麝香保心丸联合常规药物治疗老年稳定性心绞痛对心肺功能、血管内皮功能的影响观察

Observation on effects of Shexiang Baoxin pills combined with conventional drug therapy on cardiopulmonary function and vascular endothelial function in treatment of stable angina pectoris in the elderly

中文关键词: 老年  稳定性心绞痛  麝香保心丸  疗效  心肺功能  运动耐量

英文关键词: elderly  stable angina pectoris  Shexiang Baoxin pill  therapeutic effect  cardiopulmonary function  exercise tolerance

中文摘要:

      目的 探究加用麝香保心丸联合常规药物治疗老年稳定性心绞痛(SAP)对患者心绞痛症状、心肺功能、血管内皮功能及运动耐量的影响.方法 纳入2023年8月至2024年8月安徽省皖南康复医院收治的80例老年SAP患者,随机分为观察组(40例)和对照组(40例).对照组给予替格瑞洛、美托洛尔、瑞舒伐他汀常规治疗,观察组在对照组基础上加用麝香保心丸,两组均治疗8周.比较两组心绞痛症状改善总有效率,治疗前后心绞痛发作情况、心肺功能指标、血管内皮功能指标、运动耐量指标和不良反应发生率.结果 治疗后,观察组心绞痛症状改善总有效率(92.50％)显著高于对照组(75.00％),观察组心绞痛发作次数、持续时间、硝酸甘油用量均显著低于对照组(0.91±0.24比1.42±0.37次/d,0.95±0.18比1.76±0.51 min/次,0.93±0.25比1.61±0.42 mg/d),观察组代谢当量、峰值氧耗量、氧脉搏、无氧阈水平均显著高于对照组(7.19±0.76 比 6.07±0.74,2.71±0.37 比 1.94±0.41 L/min,11.36±1.23 比 10.49±1.01 mL/次,1.39±0.12比1.17±0.13 L),内皮素-1水平显著低于对照组(41.54±9.32比56.37±10.48 ng/L),一氧化氮、脂联素水平显著高于对照组(68.27±14.41比52.36±12.29 μmol/L,4.03±1.14比3.15±0.93 ng/L);观察组到达运动终点时间显著长于对照组(7.13±1.49比5.78±1.25 min),最大心率、运动试验阳性例数显著低于对照组(136.75±8.14比144.27±9.01次/min,12比25例);比较治疗后两组各项指标的改变,差异均有统计学意义(P＜0.05).两组不良反应发生率分别为12.50％、15.00％,差异无统计学意义(P＞0.05).结论 在常规西药治疗基础上联合麝香保心丸可显著提高老年SAP患者的治疗效果,有效减轻心绞痛症状,改善心肺功能、血管内皮功能及运动耐量,且安全性良好.

英文摘要:

      Objective To investigate the effects of Shexiang Baoxin pills combined with conventional drug therapy on angina symptoms,cardiopulmonary function,vascular endothelial function,and exercise tolerance in elderly patients with stable angina pectoris(SAP).Methods A total of 80 elderly SAP patients admitted to Wannan Rehabilitation Hospital of Anhui Province between August 2023 and August 2024 were enrolled and randomly divided to observation group(n=40)and control group(n=40).The control group received conventional treatment(ticagrelor,metoprolol,rosuvastatin),while the observation group was treated with Shexiang Baoxin pills in addition to the conventional treatment.Both groups were treated for 8 weeks.The total effective rate of improvement in angina pectoris symptoms,the occurrence of angina pectoris,cardiopulmonary function indicators,vascular endothelial function indicators and exercise tolerance indicators before and after treatment and the incidence of adverse reactions were compared between the two groups.Results After treatment,the total effective rate for the improvement in angina pectoris symptoms in the observation group(92.50％)was significantly higher than that in the control group(75.00％).The frequency of angina pectoris attacks,duration and dosage of nitroglycerin in the observation group were significantly lower than those in the control group(0.91±0.24 vs.1.42±0.37 times/day,0.95±0.18 vs.1.76±0.51 min/time,0.93±0.25 vs.1.61±0.42 mg/day).The levels of metabolic equivalent,peak oxygen consumption,oxygen pulse,and anaerobic threshold in the observation group were significantly higher than those in the control group(7.19±0.76 vs.6.07±0.74,2.71±0.37 vs.1.94±0.41 L/min,11.36±1.23 vs.10.49±1.01 mL/time,1.39±0.12 vs.1.17±0.13 L),endothelin-1 level was significantly lower than that in the control group(41.54±9.32 vs.56.37±10.48 ng/L),and the levels of nitric oxide and adiponectin were significantly higher than those in the control group(68.27±14.41 vs.52.36±12.29 μmol/L;4.03±1.14 vs.3.15±0.93 ng/L.The time to reach the exercise endpoint in the observation group was significantly longer than that in the control group(7.13±1.49 vs.5.78±1.25 min),and the maximum heart rate and the number of positive cases in the exercise test were significantly lower than those in the control group(136.75±8.14 vs.144.27±9.01 beats/min;12 vs.25 cases).The differences in the changes of all indicators between the two groups after treatment were statistically significant(P＜0.05).The incidence of adverse reactions was 12.50％in the observation group and 15.00％in the control group,with no statistically significant difference(P＞0.05).Conclusion On the basis of conventional Western medicine treatment,the combination of Shexiang Baoxin pills can significantly improve the therapeutic effect in elderly SAP patients,effectively alleviate angina pectoris symptoms,improve cardiopulmonary function,vascular endothelial function and exercise tolerance.It has good safety.