基于陈可冀院士血瘀证辨证方法治疗冠心病稳定性心绞痛的实用性随机对照研究  

Pragmatic Randomized Controlled Trial on Treating Stable Angina Pectoris of Coronary Heart Disease Based on Chen Ke-ji's Pattern Identification Methods of Blood-Stasis Syndrome

作　　者：王安璐 罗静[2] 于美丽 高翔 张贺 寇娜 车方远 陈卓 李金根 徐浩 史大卓 陈可冀 

机构地区：[1]北京中医药大学研究生院,北京100029 [2]中日友好医院中医风湿病科,北京100029 [3]北京市丰台区铁营医院中医科,北京100079 [4]北京中医医院顺义医院心血管科,北京101300 [5]中国中医科学院西苑医院心血管病中心,北京100091

出　　处：《中国中西医结合杂志》2017年第10期1174-1180,共7页Chinese Journal of Integrated Traditional and Western Medicine

基　　金："十二五"国家科技支撑计划项目(No.2013BAI13B01)

摘　　要：目的评价基于"陈可冀院士血瘀证辨证方法"论治冠心病稳定性心绞痛的有效性及安全性。方法本研究为实用性随机对照试验,采用分层区组随机方法,将300例冠心病稳定性心绞痛患者分为试验组和对照组,每组150例。在西医常规治疗基础上,试验组接受"陈可冀院士血瘀证辨证方法"指导的治疗,对照组接受常规血瘀证辨治方法,疗程共4周。观察两组治疗前后主要指标(包括血瘀证计分、心绞痛计分)和次要指标(包括硝酸甘油停减情况、西雅图心绞痛量表评分、血液流变性各指标及其降低值)变化及不良反应。结果最终纳入253例患者进行评价分析,试验组127例,对照组126例。与本组治疗前比较,试验组与对照组的血瘀证计分、心绞痛计分和血液流变学各指标均降低,西雅图心绞痛量表评分改善(P<0.05,P<0.01);与对照组治疗后比较,试验组心绞痛计分、西雅图心绞痛量表评分、血液黏度(120.0 s-1)降低值均优于对照组(P<0.05),治疗过程中未发现明显不良反应。结论基于"陈可冀院士血瘀证辨证方法"论治冠心病稳定性心绞痛安全有效,较常规血瘀证辨治方法具有一定优势。Objective To evaluate the effectiveness and safety of treatment based on ＂Chen Ke-ji＇s pattern identification （PI） methods of blood stasis syndrome （BSS）＂ for stable angina pectoris of coronary heart diseae. Methods Totally 300 patients with stable angina pectoris were randomly assigned to the experimental group and the control group using pragmatic randomized controlled trial （PRCT）, 150 cases in each group. All patients received routine Western medical treatment. Patients in the experimental group additionally took ＂Chen Ke-ji＇s PI methods of BSS ＂-guided treatment. Meanwhile, patients in the control group received ＂conventional diagnostic criterion of BSS＂-guided treatment. The treatment lasted for four successive weeks. The primary outcomes （ including BSS scores and scores of angina symptoms）, secondary outcomes E including reduction of nitroglycerin, Seattle Angina Questionnaire （SAQ） scores and hemorrhe- ology indexesl and adverse reactions were observed before and after treatment. Results Totally 253 ca- ses were available, 127 in the experimental group and 126 in the control group. Compared with before treat- ment, BSS scores ,scores of angina symptoms, and rheology indexes of blood in both groups were statisti-cally reduced in both groups ,as well as SAQ scores was improved in both groups （P 〈0.01, P 〈0.05）. Better effect in improving angina scores, SAQ scores, and the reduction level of blood viscosity （120 s-1 ） were obtained in the experimental group compared with the control group after treatment （P 〈0.05）. No adverse reaction occurred in the two groups during the treatment course. Conclusion Treatment based on ＂Chen Ke-ji＇s PI methods of BSS＂ was effective and safe in patients with stable angina pectoris, and had certain advantages compared with treatment based on ＂conventional diagnostic methods of BSS＂.

关 键 词：陈可冀 血瘀证 冠心病 辨证论治 实用性随机对照试验 

分 类 号：R259[医药卫生—中西医结合]