Abstract:

Objective　To explore the effect of Xuefu Zhuyu Capsules combined with conventional western medicine treatment on patients with angina pectoris. Methods　This study was a randomized controlled trial. A total of 100 patients with angina pectoris admitted to the Department of Cardiovascular Medicine, Sun Simmiao Hospital of Beijing University of Chinese Medicine from January 2022 to January 2024 were selected and were divided into a conventional group (50 cases) and a combined group (50 cases) according to the envelope drawing method. In the conventional group, there were 27 males and 23 females, aged (62.32±7.38) years, with a course of disease of (5.33±0.67) years, and the New York Heart Association (NYHA) cardiac function grade was grade Ⅰ in 32 patients and grade Ⅱ in 18 patients. In the combined group, there were 29 males and 21 females, aged (62.44±7.32) years, with a course of disease of (5.37±0.72) years, and the NYHA cardiac function grade was grade Ⅰ in 30 cases and grade Ⅱ in 20 cases. The conventional group was given conventional western medicine treatment: oral isosorbide mononitrate tablet 20 mg/time, metoprolol tartrate tablet 100 mg/time, twice a day; oral aspirin enteric-coated tablet 100 mg/time, atorvastatin calcium tablet 20 mg/time, once a day. The combined group was treated with Xuefu Zhuyu Capsules on the basis of the conventional group: 6 capsules were taken orally each time, twice a day. Both groups were treated continuously for 2 months. The clinical indicators, cardiac function, Seattle Angina Questionnaire (SAQ) scores, and N-terminal pro B-type Natriuretic Peptide (NT-proBNP), creatine kinase isoenzyme (CK-MB), and soluble CD105 (sCD105) levels were compared between the two groups before and after treatment, along with adverse reactions. χ² test and t test were used. Results　Two months after treatment, the frequency of angina pectoris attack was (2.04±0.31) times/week in the combined group, the duration of angina pectoris was (1.35±0.21) min/time, the duration of shortness of breath was (1.64±0.32) d, the resting heart rate was (64.04±6.17) beats/min, the level of NT-proBNP was (135.41±22.70) U/L, the level of CK-MB was (52.33±5.46) ng/L, the level of sCD105 was (0.25±0.09) µg/L, which were lower than those in the conventional group [(3.51±0.48) times/week, (2.82±0.43) min/time, (3.03±0.55) d, (73.43±7.44) beats/min, (239.22±34.07) U/L, (66.41±6.77) ng/L, and (0.53±0.17) µg/L], with statistically significant differences (all P<0.05). In the combined group, the left ventricular ejection fraction was (65.22±7.17)%, the cardiac output was (5.23±0.66) L/min, the stroke volume was (74.77±8.16) ml/time, the cardiac index was (3.11±0.65) L·min^-1·m^-2, which were higher than those in the conventional group [(57.41±6.25)%, (4.32±0.47) L/min, (65.65±7.29) ml/time, and (2.62±0.56) L·min^-1·m^-2], with statistically significant differences (all P<0.05). The SAQ scores of the combined group were higher than those of the conventional group (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the conventional group and the combined group [8.0% (4/50) vs. 10.0% (5/50)] (χ²=0.122, P=0.727). Conclusions　On the basis of conventional western medical treatment, combining Xuefu Zhuyu Capsules can significantly improve clinical indicators, cardiac function, SAQ score, and levels of NT-proBNP, CK-MB, and sCD105 in patients with angina pectoris. The safety profile is good, and it is recommended for widespread application.

Key words:

Angina Pectoris, Xuefu Zhuyu Capsules, Clinical indicators, Angina score

摘要：

目的　探究血府逐瘀胶囊联合西医常规治疗对心绞痛患者的影响。方法　本研究为随机对照试验。选取2022年1月到2024年1月北京中医药大学孙思邈医院心血管内科收治的100例心绞痛患者，按信封抽签法分为常规组（50例）和联合组（50例）。常规组男27例，女23例，年龄（62.32±7.38）岁，病程（5.33±0.67）年；纽约心脏病学会心功能分级：Ⅰ级32例，Ⅱ级18例。联合组男29例，女21例，年龄（62.44±7.32）岁，病程（5.37±0.72）年；纽约心脏病学会心功能分级：Ⅰ级30例，Ⅱ级20例。常规组给予常规西医治疗，口服单硝酸异山梨酯片20 mg/次、酒石酸美托洛尔片100 mg/次，每天2次；口服阿司匹林肠溶片100 mg/次、阿托伐他汀钙片20 mg/次，每天1次。联合组在常规组基础上联合血府逐瘀胶囊治疗，每次口服6粒，每天2次。两组均连续治疗2个月。比较两组治疗前后的临床指标、心功能、西雅图心绞痛量表（SAQ）、N末端脑利钠肽前体（NT-proBNP）、肌酸激酶同工酶（CK-MB）、可溶性CD105（sCD105）水平及不良反应。采用χ²检验、t检验进行统计分析。结果　治疗2个月后，联合组的心绞痛发作频率、心绞痛持续时间、气短持续时间、静息心率、NT-proBNP、CK-MB、sCD105分别为（2.04±0.31）次/周、（1.35±0.21）min/次、（1.64±0.32）d、（64.04±6.17）次/min、（135.41±22.70）U/L、（52.33±5.46）ng/L、（0.25±0.09）µg/L，常规组上述指标分别为（3.51±0.48）次/周、（2.82±0.43）min/次、（3.03±0.55）d、（73.43±7.44）次/min、（239.22±34.07）U/L、（66.41±6.77）ng/L、（0.53±0.17）µg/L，差异均有统计学意义（均P<0.05）；联合组的左心室射血分数、心输出量、每搏输出量、心脏指数分别为（65.22±7.17）%、（5.23±0.66）L/min、（74.77±8.16）ml/次、（3.11±0.65）L·min^-1·m^-2，常规组上述指标分别为（57.41±6.25）%、（4.32±0.47）L/min、（65.65±7.29）ml/次、（2.62±0.56）L·min^-1·m^-2，差异均有统计学意义（均P<0.05）；联合组的SAQ各项评分均高于常规组（均P<0.05）。常规组和联合组的不良反应发生率比较［8.0%（4/50）比10.0%（5/50）］，差异无统计学意义（χ²=0.122，P=0.727）。结论　在西医常规治疗的基础上联合血府逐瘀胶囊治疗可显著改善心绞痛患者的临床指标、心功能、SAQ评分及NT-proBNP、CK-MB、sCD105水平，且安全性良好，建议推广应用。

关键词:

心绞痛, 血府逐瘀胶囊, 临床指标, 心绞痛评分