通心络胶囊对冠心病介入治疗手术后患者的疗效

潘强强 卢家忠 张标 吕新才 潘登月 戎成政 赵德轩 侯秀洁

摘要 目的：探究通心絡胶囊对冠心病患者经皮冠状动脉介入治疗（PCI）后患者的疗效。方法：选取2018年1月至2019年12月阜阳市第二人民医院收治的冠心病心绞痛患者84例作为研究对象，按照随机数字表法随机分为对照组和观察组，每组42例。所有患者均行PCI，对照组手术后给予低分子肝素钠注射液、硫酸氢氯吡格雷片、阿司匹林肠溶片治疗，观察组在此基础上联合通心络胶囊治疗，2个月为1个疗程，2组均治疗3个疗程。比较2组治疗后的临床疗效，治疗前后的心绞痛改善情况、内皮功能及血流变学指标。结果：治疗后，观察组临床症状改善、心电图改善有效率分别为97.62%、85.71%，均高于对照组的78.57%、59.52%（P<0.05）。与治疗前比较，治疗后，2组心绞痛发作频率降低，观察组低于对照组（P<0.05），心绞痛持续时间缩短，观察组短于对照组（P<0.05）。与治疗前比较，治疗后，观察组血管内皮依赖性舒张功能（FMD）增大，且大于对照组（P<0.05）。与治疗前比较，治疗后，2组全血高/低切黏度、红细胞聚集指数、血浆黏度、红细胞压积均降低（P<0.05），观察组低于对照组（P<0.05）。结论：通心络胶囊可改善行介入治疗的冠心病心绞痛患者心绞痛症状，并可改善患者手术后内皮功能及血液高凝状态，进而有助于改善患者临床症状，提高疗效。

关键词 冠心病;心绞痛皮冠状动脉;介入治疗;通心络胶囊;心电图;内皮功能;血流变学;疗效

Abstract Objective：To explore the effects of Tongxinluo Capsules on patients after coronary interventional therapy.Methods：A total of 84 patients with coronary heart disease and angina pectoris admitted to Fuyang Second People′s Hospital from January 2018 to December 2019 were selected as the research objects and were randomly divided into a control group and an observation group，with 42 cases in each group.All patients underwent interventional therapy.The control group was treated with low-molecular-weight heparin sodium injection，clopidogrel bisulfate tablets，and aspirin enteric-coated tablets for the treatment after surgery.The observation group was treated with Tongxinluo Capsules on the base of the control group.2 month was a course of treatment，and both groups have 3 courses of treatment.The clinical efficacy of the 2 groups after treatment，the improvement of angina pectoris，endothelial function and hemorheology indexes before and after treatment of the 2 groups were compared.Results：After treatment，the effective rates of clinical symptom improvement and electrocardiogram improvement in the observation group were 97.62% and 85.71%，respectively，were higher than those in the control group（78.57% and 59.52%）（P<0.01）.Compared with before treatment，after treatment，the frequency of angina pectoris in the 2 groups decreased，the observation group was lower than the control group（P<0.01），the duration of angina pectoris was shortened，and the observation group was shorter than the control group（P<0.01）.Compared with those before treatment，after treatment，the FMD of the observation group increased and was greater than that of the control group（P<0.01）.Compared with those before treatment，after treatment，the whole blood high/low shear viscosity，red blood cell aggregation index，plasma viscosity，hematocrit decreased of the 2 groups decreased（P<0.05 or P<0.01），and the observation group was lower than the control group（P<0.05 or P<0.01）.Conclusion：Tongxinluo Capsules could significantly improve the symptoms of angina pectoris in patients with coronary heart disease and angina pectoris undergoing interventional therapy，and could improve the endothelial function and blood hypercoagulability of patients after surgery，thereby helping to improve the clinical symptoms of patients and improve the efficacy.

Keywords Coronary heart disease; Angina pectoris; Percutaneous Coronary Intervention; Tongxinluo Capsules; Electrocardiogram; Endothelial function; Hemorheology; Efficacy

中图分类号：R289.5;R541文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.10.014

经皮冠状动脉介入治疗（Percutaneous Coronary Intervention，PCI）是目前治疗冠心病心绞痛的重要措施，可有效减少患者心肌梗死、心力衰竭的发生，但术中会对血管内皮造成机械性损伤[1-2]。目前，临床治疗冠心病心绞痛多以常规对症治疗为主，其中低分子肝素钠注射液、硫酸氢氯吡格雷片、阿司匹林肠溶片等作为常规对症治疗药物，用于治疗冠心病心绞痛可在一定程度上控制患者病情，但仅靠常规对症治疗对部分病情严重者疗效不明显[3]。中医理论认为，血瘀、络瘀及气虚等是冠心病心绞痛的主要病机[4]，故中医治疗冠心病心绞痛应以活血化瘀、益气、止痛等为主。……