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目的 探讨红元胶囊联合氯沙坦钾治疗围绝经期微血管性心绞痛气滞血瘀证的临床疗效。方法 采用回顾性队列研究方法，纳入2022年2月至2025年2月于河北省沧州中西医结合医院就诊的围绝经期微血管性心绞痛气滞血瘀证患者90例，采用氯沙坦钾片(每次50 mg，每日1次)治疗的患者纳入单药治疗组(45例)，采用氯沙坦钾片(每次50 mg，每日1次)+红元胶囊(每次1.2 g，每日3次)治疗的患者纳入联合治疗组(45例)。比较两组的临床疗效、心绞痛症状、血管内皮功能指标、冠状动脉微循环指标及不良反应发生率。结果 联合治疗组患者的总有效率高于单药治疗组[91.11%(41/45)vs 73.33%(33/45)，χ2=4.865,P<0.05]。联合治疗组心绞痛发作频率、持续时间、视觉模拟量表评分[分别为(2.13±1.08)次/周、(1.82±0.65)min/次、(1.87±0.34)分]低于单药治疗组[分别为(4.35±1.42)次/周、(3.53±0.97)min/次、(2.96±0.71)分，t=8.372、9.848、9.306，均P<0.05]，联合治疗组一氧化氮水平[(47.32±4.78)μmol/L]高于单药治疗组[(42.75±5.42)μmol/L,t=4.243,P<0.05]，内皮素1、超敏C反应蛋白水平[分别为(60.33±8.38)pg/mL、(3.87±0.52)mg/L]低于单药治疗组[分别为(72.35±9.40)pg/mL、(4.92±0.81)mg/L,t=6.403、7.309，均P<0.05]；联合治疗组心肌平台期强度、再充盈平均速度、冠状动脉血流储备水平[分别为(3.18±0.40)dB、(1.11±0.13)1/s、(3.52±0.53)]高于单药治疗组[分别为(2.72±0.36)dB、(0.89±0.11)1/s、(2.42±0.42),t=5.742、8.575、10.920，均P<0.05]，联合治疗组与单药治疗组不良反应发生率差异无统计学意义[15.56%(7/45)vs 11.11%(5/45)，χ2=0.385,P>0.05]。结论 红元胶囊联合氯沙坦钾治疗围绝经期微血管性心绞痛气滞血瘀证的临床疗效优于单药治疗，与患者心绞痛症状减轻，血管内皮功能修复及冠状动脉微循环障碍改善相关，安全性良好。
Abstract：Objective To investigate the clinical efficacy of losartan potassium combined with Hongyuan capsule in the treatment of perimenopausal microvascular angina with Qi stagnation and blood stasis syndrome. Methods A retrospective analysis was conducted. A total of 90 perimenopausal patients with microvascular angina and Qi stagnation and blood stasis syndrome, treated at Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province from February 2022 to February 2025, were enrolled. Patients were divided into two groups: the monotherapy group(45 cases) received losartan potassium tablets(50 mg once daily), and the combination therapy group(45 cases) received losartan potassium tablets(50 mg once daily) plus Hongyuan capsule(1.2 g three times daily). The clinical efficacy, angina symptoms, vascular endothelial function indicators, coronary microcirculation parameters, and adverse reactions were compared between the two groups. Results The total response rate in the combination therapy group was 91.11%(41/45), significantly higher than 73.33%(33/45) in the monotherapy group(χ2=4.865, P<0.05). The frequency of angina attacks, duration of each attack, and Visual Analog Scale scores in the combination therapy group((2.13±1.08) times/week,(1.82±0.65) min/time,(1.87±0.34) points) were significantly lower than those in the monotherapy group((4.35±1.42) times/week,(3.53±0.97) min/time,(2.96±0.71) points)(t=8.372, 9.848, 9.306; all P<0.05). Nitric oxide levels in the combination therapy group((47.32±4.78) μmol/L) were higher than those in the monotherapy group((42.75±5.42) μmol/L)(t=4.243, P<0.05), while endothelin-1 and high-sensitivity C-reactive protein levels in the combination therapy group((60.33±8.38) pg/mL,(3.87±0.52) mg/L, respectively) were lower than those in the monotherapy group((72.35±9.40) pg/mL,(4.92±0.81) mg/L, respectively)(t=6.403, 7.309, both P<0.05). Myocardial plateau intensity, mean reperfusion velocity, and coronary flow reserve in the combination therapy group((3.18±0.40) dB,(1.11±0.13) 1/s,(3.52±0.53), respectively) were significantly higher than those in the monotherapy group((2.72±0.36) dB,(0.89±0.11) 1/s,(2.42±0.42), respectively)(t=5.742,8.575,10.920, all P<0.05). The incidence of adverse reactions in the combination therapy group was 15.56%(7/45), while that in the monotherapy group was 11.11%(5/45)(χ2=0.385, P>0.05). Conclusion The combination of losartan potassium combined with Hongyuan capsule demonstrates superior clinical efficacy compared to monotherapy in treating perimenopausal microvascular angina with Qi stagnation and blood stasis syndrome. This is associated with alleviation of angina symptoms, repair of vascular endothelial function, improvement of coronary microcirculation disorders, with a favorable safety profile.
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基本信息:
中图分类号:R541.4
引用信息:
[1]苑树高,刘亭亭,李美霞,等.红元胶囊联合氯沙坦钾治疗围绝经期微血管性心绞痛[J].中国药物应用与监测,2026,23(04):560-564.
基金信息:
河北省中医药管理局计划项目（2019299）
2026-04-25
2026-04-25