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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 ·
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