中医辨证结合西医常规治疗对稳定性冠心病患者冠状动脉狭窄程度的影响  

Effect of Combination of Chinese Medicine and Western Medical Routine Therapy on Coronary Stenosis of Stable Coronary Heart Disease Patients: A Self-control Study

作　　者：曲华[1] 柴华[1,2] 梁芳 高铸烨[1] 史大卓 QU Hua;CHAI Hua;LIANG Fang;GAO Zhu-ye;SHI Da-zhuo(Center for Cardiovascular Disease, Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing (100091);School of Clinical Medicine,Beijing University of Chinese Medicine,Beijing (100029))

机构地区：[1]中国中医科学院西苑医院心血管病中心,北京100091 [2]北京中医药大学临床医学院,北京100029

出　　处：《中国中西医结合杂志》2019年第2期157-161,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家十二五科技支撑计划(No.2013BAI02B01);中医药行业专项课题:重大新药创制课题(No.2009ZX09502-031)

摘　　要：目的观察中医辨证结合西医常规治疗对稳定性冠心病患者冠状动脉狭窄程度的影响。方法采用单中心、自身前后对照的临床设计,入选2014年10月—2016年9月就诊于中国中医科学院西苑医院心血管专病门诊的67例稳定性冠心病患者,在西药规范化治疗基础上辨证加用中药汤剂口服,每次100～150m L,每日2次,每4周根据辨证调整处方1次,服药至少24周/年,观察1年。观察治疗前后患者冠状动脉狭窄程度、心绞痛计分及欧洲健康量表评分[包括健康五维描述系统(EQ-5D)、视觉模拟标尺得分(EQ-VAS)评分]。结果 1年随访中,3例患者未能坚持服用中药,4例患者未行冠状动脉计算机断层扫描造影(CTA)复查,最终纳入分析60例患者。治疗1年后与治疗前比较,患者冠状动脉Gensini评分、冠状动脉最重狭窄程度和心绞痛计分均降低(P <0. 05,P <0. 01),EQ-5D和EQ-VAS评分较治疗前提高(P <0. 01,P <0. 05)。结论中医辨证结合西医常规治疗可降低稳定性冠心病患者冠状动脉狭窄程度,改善心绞痛症状,提高患者生活质量。Objective To observe the effect of combination of Chinese medicine and Western medical routine therapy on coronary stenosis of stable coronary heart disease( CHD) patients. Methods A self-control study was performed,67 diagnosed stable CHD patients were enrolled in Xiyuan Hospital from October 2014 to September 2016. The patients were treated with Chinese medicine and routine Western medicine,and Chinese medicine was administrated 100 ~ 150 m L each time,twice daily and adjusted every 4 weeks according to syndrome differentiation. The frequency of taking Chinese medicine was at least 24 weeks a year,and the period of follow-up was 1 year. The stenosis of coronary artery was observed,and the scores of angina,European Questionnaire 5 Dimension( EQ-5 D) as well as European Questionnaire Visual Analogue Scale( EQVAS) were calculated before and after 1 year treatment. Results During the follow-up,3 patients failed to insist on taking Chinese medicine and 4 patients did not reexamine coronary computed tomography angiography( CTA),and finally 60 stable CHD patients were included in the analysis. After 1 year’s treatment,the scores of angina,Gensini and the most severe stenosis of coronary decreased(P < 0. 05,P < 0. 01),and the scores of EQ-5 D and EQ-VAS increased(P < 0. 05,P <0. 01). Conclusions Combination of Chinese medicine and Western medical routine therapy significantly reduced the stenosis of coronary and improved the life quality of stable CHD patients.

关 键 词：中医辨证治疗 稳定性冠心病 冠状动脉Gensini评分 自身对照研究 

分 类 号：R541.4[医药卫生—心血管疾病]