸酯类、血管紧张素受体拮抗剂等，由于其作用途径单一、保护作用有限，加之其不良反应，导致临床应用受限，因而治疗CHD的疗效并不理想。中医学理论认为CHD主要病机在于气虚血瘀，心脉痹阻不通，故治疗应以扶正祛邪，疏通心脉为主[3-4]。血栓通注射液是从中药三七提取研制而成，对心、脑血管均具有广泛的药理活性，因此本研究在常规治疗的基础上联合血栓通注射液治疗CHD，探究其对CHD患者血液流变学、血小板活化功能的影响。……