Page 95 - 《中国药房》2023年23期

替格瑞洛联合复方血栓通胶囊治疗不稳定型心绞痛的临床观察
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柴松波 ，杜亚康 ，张淑娟 ，兀江波 ，张伟萍 ，王晓飞（1.三门峡市中医院心病科，河南 三门峡 472099；2.河
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南中医药大学第二临床医学院心病科，郑州 450002；3.三门峡市中医院药剂科，河南 三门峡 472099）
中图分类号 R972 文献标志码 A 文章编号 1001-0408（2023）23-2901-05
DOI 10.6039/j.issn.1001-0408.2023.23.15
摘 要 目的 观察替格瑞洛联合复方血栓通胶囊治疗不稳定型心绞痛的疗效及安全性。方法 将2021年1月－2022年12月三
门峡市中医院收治的120例不稳定型心绞痛气阴两虚兼血瘀型患者随机分为氯吡格雷组（A组）、替格瑞洛组（B组）和联合用药组
（C组），每组40例。A组患者在常规治疗基础上加用氯吡格雷口服；B组患者在常规治疗基础上加用替格瑞洛口服；C组患者在常
规治疗基础上加用替格瑞洛和复方血栓通胶囊口服。治疗12周后评价3组患者的临床疗效、心绞痛发作情况、凝血功能指标、心
功能指标、中医证候疗效、不良心血管事件和出血事件发生情况。结果 A、B、C组患者的总有效率分别为77.5%、85.0%、90.0%，不
良心血管事件和出血事件总发生率分别为 7.5%、7.5%、5.0%，差异均无统计学意义（P＞0.05）。3 组患者治疗后的心绞痛发作次
数、心绞痛持续时间、气短持续时间均较治疗前显著减少或缩短（P＜0.05）；C 组患者治疗后的心绞痛发作次数显著少于 A、B 组
（P＜0.05）。3组患者治疗后的纤维蛋白原（FBG）、D-二聚体水平均显著低于治疗前（P＜0.05）；A组患者的FBG、D-二聚体水平显
著高于B、C组（P＜0.05）。3组患者治疗后的左室收缩末期内径、左室舒张末期内径均显著短于治疗前，左室射血分数均显著高于
治疗前（P＜0.05），但组间比较差异无统计学意义（P＞0.05）。A、B、C 组患者的中医证候疗效总有效率分别为 67.5%、80.0%、
87.5%，其中C组显著高于A组（P＜0.05）。结论 替格瑞洛联合复方血栓通胶囊可显著减少不稳定型心绞痛患者的心绞痛发作次
数，降低FBG、D-二聚体水平，改善中医证候疗效，且不增加出血风险。
关键词 不稳定型心绞痛；替格瑞洛；复方血栓通胶囊；心绞痛发作次数

Clinical observation of ticagrelor combined with Compound xueshuantong capsule in the treatment of
unstable angina pectoris
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CHAI Songbo ，DU Yakang ，ZHANG Shujuan ，WU Jiangbo ，ZHANG Weiping ，WANG Xiaofei（1. Dept. of
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Cardiology， Sanmenxia Hospital of Traditional Chinese Medicine， Henan Sanmenxia 472099， China；2. Dept. of
Cardiology， Second Clinical Medical College， Henan University of Chinese Medicine， Zhengzhou 450002，
China；3. Dept. of Pharmacy， Sanmenxia Hospital of Traditional Chinese Medicine， Henan Sanmenxia 472099，
China）
ABSTRACT OBJECTIVE To observe the efficacy and safety of ticagrelor combined with Compound xueshuantong capsules in
the treatment of unstable angina pectoris. METHODS Totally 120 patients with unstable angina pectoris with deficiency of Qi and
Yin combined admitted to Sanmenxia Hospital of Traditional Chinese Medicine from January 2021 to December 2022 were
randomly divided into clopidogrel group （group A）， ticagrelor group （group B） and combined medication group （group C）， with
40 patients in each group. In addition to conventional treatment， group A was given clopidogrel orally； group B was given
ticagrelor orally； group C was given ticagrelor and Compound xueshuantong capsule orally. After 12 weeks of treatment， the
clinical efficacy， frequency of angina attacks， coagulation function indicators， cardiac function indicators， traditional Chinese
medicine syndrome efficacy， and the incidence of adverse cardiovascular events and bleeding incidence were evaluated in the 3
groups. RESULTS The total effective rates of group A， group B and group C were 77.5%， 85.0% and 90.0%， respectively. The
incidence of adverse cardiovascular events and bleeding events were 7.5%， 7.5% and 5.0% in the respective groups， with no
statistically significant difference （P＞0.05）. The frequency of angina attacks， duration of angina attacks and duration of dyspnea
were significantly reduced or shortened in all 3 groups after treatment compared to before treatment （P＜0.05）. The frequency of
angina attacks in group C was significantly lower than that in groups A and B after treatment （P＜0.05）. The levels of fibrinogen
（FBG） and D-dimer in all 3 groups were significantly lower
Δ 基金项目 河南省中医药拔尖人才培养项目专项课题（No.
after treatment compared to before treatment （P＜0.05）； group
2022ZYBJ29）；河南省自然科学基金项目（No.212300410169）
＊第一作者 副主任中医师，博士。研究方向：中医药防治心血管 A had significantly higher levels of FBG and D-dimer
内科疾病的基础和临床研究。 E-mail：chaisongbosmx@163.com compared to group B and C （P＜0.05）. The left ventricular

中国药房 2023年第34卷第23期 China Pharmacy 2023 Vol. 34 No. 23 · 2901 ·