目的观察通脉颗粒的临床疗效尤其是对冠心病心绞痛患者运动耐量和生活质量的影响。方法将47例劳力性心绞痛患者随机分为消心痛组(23例)和通脉颗粒组(24例),前者予消心痛10 mg tid,后者予通脉颗粒3 g Bid,观察比较两种药物的临床疗效及...目的观察通脉颗粒的临床疗效尤其是对冠心病心绞痛患者运动耐量和生活质量的影响。方法将47例劳力性心绞痛患者随机分为消心痛组(23例)和通脉颗粒组(24例),前者予消心痛10 mg tid,后者予通脉颗粒3 g Bid,观察比较两种药物的临床疗效及其副作用,并分别记录和评定治疗前、治疗一月、三月时一周内心绞痛发作次数和硝酸甘油用量以及运动耐量和生活质量;观察期间停用其它抗心肌缺血药物,若发生心绞痛,临时予硝酸甘油舌下含服控制。结果心绞痛患者服用通脉颗粒1个月时心绞痛发作次数及硝酸甘油用量明显减少,运动耐量和生活质量明显改善,总有效率79.2%,但较消心痛组疗效差;治疗三月时通脉颗粒疗效进一步提高,而消心痛疗效呈下降趋势,两组间有显著性差异(P<0.05);整个观察进程中,消心痛组共6例发生不同程度头痛、颜面潮红、体位性低血压等副作用,而通脉颗粒组无1例发生此类现象。结论通脉颗粒治疗冠心病心绞痛有明显疗效,可明显减少心绞痛发作次数和硝酸甘油用量,明显改善患者运动耐量和生活质量,且3个月内在耐药性和药物副作用方面较消心痛有明显优势。展开更多
TongMai Granules is a Chinese medicine patent drug to treat cardiovascular diseases.It is prepared from the water extract of Dan-shen,Chuan-xiong and Ge-gen.The main compounds of TongMai Granules are isoflavone glycos...TongMai Granules is a Chinese medicine patent drug to treat cardiovascular diseases.It is prepared from the water extract of Dan-shen,Chuan-xiong and Ge-gen.The main compounds of TongMai Granules are isoflavone glycosides,isoflavones,and phenolic acids.However,it is difficult to detect low-polar compounds such as tanshinones and phthalides though they may also contribute to the therapeutic effect.In this work,an off-line two-dimensional chromatography method was developed to enrich the minor constituents in TongMai Granules.The extract was subjected to an SEP-PAK silica SPE column and eluted with petroleum ether,ethyl acetate–methanol(6:1,v/v),and methanol,successively.The three fractions were then analyzed using ultra-high performance liquid chromatography coupled with orbitrap mass spectrometry(UHPLC/orbitrap-MS).The isoflavones from Ge-gen,phenolic acids from Dan-shen and phthalides from Chuan-xiong were distributed in different fractions.A total of 131 compounds,including 59 from Ge-gen,26 from Dan-shen,43 from Chuan-xiong,and 3 common ones from Dan-shen and Chuan-xiong were tentatively identified.Among them,26 compounds were identified by comparing with reference standards.This study set a good example for comprehensive analysis of the constituents in traditional Chinese medicine formula.展开更多
文摘目的观察通脉颗粒的临床疗效尤其是对冠心病心绞痛患者运动耐量和生活质量的影响。方法将47例劳力性心绞痛患者随机分为消心痛组(23例)和通脉颗粒组(24例),前者予消心痛10 mg tid,后者予通脉颗粒3 g Bid,观察比较两种药物的临床疗效及其副作用,并分别记录和评定治疗前、治疗一月、三月时一周内心绞痛发作次数和硝酸甘油用量以及运动耐量和生活质量;观察期间停用其它抗心肌缺血药物,若发生心绞痛,临时予硝酸甘油舌下含服控制。结果心绞痛患者服用通脉颗粒1个月时心绞痛发作次数及硝酸甘油用量明显减少,运动耐量和生活质量明显改善,总有效率79.2%,但较消心痛组疗效差;治疗三月时通脉颗粒疗效进一步提高,而消心痛疗效呈下降趋势,两组间有显著性差异(P<0.05);整个观察进程中,消心痛组共6例发生不同程度头痛、颜面潮红、体位性低血压等副作用,而通脉颗粒组无1例发生此类现象。结论通脉颗粒治疗冠心病心绞痛有明显疗效,可明显减少心绞痛发作次数和硝酸甘油用量,明显改善患者运动耐量和生活质量,且3个月内在耐药性和药物副作用方面较消心痛有明显优势。
基金National Key Research and Development Program of China(Grant No.2018YFC1707301,2018YFC1707304)。
文摘TongMai Granules is a Chinese medicine patent drug to treat cardiovascular diseases.It is prepared from the water extract of Dan-shen,Chuan-xiong and Ge-gen.The main compounds of TongMai Granules are isoflavone glycosides,isoflavones,and phenolic acids.However,it is difficult to detect low-polar compounds such as tanshinones and phthalides though they may also contribute to the therapeutic effect.In this work,an off-line two-dimensional chromatography method was developed to enrich the minor constituents in TongMai Granules.The extract was subjected to an SEP-PAK silica SPE column and eluted with petroleum ether,ethyl acetate–methanol(6:1,v/v),and methanol,successively.The three fractions were then analyzed using ultra-high performance liquid chromatography coupled with orbitrap mass spectrometry(UHPLC/orbitrap-MS).The isoflavones from Ge-gen,phenolic acids from Dan-shen and phthalides from Chuan-xiong were distributed in different fractions.A total of 131 compounds,including 59 from Ge-gen,26 from Dan-shen,43 from Chuan-xiong,and 3 common ones from Dan-shen and Chuan-xiong were tentatively identified.Among them,26 compounds were identified by comparing with reference standards.This study set a good example for comprehensive analysis of the constituents in traditional Chinese medicine formula.
