白玉参景脉通汤对痰瘀互阻型冠心病心绞痛心血管剩余风险影响的临床观察  

Effect of “Baiyu Shenjin Maitong Decoction”on angina pectoris in CHD of phlegm and stasis syndrome and cardiovascular residual risk

作　　者：张焱[1] 姚迪[2] 朱怡菁[1] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院内科,上海200437 [2]上海市普陀区中心医院心内科,上海200062

出　　处：《上海中医药杂志》2014年第6期36-39,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：上海市教委科研创新项目(11YS73)

摘　　要：目的观察白玉参景脉通汤治疗痰瘀互阻型冠心病心绞痛的临床疗效及其对心血管剩余风险的影响。方法将60例痰瘀互阻型冠心病心绞痛患者按随机数字表分为治疗组与对照组,每组30例。对照组采用西药常规治疗,治疗组在对照组治疗基础上加服白玉参景脉通汤。两组疗程均为2个月,观察临床疗效,比较中医证候积分;并通过对血脂相关指标(TC、TG、HDL-C、LDL-C)水平变化情况的分析,评价心血管剩余风险。结果①治疗组、对照组总有效率分别为90.00%、83.33%;组间临床疗效比较,差异无统计学意义(P>0.05)。②治疗前后组内比较,两组胸痛、胸闷、气短、脘痞、身重的中医证候积分及总积分差异均有统计学意义(P<0.05);治疗组心悸积分差异有统计学意义(P<0.05),而对照组心悸积分差异无统计学意义(P>0.05)。组间治疗后比较,胸痛、心悸及总积分差异有统计学意义,治疗组优于对照组(P<0.05)。③治疗前后组内比较,两组TC、TG、LDL-C水平差异均有统计学意义(P<0.05);治疗组HDL-C水平差异有统计学意义(P<0.05),而对照组HDL-C水平差异无统计学意义(P>0.05)。组间治疗后比较,TG、HDL-C水平差异有统计学意义,治疗组优于对照组(P<0.05)。结论白玉参景脉通汤结合西医常规疗法治疗痰瘀互阻型冠心病心绞痛,不仅可明显改善临床症状,调节血脂水平,还可通过升高HDL-C降低心血管事件剩余风险。Objective To observe the clinical efficacy of ＂Baiyu Shenjin Maitong Decoction＂ on angina pectoris in CHD of phlegm and stasis syndrome and cardiovascular residual risk. Methods Sixty patients with coronary heart disease were randomized into treatment group and control group according to random number table, with 30 patients in each group. Control group was treated by western routine therapy, and treatment group was added with ＂Baiyu Shenjin Maitong Decoction＂, with the course of 2 months. The clinical efficacy was observed. The TCM syndrome score and levels of TC, TG, HDL-C and LDL-C were compared to evaluate cardiovascular residual risk. Results ①The overall effective rate was 90.00% in the treatment group and 83.33% in the control group, without significant difference in clinical efficacy between the two groups （P 〉 0.05 ）. ② Compared to the condition before and after the experiment, the scores of TCM symptoms in each group showed statistical differences in chest pain, chest oppression, short of breath, epigastric fullness and total score （ P 〈 0. 05 ） ; with statistical difference in palpitation in treatment group （ P 〈 0.05 ）, but no significant difference in palpitation in control group （ P 〉 0.05 ）. There were significant differences in scores of chest pain, palpitation and total score after treatment between the two groups, and the treatment group was superior to the control group （ P 〈 0.05 ）. （~） The serum TC, TG and LDL-C levels of both groups showed statistical differences between before and after treatment （ P 〈 0.05 ） ; There was significant difference in the level of HDL-C in treatment group （P 〈 0.05 ）, while no statistical difference was observed in the control group （ P 〉 0.05 ）. After treatment, there were significant differences in TG and HDL-C between the two groups, and the control group was superior to control group （ P 〈 0.05 ）. Conclusion ＂Baiyu Shenjin Maitong Decoction＂ may improve symptoms of coronary heart disea

关 键 词：冠心病心绞痛 痰瘀互阻 白玉参景脉通汤 心血管剩余风险 

分 类 号：R259[医药卫生—中西医结合]