复方丹参滴丸联合耳穴埋豆及穴位按摩对稳定性心绞痛的干预  

Effect of Compound Danshen Dripping Pills Combined with Auricular Point Sticking and Acupoint Massage on Stable Angina Pectoris

作　　者：黄春雨[1] 周果[2] 李刚[2] 吴建明[2] 徐雪梅[2] 崔红艳[2] 季燕华 耿桂灵[1] 

机构地区：[1]南通大学护理学院,江苏南通226001 [2]南通市第三人民医院,江苏南通226006

出　　处：《中国实验方剂学杂志》2017年第2期175-180,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：南通市市级科技计划(指导性)立项项目(HS13968);2014年度教育部人文社会科学研究一般项目(14YJAZH022)

摘　　要：目的:观察复方丹参滴丸联合耳穴埋豆及穴位按摩的长期干预,对稳定性心绞痛血瘀证生活质量和缺血事件的影响。方法:180例患者随机按就诊先后顺序,以数字表法分为观察组和对照组各90例。对照组在非药物干预的基础上,给予拜阿司匹林肠溶片,0.1 g/次,1次/d;瑞舒伐他汀钙片,5 mg/次,1次/d;硝苯地平缓释片,10 mg/次,1次/d;硝酸甘油片,0.5 mg/次,舌下含服,必要时使用。观察组在对照组西医常规治疗的基础上加服复方丹参滴丸,10丸/次,3次/d,舌下含服;和耳穴埋豆及穴位按摩。两组患者均进行6个月的治疗,并进行6个月的随访观察。进行治疗前后西雅图心绞痛量表(SAQ),血瘀证评分;记录硝酸甘油的停减率,记录心绞痛发作情况;进行心电图检查,记录12个月内缺血事件的发生情况,进行安全性评价。结果:观察组治疗心绞痛临床疗效总有效率为87.78%,对照组为74.44%,观察组高于对照组(χ~2=5.221,P<0.05);观察组心电图临床疗效总有效率为88.89%,对照组为76.67%,观察组高于对照组(χ~2=4.715,P<0.05);观察组中医证候疗效总有效率为90%,对照组为62.22%,观察组高于对照组(χ~2=19.096,P<0.05);治疗后观察组每月心绞痛发作次数和硝酸甘油用量均少于对照组(P<0.01);治疗后观察组SAQ量表的活动受限程度、心绞痛稳定状态、心绞痛发作情况、治疗满意程度及疾病认识程度评分和总分均高于对照组(P<0.01);观察组硝酸甘油停减率高于对照组(χ~2=4.357,P<0.05);观察组心脏缺血事件发生率为6.67%,低于对照组的17.78%(χ~2=5.178,P<0.05);两组患者不良反应的发生率组间比较无统计学差异。结论:在西医常规治疗的基础上,采用复方丹参滴丸联合耳穴埋豆及穴位按摩的中医综合措施长期防治SAP血瘀证患者,能减少心绞痛发生、减少硝酸甘油使用,改善症状,提高患者的生活质量,减少缺血事件发生,提高临床疗效,且安全性好Objective： To observe the effects of compound Danshen dripping pills combined with auricular point sticking and acupoint massage on the quality of life and ischemia events in patients with stable angina pectoris（ blood stasis syndrome）. Method： One hundred and eighty patients were randomly divided into control group（ 90 cases） and observation group（ 90 cases） by visiting sequence according to random number table. Based on non-drug intervention, patients in control group took Bayaspirin enteric-coated tablets,0. 1 g/time,1 time/day. Rosuvastatin calcium tablets,5 mg/time,1 time/day. Nifedipine tablets,10 mg/time,1 time/day; nitroglycerin tablets,sublingual buccal immunotherapy in necessity,0. 5 mg/time. Routine westem medicine on based the control group,patients in observation group added compound Danshen dripping pills,10 pills/time,3 times/day,sublingual buccal therapy. Combined with auricular point sticking and acupoint massage. The treatment course was 6 months for both groups,and 6 months of follow-up were recorded. Before and after treatment,scores of Seattle Angina Questionnaire（ SAQ） and blood stasis syndrome were graded. Stopping or reducing rate of the Nitroglycerin tablets and episode of angina were recorded. Electrocardiogram examination was taken and ischemia events in 12 months were recorded for safety evaluation. Result： The total clinical effective rate for angina pectoris was 87. 78% in observation group,higher than 74. 44% in control group（ χ^2= 5. 221,P〈0. 05）. The total clinical effective rate for electrocardiogram examination was 88. 89% in observation group,higher than 76. 67% in control group（ χ^2= 4. 715,P〈0. 05）. The total clinical effective rate for traditional Chinese medicine（ TCM） syndrome was 90% in observation group,higher than 62. 22% in control group（ χ^2= 19. 096,P〈0. 05）. After treatment,the onset number of angina pectoris and dosage of nitroglycerin in observation group were lower than those in control group for every month（ P〈0

关 键 词：稳定性心绞痛 血瘀证 复方丹参滴丸 生活质量 耳穴埋豆 穴位按摩 缺血事件 

分 类 号：R287[医药卫生—中药学]