血栓通联合单硝酸异山梨酯治疗不稳定型心绞痛的临床效果

摘要

Objective To explore the clinical effect of Xueshuantong combined with isosorbide mononitrate on treating unstable angina pectoris. Methods From January 2011 to December 2014,80 patients with unstable angina pectoris admitted into our hospital were selected.By a random number table,they were evenly divided into two groups. Symptomatic and supportive treatment was provided between two groups.In control group,isosorbide mononitrate was used for coronary dilatation and decompression.In the observation group,half original dosage of isosorbide mononitrate combined with Xueshuantong was adopted.Two weeks continuous treatment was applied between two groups.The whole blood viscosity,fibrinogen and hematocrit,creatine kinase MB (CK-MB),troponin,and left ventricular ejection fraction changes before and after treatment were compared.The adverse reaction and clinical symptom improvement was calculated. Results In observation group,the whole blood viscosity after treatment was lower than that in control group (P<0.05),so were fibrinogen level,hematocrit, CK-MB level,troponin, and left ventricular ejection fraction (P<0.05).The overall incidence of symptoms like headache and vertigo,flushed face,digestive tract discomfort,and postural hypotension in observation group was less than that in control group (P<0.05).After therapy,the monthly frequency in observation group was less and time of duration each time was shorter in comparison with that in control group (P<0.05). Conclusion Xueshuantong combined with isosorbide mononitrate on treating unstable angina pectoris can greatly improve hemorheological indexes,alleviate patient's clinical symptoms with few adverse reactions,which is worthy of clinical promotion.%目的 探讨血栓通联合单硝酸异山梨酯治疗不稳定型心绞痛的临床效果. 方法选择2011年1月~2014年12月我院收治的不稳定型心绞痛患者80例,按随机数字法分为两组,各40例. 均实施对症支持治疗,对照组给予单硝酸异山梨酯扩冠、降压;观察组给予减半剂量单硝酸异山梨酯联合血栓通治疗. 两组均连续治疗2周,比较两组治疗前后全血黏度、纤维蛋白原、血细胞比容水平、肌酸激酶同工酶(CK-MB)、肌钙蛋白及左室射血分数变化情况,统计治疗过程中不良反应及临床症状改善情况. 结果 治疗后观察组全血黏度低于对照组(P<0.05),纤维蛋白原水平低于对照组(P<0.05),血细胞比容小于对照组(P<0.05),CK-MB水平低于对照组(P<0.05),肌钙蛋白水平低于对照组(P<0.05),左室射血分数高于对照组(P<0.05);观察组发生头痛头晕、面色潮红、消化道不适及体位性低血压的整体发生率显著低于对照组(P<0.05),治疗后观察组每月发作次数少于对照组(P<0.05),每次持续时间短于对照组(P<0.05). 结论 血栓通联合单硝酸异山梨酯治疗不稳定型心绞痛,能显著改善血液流变学指标,缓解患者临床症状,且治疗不良反应少,值得临床推广.