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关婷婷, 刘金霞, 王嵩亮, 杨娜, 鲁静, 杨丽丽.芪苈强心胶囊联合盐酸地尔硫䓬治疗老年冠心病心绞痛患者的临床研究[J].湖南中医药大学学报,2026,46(9):1928-1934[点击复制] |
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| 芪苈强心胶囊联合盐酸地尔硫䓬治疗老年冠心病心绞痛患者的临床研究 |
| 关婷婷,刘金霞,王嵩亮,杨娜,鲁静,杨丽丽 |
| (湖北省荆门市中医医院全科医疗科·老年病科, 湖北 荆门 448000;湖北省荆门市中医医院急诊科, 湖北 荆门 448000;湖北省荆门市中医医院生殖健康与不孕症科, 湖北 荆门 448000) |
| 摘要: |
| 目的 探究芪苈强心胶囊联合盐酸地尔硫䓬对老年冠心病（CHD）心绞痛患者的临床疗效。方法 选取湖北省荆门市中医医院全科医疗科·老年病科2021年6月至2023年6月收治的老年CHD心绞痛患者240例，采用随机数字表法分为基础组（60例）、对照组A（60例）、对照组B（60例）和观察组（60例）。基础组给予常规治疗；对照组A在常规治疗基础上口服芪苈强心胶囊，1.2 g/次，3次/d；对照组B在常规治疗基础上口服盐酸地尔硫䓬治疗，起始30 mg/次，4次/d，若疗效不佳，可于治疗1周后增至60 mg/次，4次/d；观察组在常规治疗基础上口服芪苈强心胶囊、盐酸地尔硫䓬，用法用量同对照组A、对照组B。4组均连续治疗1个月。比较4组患者临床疗效、心电图疗效、血脂指标[甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）]、心功能指标[左室射血分数（LVEF）、左室收缩末内径（LVESD）、左室舒张末内径（LVEDD）]、血液流变学指标[纤维蛋白原（Fg）、血浆黏度（PV）和红细胞聚集指数]及炎症因子[肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）、可溶性尿激酶纤溶酶原激活物受体（suPAR）]水平，并评估用药安全性。结果 治疗后，观察组患者临床总有效率、心电图总有效率均高于基础组、对照组A、对照组B（P＜0.05），且对照组A、对照组B患者临床总有效率、心电图总有效率均高于基础组（P＜0.05）。与治疗前比较，4组患者治疗后TG水平、TC水平、LDL-C水平、LVESD、LVEDD、PV、Fg、红细胞聚集指数及CRP水平、suPAR水平、TNF-α水平均降低（P＜0.05），HDL-C水平、LVEF均升高（P＜0.05）。与基础组、对照组A、对照组B比较，观察组患者治疗后TG水平、TC水平、LDL-C水平、LVESD、LVEDD、PV、Fg、红细胞聚集指数及CRP水平、suPAR水平、TNF-α水平均降低（P＜0.05），HDL-C水平、LVEF均升高（P＜0.05）。与基础组比较，对照组A、对照组B患者治疗后PV、Fg、红细胞聚集指数、CRP水平、suPAR水平、TNF-α水平均降低（P＜0.05）。4组患者不良反应发生率比较，差异无统计学意义（P>0.05）。结论 芪苈强心胶囊联合盐酸地尔硫䓬短期（1个月）可提高老年CHD心绞痛患者的临床疗效和心电图疗效，改善血脂、血液流变学和心功能等指标，并降低炎症因子水平，且安全性良好。 |
| 关键词: 老年冠心病心绞痛|芪苈强心胶囊|盐酸地尔硫䓬|炎症因子|血脂|血液流变学|心功能 |
| DOI：10.3969/j.issn.1674-070X.2026.09.026 |
| 投稿时间：2026-03-30 |
| 基金项目:湖北省中医药科研项目(ZY2025L174)。 |
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| Clinical study of Qili Qiangxin Capsule combined with diltiazem hydrochloride in treating elderly patients with coronary heart disease and angina pectoris |
| GUAN Tingting, LIU Jinxia, WANG Songliang, YANG Na, LU Jing, YANG Lili |
| (Department of General Practice and Geriatrics, Jingmen Traditional Chinese Medicine Hospital, Jingmen, Hubei 448000, China;Emergency Department, Jingmen Traditional Chinese Medicine Hospital, Jingmen, Hubei 448000, China;Department of Reproductive Health and Infertility, Jingmen Traditional Chinese Medicine Hospital, Jingmen, Hubei 448000, China) |
| Abstract: |
| Objective To explore the clinical efficacy of Qili Qiangxin Capsule (QLQXC) combined with diltiazem hydrochloride in treating elderly patients with coronary heart disease (CHD) and angina pectoris. Methods A total of 240 elderly patients with CHD and angina pectoris admitted to Department of General Practice and Geriatrics, Jingmen Traditional Chinese Medicine Hospital, Hubei Province, China, from June 2021 to June 2023 were enrolled and divided into basic group, control group A, control group B, and observation group using a random number table method, with 60 patients in each group. The basic group received conventional treatment. On the basis of conventional treatment, control group A was given oral QLQXC at 1.2 g per dose, three times daily. On the basis of conventional treatment, control group B received oral diltiazem hydrochloride at an initial dose of 30 mg per dose, four times daily. If treatment response was unsatisfactory, the dose could be titrated up to 60 mg per dose, four times daily after one week of therapy. The observation group received oral QLQXC and diltiazem hydrochloride on the basis of conventional treatment, with the same usage and dosage as those in control groups A and B. All four groups were treated continuously for one month. The clinical efficacy, electrocardiographic efficacy, blood lipid indices [triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)], cardiac function indices [left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD)], hemorheological indices [fibrinogen (Fg), plasma viscosity (PV), and erythrocyte aggregation index], and inflammatory factor levels [tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), soluble urokinase plasminogen activator receptor (suPAR)] were compared among the four groups, and the medication safety was evaluated. Results After treatment, the total clinical effective rate and total electrocardiographic effective rate in the observation group were higher than those in the basic group, control group A, and control group B (P<0.05), and the total clinical effective rate and total electrocardiographic effective rate in control groups A and B were higher than those in the basic group (P<0.05). After treatment, compared with before treatment, the levels of TG, TC, LDL-C, CRP, suPAR, and TNF-α and the values of LVESD, LVEDD, PV, Fg, and erythrocyte aggregation index decreased in all four groups (P<0.05), while HDL-C levels and LVEF increased (P<0.05). After treatment, compared with the basic group, control group A, and control group B, the observation group had lower levels of TG, TC, LDL-C, CRP, suPAR, and TNF-α and lower values of LVESD, LVEDD, PV, Fg, and erythrocyte aggregation index (P<0.05), and higher HDL-C levels and LVEF (P<0.05). After treatment, compared with the basic group, control groups A and B had lower values of PV, Fg, and erythrocyte aggregation index and lower levels of CRP, suPAR, and TNF-α (P<0.05). There was no statistically significant difference in the incidence of adverse reactions among the four groups (P>0.05). Conclusion Short-term (1-month) treatment with QLQXC combined with diltiazem hydrochloride can improve the clinical efficacy and electrocardiographic efficacy, ameliorate indicators such as blood lipid profiles, hemorheological parameters, and cardiac function, and reduce inflammatory factor levels in elderly patients with CHD and angina pectoris, with a good safety profile. |
| Key words: elderly patients with coronary heart disease and angina pectoris|Qili Qiangxin Capsule|diltiazem hydrochloride|inflammatory factors|blood lipids|hemorheology|cardiac function |
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