目的：探讨葛根素联合曲美他嗪治疗稳定型心绞痛临界病变患者的疗效。方法选取2012年3月-2013年10月本院收治的稳定型心绞痛临界病变患者120例，采用随机数字表法分成对照组和观察组，各60例。对照组给予冠心病二级预防，观察组在冠心病二级预防基础上加用葛根素片（50 mg/次，3次/ d）和曲美他嗪片（20 mg/次，3次/ d），连续服用12周。比较两组患者治疗前，治疗后第6、12周心绞痛分级、硝酸甘油用量以及活动平板运动试验持续时间。结果治疗后第6、12周对照组与观察组心绞痛分级比较，差异有统计学意义（ u =2.830，P =0.005；u =2.673，P =0.007）。两组不同时间硝酸甘油用量比较，差异有统计学意义；两组患者硝酸甘油用量差异有统计学意义；治疗方法与治疗时间存在交互作用（ F时间=3.676，F组间=8.213，F交互=3.842，P时间=0.028，P组间=0.007，P交互=0.025）。两组不同时间活动平板运动试验持续时间比较，差异有统计学意义；两组患者活动平板运动试验持续时间差异有统计学意义；治疗方法与活动平板运动试验进行时间存在交互作用（ F时间=4.059，F组间=7.634， F交互=3.725，P时间=0.021，P组间=0.009，P交互=0.029）。结论葛根素联合曲美他嗪能有效减轻稳定型心绞痛临界病变患者的心绞痛症状、减少硝酸甘油用量以及提高患者的运动耐量，对稳定型心绞痛临界病变患者具有较好的临床应用价值。%Objective To investigate the effect of combination therapy of puerarin and trimetazidine in the treatment of patients with stable angina pectoris and intermediate coronary stenosis. Methods 120 patients with stable angina pectoris and in-termediate coronary stenosis admitted to our hospital from March 2012 to October 2013 were randomly divided into control group and observation group,with each group 60 cases. The control group was given secondary prevention of coronary heart disease, while the observation group was given additional puerarin tablet ( 50 mg/ time,3 times/ day ) and trimetazidine tablet (20 mg/ time,3 times/ day)for 12 weeks. The grading of angina pectoris,nitroglycerin consumption and treadmill exercise test duration of the two groups were compared before treatment and 6 and 12 weeks after treatment. Results After 6 and 12 weeks treatment,the grading of angina pectoris between the control group and observation group showed statistically significant difference (u = 2. 830,P = 0. 005;u = 2. 673,P = 0. 007). The nitroglycerin consumption between the two groups showed statistically significant differences at different times,there was statistically significant difference in nitroglycerin consumption between two groups,there was interaction between treatment methods and treatment time(Ftime = 3. 676,Fgroup = 8. 213,Finteraction = 3. 842, P time = 0. 028,Pgroup = 0. 007,Pinteraction = 0. 025). The treadmill exercise test duration between the two groups showed statistical-ly significant differences at different times,there was statistically significant difference in treadmill exercise test duration between two groups,there was interaction between treatment methods and treadmill exercise test duration(Ftime = 4. 059,Fgroup = 7. 634, F interaction = 3. 725,Ptime = 0. 021,Pgroup = 0. 009,Pinteraction = 0. 029). Conclusion Combination therapy of puerarin and trime-tazidine shows satisfactory clinical value by effectively alleviating the symptoms,reducing nitroglycerin consumption and impro-ving exercise tolerance of patients with stable angina pectoris and intermediate coronary stenosis.
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