摘要
目的 探讨芪冬颐心口服液联合常规西医对冠心病患者的应用效果及对糖脂代谢、血液黏度的影响.方法 前瞻性选取2021年1月至2024年1月铜川市中医医院收治的128例冠心病患者,按照随机数字表法将其分为观察组与对照组,每组各64例.对照组采用常规西医治疗(包括利尿剂、阿司匹林、他汀类等药物治疗,并合理饮食,控制诱因等),观察组采用芪冬颐心口服液(每日3次,每次20 mL)联合常规西医治疗.比较两组的临床疗效,治疗前及治疗4周后的中医证候积分(心悸不安、盗汗、夜尿频多、耳鸣、失眠、心烦、易惊、腰膝酸软、记忆力减退)、糖代谢[餐后2 h血糖(2 hPBG)、空腹血糖及糖化血红蛋白(HbAlc)]、脂代谢[总胆固醇、甘油三酯、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、血液黏度(血浆黏度、全血黏度低切变率、全血黏度高切变率)变化.结果 观察组总有效率为93.75％,高于对照组(79.69％),差异有统计学意义(P＜0.05).治疗4周后,两组患者心悸不安、盗汗、夜尿频多、耳鸣、失眠、心烦、易惊、腰膝酸软、记忆力减退等各相关中医证候积分均较治疗前降低,且观察组各相关中医证候积分分别为(0.94±0.14)、(0.63±0.17)、(1.49±0.24)、(1.33±0.12)、(1.62±0.24)、(1.11±0.23)、(1.85±0.28)、(0.67±0.08)、(1.65±0.24)分,均低于对照组,差异均有统计学意义(P＜0.05).治疗4周后,两组患者2 h PBG、空腹血糖、HbAlc均较治疗前降低,差异均有统计学意义(P＜0.05),但观察组与对照组血糖指标比较,差异均无统计学意义(P＞0.05).治疗4周后,两组患者的总胆固醇、甘油三酯、LDL-C水平均较治疗前降低,HDL-C均较治疗前升高,且观察组的总胆固醇、甘油三酯、LDL-C水平分别为(4.36±1.52)、(1.84±0.31)、(2.12±0.64)mmol/L,均低于对照组,观察组HDL-C为(1.69±0.24)mmol/L,高于对照组,差异均有统计学意义(P＜0.05).治疗4周后,两组血浆黏度、全血黏度低切变率、全血黏度高切变率均较治疗前降低,且观察组的血浆黏度、全血黏度低切变率、全血黏度高切变率分别为(1.21±0.18)、(8.32±1.18)、(4.29±0.24)mpa·s,均低于对照组,差异均有统计学意义(P＜0.05).结论 针对冠心病患者在常规西医治疗基础上增加芪冬颐心口服液治疗可提升临床疗效,可减轻患者相关中医症状,虽然对糖代谢水平无明显影响,但可进一步改善患者脂代谢水平,降低血液黏度.
Abstract
Objective To explore the application effect of Qidong Yixin Oral Liquid combined with conventional Western medicine on cor-onary heart disease patients and its impact on glucose and lipid metabolism,blood viscosity.Methods A total of 128 patients with coronary heart disease admitted to Tongchuan Hospital of Traditional Chinese Medicine from January 2021 to January 2024 were prospectively selected and divided into the observation group and the control group according to the random number table method,with 64 cases in each group.The control group was treated with conventional Western medicine(including diuretics,aspirin,statins and other drugs,with a reasonable diet,control of triggers,etc.),and the observation group was treated with Qidong Yixin Oral Liquid(20 mL 3 times a day)combined with conventional Western medi-cine.The clinical efficacy of the two groups was compared,and the TCM syndrome scores(palpitations,night sweats,frequent urination at night,tinnitus,insomnia,upset,irritability,soreness and weakness of waist and knees,memory loss),glucose metabolism[2 h postprandial blood glu-cose(2 hPBG),fasting blood glucose and glycosylated hemoglobin(HbAlc)],lipid metabolism[total cholesterol,triglycerides,high-density lipoprotein(HDL-C),low-density lipoprotein(LDL-C)],blood viscosity(plasma viscosity,whole blood viscosity low shear rate,whole blood viscosity high shear rate)before treatment,after 4 weeks of treatment were compared.Results The total effective rate of the observation group was 93.75％,which was higher than that of the control group(79.69％),and the difference was statistically significant(P＜0.05).Af-ter 4 weeks of treatment,the scores of TCM syndromes such as palpitation,night sweats,frequent nocturia,tinnitus,insomnia,upset,frighte-ning,soreness and weakness of waist and knees,and memory loss in the two groups were lower than those before treatment,and the scores of TCM syndromes in the observation group were(0.94±0.14),(0.63±0.17),(1.49±0.24),(1.33±0.12),(1.62±0.24),(1.11±0.23),(1.85±0.28),(0.67±0.08)and(1.65±0.24)points,respectively,which were lower than those in the control group,and the differences were statistically significant(P＜0.05).After 4 weeks of treatment,2 h PBG,fasting blood glucose and HbAlc in the two groups were lower than those before treatment,and the differences were statistically significant(P＜0.05),but there were no statistically significant differences in blood glucose index between the observation group and the control group(P＞0.05).After 4 weeks of treatment,the levels of total cholesterol,triglyceride and LDL-C in the two groups were lower than those before treatment,and HDL-C was higher than that before treatment,the levels of total cholesterol,triglyceride and LDL-C in the observation group were(4.36±1.52),(1.84±0.31)and(2.12±0.64)mmol/L,respec-tively,which were lower than those in the control group,and HDL-C was(1.69±0.24)mmol/L,which was higher than that in the control group,the differences were statistically significant(P＜0.05).After 4 weeks of treatment,the plasma viscosity,whole blood viscosity low shear rate,whole blood viscosity high shear rate in the two groups were lower than those before treatment,and the plasma viscosity,whole blood viscosity low shear rate,whole blood viscosity high shear rate in the observation group were(1.21±0.18),(8.32±1.18)and(4.29±0.24)mpa·s,respectively,which were lower than those in the control group,the differences were statistically significant(P＜0.05).Conclusion Adding Qidong Yixin oral treatment to routine Western medicine treatment for coronary heart disease patients can improve clinical efficacy and alleviate re-lated traditional Chinese medicine symptoms.Although it has no significant effect on glucose metabolism levels,it can further improve patient lipid metabolism levels and reduce blood viscosity.
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