麝香通心滴丸对冠状动脉慢血流患者冠脉血流储备的影响

韩勇; 铁春苗; 沈男男

doi:10.16766/j.cnki.issn.1674-4152.003675

麝香通心滴丸对冠状动脉慢血流患者冠脉血流储备的影响

doi: 10.16766/j.cnki.issn.1674-4152.003675

1.
绍兴文理学院附属医院药剂科, 浙江绍兴 312000
2.
绍兴文理学院附属医院心血管内科

基金项目:

浙江省医学会临床医学专项资金项目 2023ZYC-A55

浙江省教育厅一般科研项目 Y202249053

详细信息

通讯作者:
沈男男，E-mail：shennannan_123@163.com

中图分类号: R543.3
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出版历程
- 收稿日期: 2024-02-10

Effect of Shexiang Tongxin Dripping Pills on coronary flow reserve in patients with coronary slow flow phenomenon

1.
Department of Pharmacy, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang 312000, China

摘要

摘要: 目的观察麝香通心滴丸治疗冠状动脉慢血流的临床疗效，探究麝香通心滴丸对患者冠脉血流储备(CFR)的改善作用。方法将绍兴文理学院附属医院2023年1—12月收治的88例冠状动脉慢血流患者按随机数字表法分为对照组(44例)、观察组(44例)，对照组予常规治疗，观察组合用麝香通心滴丸治疗。比较2组治疗前后凝血功能、校正的TIMI血流帧数(CTFC)、冠脉血流储备、炎性因子以及不良反应。结果治疗4周后，观察组凝血酶时间[(22.56±1.31)s]、凝血酶原时间[(13.41±1.16)s]、活化部分凝血活酶时间[(42.80±3.83)s]均大于对照组[(19.53±1.94)s、(12.19±0.99)s、(38.74±4.17)s]，差异有统计学意义(P＜0.05)；观察组纤维蛋白原[(2.03±0.43)g/L]低于对照组[(2.38±0.49)g/L]，差异有统计学意义(F=56.916，P＜0.05)。观察组CTFC、冠状动脉血流峰值速度水平低于对照组，观察组最大冠状动脉血流峰值速度、CFR水平高于对照组(P＜0.05)；观察组高敏C反应蛋白、白细胞介素-6低于对照组(P＜0.05)；2组不良反应发生率比较差异无统计学意义(P＞0.05)。结论冠状动脉慢血流患者应用麝香通心滴丸治疗有较好的效果，对患者凝血功能、炎性因子有明显的改善作用，还能增加冠脉血流储备，不良反应少。
- 冠状动脉慢血流 /
- 麝香通心滴丸 /
- 凝血功能 /
- 冠脉血流储备
Abstract: Objective To investigate the clinical efficacy of Shexiang Tongxin Dripping Pills in treating coronary slow flow phenomenon (CSFP), and to explore its effect on improving coronary flow reserve (CFR) in patients. Methods Eighty-eight patients with coronary slow flow who were admitted to Affiliated Hospital of Shaoxing University from January to December 2023 were selected and randomly divided into the control group (n=44) and the observation group (n=44). The control group was given conventional treatment, and the observation group was treated with Shexiang Tongxin Dripping Pills in addition to the conventional treatment. The blood coagulation function, corrected TIMI frame count (CTFC), CFR and inflammatory factors before and after treatment were compared, as well as the adverse reactions after medication. Results After 4 weeks of treatment, the thrombin time (TT) in the observation group [(22.56±1.31) s] was higher than that in the control group [(19.53±1.94) s], and the difference was statistically significant (P < 0.05). Similarly, the prothrombin time (PT) in the observation group [(13.41±1.16) s] was higher than that in the control group [(12.19±0.99) s] with a statistically significant difference as well (P < 0.05). Additionally, the activated partial thromboplastin time (APTT) in the observation group [(42.80±3.83) s] was also higher compared to APTT [(38.74±4.17) s] in the control group (P < 0.05). On contrary, fibrinogen (Fib) in the observation group [(2.03±0.43) g/L] was lower than the control group [(2.38±0.49) g/L] with statistically significant difference (F=56.916, P < 0.05). The levels of CTFC and basal flow velocity (BFV) in the observation group were lower than those in the control group, while the maximal flow velocity (MFV) and CFR levels were higher than those in the control group (P < 0.05). The levels of hypersensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6) in the observation group were lower than those in the control group (P < 0.05). There was no statistically significant difference in adverse reactions between two groups (P > 0.05). Conclusion Shexiang Tongxin Dripping Pills have better effect in the treatment of patients with coronary slow flow, it can relieve the clinical symptoms of patients, improve the coagulation function and inflammatory factors significantly, and can increase CFR, while having fewer adverse reactions.
- Coronary slow flow phenomenon /
- Shexiang Tongxin Dripping Pills /
- Coagulation function /
- Coronary flow reserve
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表 1 2组冠状动脉慢血流患者治疗前后凝血功能比较(x±s)

Table 1. Comparison of coagulation function between two groups of patients with coronary slow flow phenomenon(x±s)

组别	例数	TT(s)		PT(s)		APTT(s)		Fib(g/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	44	17.37±1.82	19.53±1.94^b	10.84±0.86	12.19±0.99^b	28.83±2.62	38.74±4.17^b	3.15±0.58	2.38±0.49^b
观察组	44	17.35±1.84	22.56±1.31^b	10.91±0.88	13.41±1.16^b	28.85±2.48	42.80±3.83^b	3.17±0.52	2.03±0.43^b
统计量		0.051^a	102.048^c	0.377^a	71.167^c	0.037^a	175.138^c	0.170^a	56.916^c
P值		0.959	＜0.001	0.707	＜0.001	0.971	＜0.001	0.865	0.001
注：^a为t值，^c为F值。与同组治疗前比较，^bP＜0.05。

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表 2 2组冠状动脉慢血流患者治疗前后CTFC、冠脉血流储备比较(x±s)

Table 2. Comparison of corrected TIMI frame count (CTFC) and blood flow reserve (CFR) before and after treatment between the two groups of patients with coronary slow flow phenomenon(x±s)

组别	例数	CTFC(帧幅)		BFV(cm/s)		MFV(cm/s)		CFR
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	44	36.67±11.38	29.57±7.28^b	30.18±9.13	28.55±6.52^b	66.01±6.36	68.03±6.97^b	2.19±0.70	2.38±0.63^b
观察组	44	36.72±11.35	16.73±2.59^b	30.16±9.07	24.03±4.26^b	66.02±6.32	80.47±7.45^b	2.18±0.69	3.35±0.75^b
统计量		0.021^a	71.261^c	0.010^a	9.305^c	0.007^a	56.004^c	0.067^a	35.254^c
P值		0.984	＜0.001	0.992	＜0.001	0.994	＜0.001	0.946	＜0.001
注：^a为t值，^c为F值。与同组治疗前比较，^bP＜0.05。

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表 3 2组冠状动脉慢血流患者治疗前后炎性因子水平比较(x±s)

Table 3. Comparison of inflammatory factors before and after treatment between two groups of patients with coronary slow flow phenomenon(x±s)

组别	例数	hs-CRP(mg/L)		IL-6(ng/L)
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	44	6.73±2.22	4.38±2.15^b	55.33±13.53	35.78±10.75^b
观察组	44	6.70±2.19	2.33±1.14^b	55.54±13.35	21.50±9.37^b
统计量		0.064^a	58.972^c	0.073^a	98.527^c
P值		0.949	＜0.001	0.942	＜0.001
注：^a为t值，^c为F值。与同组治疗前比较，^bP＜0.05。

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表 4 2组冠状动脉慢血流患者不良反应比较[例(%)]

Table 4. Comparison of adverse reactions between two groups of patients with coronary slow flow phenomenon[cases(%)]

组别	例数	皮疹	皮下瘀点或瘀斑	腹痛腹泻	牙龈出血	总发生
对照组	44	1(2.27)	0	2(4.55)	1(2.27)	4(9.09)
观察组	44	0	1(2.27)	0	0	1(2.27)
χ²值				0.512		0.848
P值		0.999^a	0.999^a	0.474	0.999^a	0.357
注：^a采用Fisher精确检验。

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