1.中国中医科学院 望京医院,北京 100102
2.北京中医医院 顺义医院,北京 101300
3.中国中医科学院 广安门医院,北京 100053
张辰浩,主任医师,博士生导师,副教授,从事中西医结合心血管疾病的基础与临床研究,E-mail:zhangch500@126.com
董宇,博士,副研究员,从事中药药代动力学与临床药理研究,E-mail:dongyu250541@126.com
李晓涛,博士,副主任医师,从事中西医结合心血管疾病的基础与临床研究,E-mail:lxt_med@163.com
收稿:2024-07-23,
录用:2024-09-13,
网络出版:2024-10-08,
纸质出版:2024-12-05
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张辰浩,王佳,刘一颖等.通心络胶囊对气虚血瘀型慢性冠脉综合征患者抗缺血药物使用的影响: 一项多中心、前瞻性队列研究[J].中国实验方剂学杂志,2024,30(23):149-156.
ZHANG Chenhao,WANG Jia,LIU Yiying,et al.Effect of Tongxinluo Capsules on Use of Anti-ischemic Drugs in Patients with Chronic Coronary Syndrome of Qi Deficiency and Blood Stasis: A Multicenter, Prospective Cohort Study[J].Chinese Journal of Experimental Traditional Medical Formulae,2024,30(23):149-156.
张辰浩,王佳,刘一颖等.通心络胶囊对气虚血瘀型慢性冠脉综合征患者抗缺血药物使用的影响: 一项多中心、前瞻性队列研究[J].中国实验方剂学杂志,2024,30(23):149-156. DOI: 10.13422/j.cnki.syfjx.20250392.
ZHANG Chenhao,WANG Jia,LIU Yiying,et al.Effect of Tongxinluo Capsules on Use of Anti-ischemic Drugs in Patients with Chronic Coronary Syndrome of Qi Deficiency and Blood Stasis: A Multicenter, Prospective Cohort Study[J].Chinese Journal of Experimental Traditional Medical Formulae,2024,30(23):149-156. DOI: 10.13422/j.cnki.syfjx.20250392.
目的
2
探讨通心络胶囊对气虚血瘀型慢性冠脉综合征患者抗缺血药物使用的影响。
方法
2
采用多中心、前瞻性队列研究的方法,将通心络胶囊干预治疗作为暴露因素,分为暴露组(中西医结合治疗组)和非暴露组(西医治疗组),随访1年,分别观察入组当天,3、6、12个月时各组抗缺血药物使用的情况。
结果
2
研究共纳入186例患者,暴露组128人,非暴露组58人。2组基线资料差异无统计学意义。第3月随访时,与非暴露组比较,暴露组患者使用一线抗缺血药种类显著降低(
P
<
0.01);此差异在第6月时仍具有统计学意义(
P
<
0.05);至第12月时差异无统计学意义。在第3、6月随访时,两组使用二线抗缺血药种类差异无统计学意义;在第12月随访时,与非暴露组比较,暴露组使用二线抗缺血药物的种类显著减少(
P
<
0.01)。第3月随访时,与基线比较,两组使用一线抗缺血药种类均有减少(
P
<
0.05),暴露组减少更明显(
P
<
0.05)。第6月随访时,与基线比较,暴露组使用二线抗缺血药物种类明显减少(
P
<
0.05),而非暴露组无明显变化,差异无统计学意义。第12月随访时,与非暴露组比较,暴露组使用二线抗缺血药物种类差异有统计学意义(
P
<
0.05),一线药物比较差异无统计学意义。
结论
2
通心络胶囊能有效减少气虚血瘀型慢性冠脉综合征患者抗缺血药物的使用。
Objective
2
To investigate the effect of Tongxinluo capsules on the use of anti-ischemic drugs in patients with chronic coronary syndrome (CCS) of Qi deficiency and blood stasis.
Method
2
A multicenter,prospective cohort study was conducted,with Tongxinluo capsules intervention as the exposure factor. Patients were divided into an exposed group (combination of traditional Chinese and western medicine) and a non-exposed group (western medicine alone),and followed up for one year. The use of anti-ischemic drugs was observed on the day of enrollment and at 3,6,12 months.
Result
2
A total of 186 patients were enrolled,with 128 in the exposed group and 58 in the non-exposed group. There were no statistically significant differences in baseline characteristics between the two groups. At the 3-month follow-up,the types of first-line anti-ischemic drugs used in the exposed group were significantly fewer than those in the non-exposed group (
P
<
0.01),and this difference remained statistically significant at 6 months (
P<
0.05) but was no longer significant at 12 months. At the 3- and 6-month follow-ups,there were no significant differences between the two groups in the types of second-line anti-ischemic drugs used. However,at the 12-month follow-up,the types of second-line anti-ischemic drugs used in the exposed group were significantly fewer than those in the non-exposed group (
P<
0.01). At the 3-month follow-up,both groups showed a reduction in the types of first-line anti-ischemic drugs used compared to baseline (
P
<
0.05),with a more pronounced reduction in the exposed group (
P
<
0.05). At the 6-month follow-up,the exposed group showed a significant reduction in the types of second-line anti-ischemic drugs used compared to baseline (
P
<
0.05),while no significant changes were observed in the non-exposed group. At the 12-month follow-up,the difference in the types of second-line anti-ischemic drugs between the exposed and non-exposed gro
ups was statistically significant (
P
<
0.05),while there was no significant difference in the types of first-line anti-ischemic drugs.
Conclusion
2
Tongxinluo capsules can effectively reduce the use of anti-ischemic drugs in patients with CCS of Qi deficiency and blood stasis.
MESNIER J , DUCROCQ G , DANCHIN N , et al . International observational analysis of evolution and outcomes of chronic stable angina:The multinational CLARIFY study [J]. Circulation , 2021 , 144 ( 7 ): 512 - 523 .
中华医学会心血管病学分会 , 中华心血管病杂志编辑委员会 . 中国慢性冠脉综合征患者诊断及管理指南 [J]. 中华心血管病杂志 , 2024 , 52 ( 6 ): 589 - 614 .
MARON D J , HOCHMAN J S , REYNOLDS H R , et al . Initial invasive or conservative strategy for stable coronary disease [J]. N Engl J Med , 2020 , 382 ( 15 ): 1395 - 1407 .
FERRARI R , CAMICI P G , CREA F , et al . Expert consensus document:A 'diamond' approach to personalized treatment of angina [J]. Nat Rev Cardiol , 2018 , 15 ( 2 ): 120 - 132 .
许佳怡 , 拓西平 . 老年冠心病心绞痛患者硝酸酯类药物及其他药物应用进展 [J]. 中国循证心血管医学杂志 , 2023 , 15 ( 4 ): 510 - 512 .
中华中医药学会心血管病分会 . 冠心病稳定型心绞痛中医诊疗指南 [J]. 中医杂志 , 2019 , 60 ( 21 ): 1880 - 1890 .
黄文娟 , 蒋兵 , 赵生俊 . 中成药治疗气滞血瘀型稳定型心绞痛的临床综合评价 [J]. 中国实验方剂学杂志 , 2024 , 30 ( 19 ): 163 - 169 .
李阜哲 . 冠心病不同临床分型的中医证型与客观指标相关性分析 [D]. 沈阳 : 辽宁中医药大学 , 2023 .
李兰兰 , 吴茜 , 吕乾瑜 , 等 . 稳定型心绞痛的中医证候分布及用药规律研究 [J]. 世界中医药 , 2023 , 18 ( 20 ): 2977 - 2982 .
中华中医药学会心血管病分会 . 冠心病心绞痛证候要素诊断标准 [J]. 中医杂志 , 2018 , 59 ( 6 ): 539 - 540 .
KNUUTI J , WIJNS W , SARASTE A , et al . 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes [J]. Eur Heart J , 2020 , 41 ( 3 ): 407 - 477 .
郭宏洲 , 黄榕翀 . 2019 ESC慢性冠状动脉综合征指南解读 [J]. 中国循环杂志 , 2019 , 34 ( S1 ): 18 - 23 .
BALLA C , PAVASINI R , FERRARI R . Treatment of angina:Where are we? [J]. Cardiology , 2018 , 140 ( 1 ): 52 - 67 .
王雪娇 , 邵祯 , 孟超 , 等 . 急性冠脉综合征"寒热"的研究进展 [J]. 中国实验方剂学杂志 , 2024 , 30 ( 6 ): 246 - 252 .
耿小飞 , 范新彪 , 严志鹏 , 等 . 病证结合分阶段辨治冠心病临证思考 [J]. 中国中西医结合杂志 , 2024 , 44 ( 5 ): 603 - 607 .
李佳铭 , 姜钧文 . 基于CiteSpace的气虚血瘀型冠状动脉粥样硬化性心脏病知识图谱可视化分析 [J]. 中医临床研究 , 2024 , 16 ( 2 ): 37 - 41 .
BODEN W E , MARZILLI M , CREA F , et al . Evolving management paradigm for stable ischemic heart disease patients:JACC review topic of the week [J]. J Am Coll Cardiol , 2023 , 81 ( 5 ): 505 - 514 .
秘红英 . 基于数据挖掘的吴以岭教授治疗冠心病心绞痛医案分析及通心络胶囊网络药理学研究 [D]. 石家庄 : 河北医科大学 , 2018 .
李雅文 , 常丽萍 , 秘红英 , 等 . 基于脉络学说探析慢性冠脉综合征的病机及治疗 [J]. 中国实验方剂学杂志 , 2021 , 27 ( 1 ): 196 - 202 .
霍勇 , 吴宗贵 , 林谦 , 等 . 通心络防治冠心病临床应用中国专家共识 [J]. 中国介入心脏病学杂志 , 2024 , 32 ( 4 ): 181 - 190 .
郭流漓 , 杨昊霖 , 杨志华 , 等 . 通心络胶囊治疗冠状动脉微血管病的临床疗效及其作用机制研究进展 [J]. 现代药物与临床 , 2024 , 39 ( 2 ): 530 - 535 .
LI G , XU Q , HAN K , et al . Experimental evidence and network pharmacology-based analysis reveal the molecular mechanism of Tongxinluo capsule administered in coronary heart diseases [J]. Biosci Rep , 2020 , 40 ( 10 ): BSR20201349 .
张世海 . 通心络胶囊联合曲美他嗪治疗冠心病心绞痛的临床观察 [J]. 天津药学 , 2021 , 33 ( 1 ): 28 - 29 .
王芸素 , 陈联发 , 王朝阳 . 耳穴压豆联合通心络胶囊治疗气虚血瘀型稳定性心绞痛临床研究 [J]. 中医药临床杂志 , 2019 , 31 ( 1 ): 127 - 131 .
师浩 , 桑延晓 , 贠静辉 , 等 . 通心络胶囊联合美托洛尔对冠心病心绞痛患者的临床应用价值 [J]. 实用中西医结合临床 , 2022 , 22 ( 17 ): 9 - 12 .
彭娟 . 通心络胶囊联合标本配穴灸法治疗稳定性心绞痛临床研究 [J]. 光明中医 , 2023 , 38 ( 18 ): 3567 - 3569 .
王枫 , 赵若楠 , 程宇彤 . 通心络胶囊联合双抗血小板方案对PCI术后阿司匹林抵抗患者预后的影响 [J]. 河北医学 , 2018 , 24 ( 7 ): 1081 - 1086 .
陈丽 , 袁晓玲 , 黄明月 , 等 . SGLT2抑制剂恩格列净调控Nrf2信号及氧化应激减轻心肌缺血再灌注损伤 [J]. 山西医科大学学报 , 2023 , 54 ( 6 ): 754 - 760 .
FRĄK W , HAJDYS J , RADZIOCH E , et al . Cardiovascular diseases:Therapeutic potential of SGLT-2 inhibitors [J]. Biomedicines , 2023 , 11 ( 7 ): 2085 .
王瑞 , 高钊 , 张晓东 , 等 . 白藜芦醇通过调节沉默信息调节因子1通路改善大鼠心肌缺血再灌注损伤的作用机制 [J]. 世界中医药 , 2022 , 17 ( 15 ): 2171 - 2177 .
MICHNIEWICZ E , MLODAWSKA E , LOPATOWSKA P , et al . Patients with atrial fibrillation and coronary artery disease - Double trouble [J]. Adv Med Sci , 2018 , 63 ( 1 ): 30 - 35 .
FUNAKUBO H , TANAKA A , TOBE A , et al . Impact of proteinuria on long-term prognosis in patients with coronary artery disease [J]. J Cardiovasc Med (Hagerstown) , 2023 , 24 ( 12 ): 900 - 905 .
THOMAS M , JONES P G , ARNOLD S V , et al . Interpretation of the seattle angina questionnaire as an outcome measure in clinical trials and clinical care:A review [J]. JAMA Cardiol , 2021 , 6 ( 5 ): 593 - 599 .
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