不同中医干预模式对冠心病心绞痛患者症状及生存质量的影响  

The Effect of Different Chinese Medicine Intervening Models on Symptoms and Quality of Life in Older Patients with Angina Pectoris

作　　者：许颖智[1] 张军平[1] 任淑女[1] 荣杰[1] 杨锡燕[1] 

机构地区：[1]天津中医药大学第一附属医院

出　　处：《中医杂志》2017年第6期493-497,共5页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(30901890);国家中医药管理局中医药行业科研专项(201007003-03)

摘　　要：目的观察不同中医干预模式对老年冠心病心绞痛患者的临床疗效。方法将164例老年冠心病心绞痛气虚血瘀证和气滞血瘀证患者随机分为辨证论治组和辨病通治组,每组82例。在西医常规治疗基础上,辨证论治组中气虚血瘀证患者予芪参益气滴丸0.9 g、气滞血瘀证患者予复方丹参滴丸0.27 g,每日3次口服;辨病通治组均予活血保心丸9 g,每日2次口服。两组均治疗4周。两组治疗前后采用西雅图心绞痛调查量表(SAQ)评价生存质量,治疗前及治疗后2、4周进行记录症状积分,并在治疗后评价临床疗效。结果辨证论治组临床疗效总有效率为84.15%,显著高于辨病通治组的60.98%(P<0.05),且辨证论治组中气虚血瘀证和气滞血瘀证患者疗效均分别优于辨病通治组的相应证型(P<0.05或P<0.01)。辨证论治组SAQ评分中躯体活动受限程度、心绞痛发作情况评分及总积分均高于辨病通治组(P<0.05或P<0.01)。治疗4周后两组症状积分均较治疗前显著降低,且辨证论治组低于辨病通治组(P<0.05)。结论与辨病通治干预模式比较,辨证论治干预模式治疗老年冠心病心绞痛能够更好地改善心绞痛症状及生存质量。Objective To observe clinical curative effect of different Chinese medicine intervening models in older patients with angina pectoris. Methods Totally 164 older patients with angina pectoris of Qi deficiency and blood stasis syndrome and Qi stagnation and blood stasis syndrome were randomly divided into a treatment based on syndrome differentiation group and a conventional treatment based on disease differentiation group, with 82 cases in each. In the treatment based on syndrome differentiation group, in addition to conventional treatment of western medicine, patient of Qi deficiency and blood stasis syndrome were given 0.9 g of Qishen Yiqi Droplet （芪参益气滴） orally, and patients of Qi stagnation and bh）od stasis syndrome were given 0.27 g of Compotutd Danshen Dripping Pills （复方丹参滴丸） orally, three times per day. the common treatment based on disease differentiation group was all given 9 g of Huoxue Baoxin Pill （活血保心丸） orally, twice per day. Two groups were both treated tbr 4 weeks. Before and after treatment, Seattle Angina Questionnaire （SAQ） was adopted to evaluate quality of life. Syndrome scores were recorded before treatment and at 2 or 4 weeks after treatment. Clinical curative effects were evaluated after treatment. Results The total clinical curative eft^ct in the treatment based on syndrome differentiation group was 84. 15%, which was significantly higher than 60.98% in the common treatment based on disease differentiation group （P 〈 0. 05）. And the curative effect rates in patients of Qi deficiency and blood stasis syndrome and Qi stagnation and blood stasis syndrome in the treatment based on syndrome differentiation group were all superior to those of the corresponding syndromes in the common treatment based on disease differentiation group （ P 〈 0. 05 or P 〈 0.01 ）. Physical limitation degree, angina condition score and total score in SAQ in the treatment based on syndrome differentiation group were all higher than those in the common treatm

关 键 词：冠心病 心绞痛 辨证论治 辨病通治 生存质量 

分 类 号：R259[医药卫生—中西医结合]