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目的探讨通心络胶囊联合美托洛尔缓释片治疗老年冠心病患者的疗效,及对血管内皮功能和心功能指标的影响,为冠心病的治疗提供依据。方法选取2013年4月至2015年3月在我院心内科就诊的140例老年冠心病患者,应用随机数字表法随机分为对照组和联合治疗组,每组70例。两组患者均给予常规治疗措施,对照组给予酒石酸美托洛尔缓释片,联合治疗组在对照组的基础上加用通心络胶囊,两组患者均治疗8周。评价两组患者的临床疗效,并比较治疗前后内皮功能和心功能指标的变化情况。应用SPSS 17.0软件包进行t检验和χ2检验。结果对照组总有效率为72.9%,联合治疗组总有效率为88.6%,差异有统计学意义(χ2=5.552,P<0.05)。治疗前,两组患者的一氧化氮(NO)、内皮素(ET-1)、肱动脉血流介导内皮依赖性血管舒张功能(FMD)、左室射血分数(LVEF)、心输出量(CO)、舒张早期峰值速度/舒张晚期峰值速度比值(E/A)比较,差异均无统计学意义(P>0.05);治疗后,两组患者的ET-1水平均较治疗前明显下降,NO、FMD、LVEF、CO和E/A均较治疗前明显升高,差异均有统计学意义(P<0.01),两组治疗后上述指标的差异亦有统计学意义(P<0.01)。联合治疗组中2例患者出现胃部不适,发生率为2.86%,改为餐后口服后不适症状消失。结论通心络胶囊联合美托洛尔缓释片治疗老年冠心病患者,临床疗效确切,有利于改善患者的血管内皮功能及心功能指标。
Objective To investigate the curative effect of Tongxinluo capsule combined with metoprolol sustained-release tablets on senile patients with coronary heart disease and its influence on vascular endothelial function and cardiac function index to provide basis for the treatment of coronary heart disease. Methods A total of 140 elderly patients with coronary heart disease (CHD) treated in our department from April 2013 to March 2015 were randomly divided into control group and combination therapy group, with 70 cases in each group. The patients in both groups were given routine treatment. The control group was given metoprolol tartrate sustained-release tablets. The combination therapy group was given Tongxinluo capsule on the basis of the control group. Both groups were treated for 8 weeks. The clinical efficacy of two groups of patients was evaluated, and the changes of endothelial function and cardiac function before and after treatment were compared. SPSS 17.0 software package for t test and χ2 test. Results The total effective rate was 72.9% in the control group and 88.6% in the combined treatment group, with significant difference (χ2 = 5.552, P <0.05). Before treatment, the levels of nitric oxide (NO), endothelin (ET-1), brachial artery-mediated endothelium-dependent vasodilation (FMD), left ventricular ejection fraction (LVEF), cardiac output (P> 0.05). After treatment, the ET-1 levels in both groups were significantly lower than those before treatment , NO, FMD, LVEF, CO and E / A were significantly higher than those before treatment (all P <0.01). There was also a significant difference in the above indexes between the two groups after treatment . Two patients in the combined treatment group had stomach discomfort at a rate of 2.86%, and the symptom of discomfort disappeared after oral administration. Conclusion Tongxinluo capsule combined with metoprolol sustained-release tablets in the treatment of elderly patients with coronary heart disease, clinical efficacy is exact, is conducive to improving the patient’s endothelial function and cardiac function.