参松养心胶囊联合曲唑酮治疗稳定型心绞痛PCI术后慢性失眠患者的临床疗效研究

Clinical efficacy of Shensong Yangxin Capsules combined with trazodone in patients with chronic insomnia following percutaneous coronary intervention for stable angina pectoris

摘要:

目的 探讨参松养心胶囊联合曲唑酮治疗稳定型心绞痛经皮冠状动脉介入治疗（PCI）术后慢性失眠患者的临床疗效。方法 选取2022年4月—2025年3月在宝鸡市人民医院就诊的稳定型心绞痛PCI术后慢性失眠患者84例，采用随机数字表法将其分成观察组、对照组，各42例。术后两组均接受常规治疗，对照组在常规治疗基础上口服曲唑酮；观察组在对照组基础上口服参松养心胶囊。比较两组睡眠质量、炎症反应指标、心肌损伤指标、多导睡眠图参数及心血管不良事件发生情况。结果 观察组治疗前后匹兹堡睡眠质量指数（PSQI）的差值大于对照组（P <0.05）；观察组治疗前后白细胞介素-6、超敏C反应蛋白、肿瘤坏死因子α的差值均大于对照组（P <0.05）；观察组治疗前后脑钠肽、心脏型脂肪酸结合蛋白的差值均大于对照组（P <0.05）；观察组治疗前后觉醒次数、慢波睡眠时长、睡眠潜伏期的差值均大于对照组（P <0.05）；观察组心血管不良事件总发生率低于对照组（P <0.05）。结论 参松养心胶囊联合曲唑酮可改善稳定型心绞痛PCI术后慢性失眠患者睡眠质量，改善多导睡眠图参数，减轻炎症反应与心肌损伤，降低心血管不良事件发生风险。

Abstract:

Objective To investigate the clinical efficacy of Shensong Yangxin Capsules combined with trazodone in patients with chronic insomnia following percutaneous coronary intervention (PCI) for stable angina pectoris.Methods Eighty-four patients with stable angina undergoing PCI who developed postoperative chronic insomnia between April 2022 and March 2025 at Baoji People's Hospital were enrolled. Patients were randomly assigned to the observation group or the control group using a random number table, with 42 patients in each group. Both groups received standard postoperative management. The control group received conventional treatment supplemented with trazodone. The observation group was additionally given Shensong Yangxin Capsules. Sleep quality, inflammatory markers, myocardial injury indicators, polysomnography findings, and cardiovascular adverse events were compared between groups.Results The change in Pittsburgh Sleep Quality Index (PSQI) scores from baseline to post-treatment was greater in the observation group than in the control group (P < 0.05). The pre-to-post treatment differences in interleukin-6, high-sensitivity C-reactive protein, and tumor necrosis factor-α levels were greater in the observation group than in the control group (P < 0.05). The pre-to-post treatment differences in brain natriuretic peptide and heart-type fatty acid-binding protein levels were greater in the observation group than in the control group (P < 0.05). The pre-to-post treatment differences in the number of awakenings, slow-wave sleep duration, and sleep latency were all greater in the observation group than in the control group (P < 0.05). The overall incidence of cardiovascular adverse events was lower in the observation group than in the control group (P < 0.05).Conclusion The combination of Shensong Yangxin Capsules and trazodone improves sleep quality in patients with chronic insomnia following percutaneous coronary intervention for stable angina pectoris. It enhances polysomnography parameters, reduces inflammatory responses and myocardial damage, and lowers the risk of cardiovascular adverse events.