Page 105 - 《中国药房》2022年6期

·药物与临床·

神香苏合丸辅助治疗冠状动脉三支血管病变的临床观察 Δ

李 敬 ，孙红春，豆书梅，张 羽（哈励逊国际和平医院心内科，河北 衡水 053000）
＊

中图分类号 R541；R287 文献标志码 A 文章编号 1001-0408（2022）06-0735-06
DOI 10.6039/j.issn.1001-0408.2022.06.15

摘 要 目的 探讨神香苏合丸辅助治疗冠状动脉三支血管病变的疗效及安全性。方法 将2019年2月至2021年2月哈励逊国际
和平医院收治的不稳定型心绞痛冠状动脉三支血管病变（寒凝心脉型胸痹）患者146例按随机数字表法分为观察组和对照组，每
组73例。对照组患者给予硝酸异山梨酯片+阿司匹林肠溶片+硫酸氢氯吡格雷片+阿托伐他汀钙片+富马酸比索洛尔片进行西医
治疗，观察组在对照组基础上于餐后口服神香苏合丸0.7 g/次，每天2次。于持续治疗2个疗程（3周为1个疗程，每疗程间隔1周）
时，比较两组患者的疗效及治疗前后心绞痛症状[心绞痛发作频率及持续时间、6 min步行试验（6MWT）步行距离]、中医证候积分、
心肌标志物[中性粒细胞与淋巴细胞比值（NLR）和内皮素1（ET-1）、一氧化氮（NO）、可溶性生长刺激表达基因2蛋白（sST2）、血管
紧张素Ⅱ（Ang-Ⅱ）含量]、生活质量[西雅图心绞痛量表（SAQ）、简明健康状况调查表（SF-36）评分]，并记录治疗期间不良反应和随
访期间主要不良心血管事件（MACE）的发生情况。结果 观察组患者的总有效率为 86.30％，显著高于对照组的 71.23％（P＜
0.05）。治疗前，两者患者上述各指标比较，差异均无统计学意义（P＞0.05）；治疗后，两组患者的心绞痛发作频率及持续时间、中医
证候评分、NLR和sST2、ET-1、Ang-Ⅱ含量均显著降低或缩短，6MWT步行距离、NO含量和SAQ、SF-36各维度评分均显著增加或
升高，且观察组上述指标均显著优于对照组（P＜0.05）。两组患者的不良反应发生率比较，差异无统计学意义（P＞0.05）；但观察
组患者的MACE发生率显著低于对照组（P＜0.05）。结论 神香苏合丸辅助治疗冠状动脉三支血管病变，可改善患者的心绞痛症
状和血管内皮功能，降低MACE发生率，提高其生活质量，且安全性较好。
关键词 神香苏合丸；不稳定型心绞痛；冠状动脉三支血管病变；寒凝心脉型胸痹；中性粒细胞与淋巴细胞比值；血管内皮功能

Clinical observation of Shenxiang suhe pill in the adjuvant treatment of triple vessel lesion of coronary artery
LI Jing，SUN Hongchun，DOU Shumei，ZHANG Yu（Dept. of Cardiology Medicine，Harrison International Peace
Hospital，Hebei Hengshui 053000，China）

ABSTRACT OBJECTIVE To investigate the efficacy and safety of Shenxiang suhe pill in the adjuvant treatment of triple vessel
lesion of coronary artery. METHODS From February 2019 to February 2021，146 patients with unstable angina pectoris and triple
vessel lesion of coronary artery（chest discomfort of hanning xinmai type）admitted to Harrison International Peace Hospital were
divided into observation group and control group according to random number table，with 73 cases in each group. Control group
was given Isosorbide dinitrate tablets + Aspirin enteric-coated tablets + Clopidogrel bisulfate tablets + Atorvastatin calcium tablets +
Bisoprolol fumarate tablets for western medicine treatment. Observation group was additionally given Shenxiang suhe pill 0.7 g/time
orally after meal，twice a day，on the basis of control group. After 2 courses of treatment（3 weeks as a course of treatment，with
an interval of 1 week for each course of treatment），curative effect and symptoms of angina pectoris [frequency and duration of
angina pectoris，walking distance of 6-min walking test （6MWT）]，TCM syndrome score，cardiac markers [neutrophil to
lymphocyte ratio （NLR） and the contents of endothelin-1 （ET-1），nitric oxide （NO），soluble suppression of tumorigenicity 2
（sST2），angiotensin Ⅱ（Ang- Ⅱ）] and quality of life [Seattle angina questionnaire（SAQ），36-item short form health survey
（SF-36）] before and after treatment were compared between the two groups. Adverse drug reactions（ADR）during treatment and
major adverse cardiovascular events（MACE）during follow-up were recorded. RESULTS The total response rate of the observation
group was 86.30％，significantly higher than 71.23％ of the control group（P＜0.05）. Before treatment，there was no statistical
difference in the above indexes between 2 groups（P＞0.05）. After treatment，the frequency and duration of angina pectoris，TCM
syndrome score，NLR and the contents of sST2，ET-1 and Ang-Ⅱ in the two groups decreased or shortened significantly，while
the walking distance of 6MWT，NO content，scores of each dimension in SAQ and SF-36 increased significantly；and the above
indexes in observation group were significantly better than those in control group（P＜0.05）. There was no significant difference in
the incidence of ADR between the two groups （P＞0.05）；
Δ 基金项目：河北省医学科学研究课题（No.20191767）
however，the incidence of MACE in observation group was
＊主任医师，硕士。研究方向：冠心病、心力衰竭、心血管危重症
的诊治。电话：0318-2187071。E-mail：zhiyeyishi007@sina.com significantly lower than that in control group （P＜0.05）.

中国药房 2022年第33卷第6期 China Pharmacy 2022 Vol. 33 No. 6 ·735 ·