作者：王艳1 ，吴学芬2 ，陈瑶3 ，薛强3 ，张翠翠1

单位：

1.063000河北省唐山市中医医院药学部　2.065700河北省霸州市第二医院内一科　3.063000河北省唐山市工 人医院药剂科

Units：

1.Department of Pharmacy, Tangshan Traditional Chinese Medicine Hospital, Tangshan 063000, China 2.The First Department of Internal Medicine, the Second Hospital of Bazhou, Bazhou 065700, China 3.Department of Pharmacy, Tangshan Workers' Hospital, Tangshan 063000, China

关键词：

心绞痛，稳定型；心痛舒散剂；治疗结果；脂蛋白类；转氨酶类；血液凝固试验

Keywords：

Angina, stable; Xintongshu powder; Treatment outcome; Lipoproteins; Transaminases; Blood coagulation tests

CLC：

R 541.4

DOI：

10.12114/j.issn.1008-5971.2024.00.069

Funds：

河北省中医药管理局科研计划项目（2021396）

摘要：

目的　探讨心痛舒散剂加减治疗稳定型心绞痛（SAP）的疗效及其对患者血脂、肝功能、凝血功能的 影响。方法　前瞻性选取2020年1月—2022年1月唐山市中医医院收治的SAP患者120例为研究对象，采用随机数字表法 将患者分为常规治疗组和心痛舒散剂组，每组60例。常规治疗组患者采用常规治疗，心痛舒散剂组在常规治疗组的基 础上辅以心痛舒散剂加减治疗，两组患者均治疗12周。治疗后评估两组临床疗效，比较两组治疗前后心绞痛发作情况 （心绞痛发作频率、持续时间）、血脂指标（TC、TG、HDL-C、LDL-C）、肝功能指标（ALT、AST）、凝血功能指 标〔凝血反应时间（R）、凝血形成时间（K）、最大振幅（MA）、凝固角（α角）、凝血指数（CI）〕，观察两组 治疗期间不良反应发生情况。结果　治疗后，心痛舒散剂组临床疗效优于常规治疗组（P＜0.05）。治疗后，两组心绞 痛发作频率分别低于本组治疗前，心绞痛持续时间分别短于本组治疗前（P＜0.05）；治疗后，心痛舒散剂组心绞痛发 作频率低于常规治疗组，心绞痛持续时间短于常规治疗组（P＜0.05）。治疗后，两组TC、TG、LDL-C分别低于本组 治疗前，HDL-C分别高于本组治疗前（P＜0.05）；治疗后，心痛舒散剂组TC、TG、LDL-C低于常规治疗组，HDL-C 高于常规治疗组（P＜0.05）。治疗后，心痛舒散剂组ALT、AST分别低于本组治疗前（P＜0.05）；治疗后，心痛舒散 剂组ALT、AST低于常规治疗组（P＜0.05）。治疗后，常规治疗组MA小于治疗前，CI低于治疗前（P＜0.05）；治疗 后心痛舒散剂组R、K分别长于治疗前，MA、α角分别小于治疗前，CI低于治疗前（P＜0.05）；治疗后，心痛舒散剂 组R、K长于常规治疗组，MA、α角小于常规治疗组，CI低于常规治疗组（P＜0.05）。两组治疗期间不良反应发生率 比较，差异无统计学意义（P＞0.05）。结论　心痛舒散剂加减能够提高SAP患者治疗效果，降低血脂水平，改善肝功 能和凝血功能，且安全性良好。

Abstract：

Objective To investigate the efficacy of modified Xintongshu powder in the treatment of patients with stable angina pectoris (SAP) and its influence on blood lipids, liver function, and coagulation function. Methods A total of 120 patients with SAP admitted to Tangshan Traditional Chinese Medicine Hospital from January 2020 to January 2022 were prospectively selected as the study subjects. The patients were divided into the conventional treatment group and the Xintongshu powder group by random number table method, with 60 cases in each group. The conventional treatment group received conventional treatment; the Xintongshu powder group was given modified Xintongshu powder on the basis of the conventional treatment group, both groups were treated for 12 weeks. The clinical effect of the two groups was evaluateed after treatment. The episode of angina pectoris (frequency and duration of angina pectoris) , blood lipids indicators (TC, TG, HDL-C, LDL-C) , liver function indicators (ALT, AST) , coagulation function indicators [reaction time (R) , kinetics of clot development (K) , maximum amplitude (MA) , solidification angle (α-angle) , clot index (CI) ] before and after treatment were compared between the two groups, and the incidence of adverse reactions during the treatment of the two groups was observed. Results After treatment, the clinical effect of the Xintongshu powder group was better than that of conventional treatment group (P < 0.05) . After treatment, frequency of angina pectoris in the two groups was lower than that before treatment, duration of angina pectoris was shorter than that before treatment, respectively (P < 0.05) ; after treatment, frequency of angina pectoris in Xintongshu powder group was lower than that in conventional treatment group, duration of angina pectoris in Xintongshu powder group was shorter than that in conventional treatment group (P < 0.05) . After treatment, TC, TG, and LDL-C in the two groups were lower than those before treatment, HDL-C was higher than that before treatment, respectively (P < 0.05) ; after treatment, TC, TG, and LDL-C in Xintongshu powder group were lower than those in conventional treatment group, HDL-C in Xintongshu powder group was higher than that in conventional treatment group (P < 0.05) . After treatment, ALT and AST in Xintongshu powder group were lower than those before treatment, respectively (P < 0.05) ; after treatment, ALT and AST in Xintongshu powder group were lower than those in conventional treatment group (P < 0.05) . After treatment, MA in conventional treatment group was less than that before treatment, CI was lower than that before treatment (P < 0.05) ; after treatment, R and K in Xintongshu powder group were longer than those before treatment, MA and α-angle were less than those before treatment, CI was lower than that before treatment (P < 0.05) . After treatmen, R and K in Xintongshu powder group were longer than those in conventional treatment group, MA and α-angle were less than those in conventional treatment group, CI was lower than that in conventional treatment group (P < 0.05) . There was no significant difference in the incidence of adverse reactions between the two groups during therapy ( P > 0.05) . Conclusion Modified Xintongshu powder can improve the clinical effect of SAP patients, reduce blood lipids levels, improve liver function and coagulation function, and has good safety.

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