于姣　何瑾瑜　陈捷

[摘要] 目的 觀察麝香保心丸对冠心病心绞痛患者Ghrelin/obestatin比值的影响及临床疗效。 方法 收集2012年1月～2016年6月诊治的冠心病心绞痛患者88例，随机分为观察组（n=44）和对照组（n=44），对照组采用辛伐他汀、硝酸异山梨酯片、阿司匹林常规西医治疗，观察组在对照组的基础上加用麝香保心丸治疗，两组治疗时间均为1个月。采用酶联免疫吸附试验检测Ghrelin、obestatin水平，并比较其治疗前后水平变化。 结果 观察组治疗总有效率高于对照组（77.3% vs 59.1%），差异具有统计学意义（P<0.05）。治疗后，观察组患者的心绞痛发作次数、持续时间及硝酸甘油用量均低于对照组患者[发作次数：（7.8±1.7）次/周vs（13.2±2.5）次/周；持续时间：（3.5±1.3）min/次vs （5.7±2.2）min/次；硝酸甘油用量：（2.1±0.6）mg vs（4.3±1.5）mg]，差异均有统计学意义（P<0.01）。治疗后，观察组患者Ghrelin/obestatin比值明显高于对照组患者[（62.95±14.36） vs （45.21±10.28）]，差异有统计学意义（P<0.05）。 结论 麝香保心丸治疗冠心病心绞痛疗效明显，对冠心病心绞痛的发作有一定的保护作用，能增加Ghrelin/obestatin比值。

[关键词] 麝香保心丸；冠心病；心绞痛；Ghrelin/obestatin比值

[中图分类号] R541.4；R259 [文献标识码] B [文章编号] 1673-9701（2017）23-0116-03

[Abstract] Objective To observe the effect of Shexiang Baoxin pill on the ratio of Ghrelin/obestatin in patients with angina pectoris of coronary heart disease and its clinical curative effect. Methods A total of 88 patients with coronary heart disease and angina pectoris who were diagnosed from January 2012 to June 2016 were randomly divided into observation group（n=44） and control group（n=44）， the control group was treated with simvastatin， isosorbide dinitrate tablets， aspirin and conventional western medicine. The observation group was treated with Shexiang Baoxin pills on the basis of the control group， and the treatment time was 1 month in the two groups. The levels of Ghrelin and obestatin were detected by enzyme-linked immunosorbent assay， and the changes were compared before and after treatment. Results The total effective rate of the observation group was higher than that of the control group（77.3% vs 59.1%）， the difference was statistically significant（P<0.05）. After treatment， the frequency of angina pectoris， the duration and the amount of nitroglycerin in the observation group were lower than those in the control group [Number of episodes： （7.8±1.7） times/week vs （13.2±2.5） times/week； Duration time： （3.5±1.3） min/time vs （5.7±2.2）min/time； Nitroglycerin dosage： （2.1±0.6） mg vs （4.3±1.5） mg]， the difference was statistically significant（P<0.01）. After treatment， the ratio of Ghrelin/obestatin in the observation group was significantly higher than that in the control group[（62.95±14.36） vs （45.21±10.28）]， the difference was statistically significant（P<0.05）. Conclusion Shexiang Baoxin pill is effective in the treatment of coronary heart disease and angina pectoris， it can protect the angina pectoris of coronary heart disease and increase the ratio of Ghrelin/obestatin.endprint

[Key words] Shexiang Baoxin pill； Coronary heart disease； Angina pectoris； Ghrelin/obestatin ratio

冠心病心绞痛是由于沉着在冠状动脉内膜上的白色斑块，致使血管狭窄、供血不足，引起心肌暂时或急剧缺血、缺氧的一组综合征[1]。冠心病属于中医“胸痹”、“心痛”、“真心痛”等范畴，而其病机为气虚痰瘀[2]。本文旨在通过麝香保心丸治疗冠心病心绞痛患者的临床疗效观察和Ghrelin/obestatin比值的变化，探讨麝香保心丸治疗冠心病心绞痛的临床应用价值。

1 资料与方法

1.1 一般资料

选取2012年1月～2016年6月在陕西省中医医院和浙江省余姚市人民医院诊治的冠心病心绞痛患者88例作为研究对象。冠心病心绞痛分级根据加拿大心绞痛严重度分级标准[3]。采用随机数字表法分为对照组和观察组，各44例，其中对照组男28例，女16例，年龄46～79岁，平均（58.6±10.4）岁，病程2～9年，平均（4.8±1.4）年，心絞痛分级：Ⅰ级9例，Ⅱ级17例，Ⅲ级12例，Ⅳ级6例，合并慢性疾病情况：呼吸系统疾病7例，高血压18例，糖尿病9例。观察组男29例，女15例，年龄……