摘要
目的:观察参松养心胶囊对冠状动脉粥样硬化性心绞痛合并失眠患者心肌保护作用和睡眠质量的影响。方法:采用随机数字表法将120例符合纳入要求的患者随机分为观察组和对照组,每组60例。两组患者均给予心绞痛一般基础治疗。基础治疗:低脂饮食,适当运动,控制危险因素;阿司匹林肠溶片,每次100 mg,每天1次;辛伐他汀,每次10 mg,每天1次;酒石酸美托洛尔片,每次47.5 mg,每天1次,晨服;硝酸甘油片,每次0.5 mg,舌下含服,必要时使用。对照组在基础治疗基础上,加用艾司唑仑治疗,每次1~2 mg,睡前服用;观察组在基础治疗基础上,加用参松养心胶囊治疗,每次4粒,每天3次。两组患者疗程均为4周。检测心肌钙蛋白T(cardiac troponin,CTnT)、肌酸激酶(creatine kinase,CK)和D-二聚体(D dimer,D-D)的水平;进行治疗前后心电图检查和匹兹堡睡眠质量量表(Pittsburgh sleep quality index,PSQI)评分。结果:观察组心绞痛疗效有效率为93.33%,对照组为78.33%,两组比较,差异有统计学意义(χ~2=5.551,P<0.05);观察组睡眠疗效有效率为83.33%,对照组为90.0%,差异无统计学意义(χ~2=1.153,P>0.05);治疗后观察组CTnT、CK和D-D水平均较治疗前下降,并低于治疗后对照组,差异有统计学意义(P<0.01);治疗后两组患者入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能等维度评分均明显降低,差异有统计学意义(P<0.01);治疗后观察组除日间功能评分低于对照组外差异有统计学意义(P<0.05),其他维度评分差异无统计学意义(P>0.05)。结论:参松养心胶囊治疗心绞痛合并失眠患者,对心绞痛和失眠均有较好的疗效,并对患者心肌有一定的保护作用,充分体现了中药治疗作用多层次、多效应的特点。
Objective：To observe myocardial protection and sleep quality influence of Shensong Yangxin capsules on stable angina combined with insomnia.Methods：One hundred and twenty patients were randomly divided into the control group（60 cases） and the observation group（60 cases） by random number table.Both groups＇ patients received conventional basic treatment of stable angina.And patients in control group received estazolam before sleep,1-2 mg per time.Patients in observation group took Shensong Yangxin capsules,4 pills per time,3 times a day.Courses of treatment were 4 weeks.And cardiac troponin T（CTnT）,creatine kinase（CK） and D-dimer（D-D） were detected.Before and after treatment,electrocardiogram was done and scores of Pittsburgh sleep quality index（PSQI） were graded.Results：The effective rate of stable angina in observation group was 93.33% superior to78.33% in control group（χ~2=5.551,P0.05）.And the effective rate of sleep in observation group and control group were83.33% and 90.0%,but there was no statistical significant（χ~2=1.153,P0.05）.After treatment,levels of CTnT,CK and D-D in the observation group decreased and which was lower than that in control group（P0.01）.Scores of hypnagogic time,sleep time,sleep efficiency,sleep disorders and day function decreased in both groups（P0.01）,and score of day function in observation group was lower than that in control group（P0.05）,there was no statistical significant from the difference of other scores（P0.05）.Conclusion：Shensong Yangxin capsules has a good effect to stable angina combined with insomnia,and can protect patients＇ cardiac muscle,so the multilayer and manifold effect belong to traditional Chinese medicine can be reflected.
作者
张春蓉
ZHANG Chunrong(Chongzhou People＇s Hospital, Chongzhou Sichuan China 61123)
出处
《中医学报》
CAS
2018年第2期303-306,共4页
Acta Chinese Medicine
基金
四川省卫生厅医学基金项目(2014zy051)
关键词
心绞痛合并失眠
参松养心胶囊
心肌钙蛋白T
肌酸激酶
D-二聚体
中医药疗法
中西医结合
stable angina combined with insomnia
Shensong Yangxin capsules
cardiac troponin T
creatine kinase
D-dimer
TCM therapy
integration of traditional Chinese and Western medicine
