参芪通脉汤结合西医常规疗法治疗稳定型心绞痛气虚血瘀证临床研究  

Clinical effect of Shenqi-Tongmai decoction in stable angina pectoris patients with Qi-deficiency-blood-stasis syndrome and the influence on levels of serum associated adhesion factors

作　　者：陶红琴 史志勇 安伟华 Tao Hongqin;Shi Zhiyong;An Weihua(Department of Medicine, Xinle Traditional Chinese Medicine Hospital, Xinle 050700, Chin)

机构地区：[1]河北省新乐市中医医院内二科,050700 [2]河北省新乐市中医医院放射科,050700

出　　处：《国际中医中药杂志》2018年第6期494-498,共5页International Journal of Traditional Chinese Medicine

摘　　要：目的 评价参芪通脉汤结合西医常规疗法治疗稳定型心绞痛（stable angina pectoris,SAP）气虚血瘀证的疗效.方法 将符合入选标准的110例SAP患者按随机数字表法分为2组,每组55例.对照组采用西医规范化治疗,治疗组在对照组基础上加服参芪通脉汤.2组均连续治疗4周.采用ELISA法测定血清可溶性细胞间黏附分子-1（soluble intercellular adhesion molecule-1,sICAM-1）和可溶性血管细胞间黏附分子-1（soluble vascular cell adhesion molecule-1,sVCAM-1）水平.采用西雅图心绞痛量表（Seattle Angina Questionnaire,SAQ）评价患者特定的功能状态及生活质量;按主次症进行中医证候评分;检测心电图,记录ST段下移、T波低平和T波倒置导联数,评价临床疗效.结果 治疗组心绞痛疗效总有效率为91.0%（50/55）,对照组为76.4%（42/55）,2组比较差异有统计学意义（χ2=4.251,P=0.039）.治疗组心电图疗效总有效率为92.7%（51/55）,对照组为78.2%（43/55）,2组比较差异有统计学意义（χ2=4.681,P=0.030）.治疗后,治疗组SAQ评分[（76.8±10.5）分比（67.4±10.1）分,t=4.805]高于对照组（P〈0.01）,中医证候评分[（7.1±2.2）分比（11.4±3.0）分,t=8.590]低于对照组（P〈0.01）;治疗组ST段下移导联数[（2.7±0.6）个比（3.2±0.6）个,t=4.067]、T波低平导联数[（1.7±0.3）个比（2.1±0.3）个,t=6.807]、T波倒置导联数[（1.7±0.3）个比（2.1±0.2）个,t=9.098]均低于对照组（P〈0.01）.治疗后,治疗组血清sICAM-1[（227.69±42.81）ng/ml比（275.33±48.62）ng/ml,t=5.454]、sVCAM-1[（272.04±39.87）ng/ml比（296.58±42.60）ng/ml,t=3.127]水平均低于对照组（P〈0.01）.结论 参芪通脉汤结合西医常规疗法可有效改善SAP气虚血瘀证患者心电图检查指标,提高临床疗效.Objective To investigate the effect of Shenqi-Tongmai decoction in Stable Angina pectoris Patients with Qi-deficiency-blood-stasis syndrome and the influence on serum associated adhesion factors. Methods A total of 110 patients with stable angina pectoris treated in the department of cardiology of traditional Chinese medicine hospital of Xinle city from Feb. 2015 to Feb. 2017 were divided into 2 groups according to the number random table method, with 55 in each group. All the patients were given the standardized treatment with western medicine, and the treatment group were aditionally treated with the Shenqi-Tongmai decoction. All the patients were treated for a course of 4 weeks. The TCM syndrome score, Seattle angina questionnaire （SAQ） score, electrocardiographic examination index and serum soluble intercellular adhesion molecule 1 （sICAM-1）, soluble vascular cell adhesion molecule 1 （sVCAM-1） level of the two groups before and after treatment were compared, and the clinical curative effect of the two groups was compared. Results The TCM syndrome score （7.1 ± 2.2 vs. 11.4 ± 3.0, t=8.590）, serum sICAM-1 （227.69 ± 42.81 ng/ml vs. 275.33 ± 48.62 ng/ml, t=5.454） level, serum sVCAM-1 （272.04 ± 39.87 ng/ml vs. 296.58 ± 42.60 ng/ml, t=3.127） level and lead ecg ST segment down number （2.7 ± 0.6 vs. 3.2 ± 0.6, t=4.067）, T wave of low lead numbers （1.7 ± 0.3 vs. 2.1 ± 0.3, t=6.807）, numbers of T wave inversion lead （1.7 ± 0.3 vs. 2.1 ± 0.2, t=9.908） of the treatment group were significantly lower than those of the control group （P〈0.01）. The SAQ scores （76.8 ± 10.5 vs. 67.4 ± 10.1, t=4.805） was higher than that of the control group （P〈0.01）. The curative effect of angina pectoris and electrocardiogram of the treatment group were 91.0% （50/55） and 92.7%（51/55）, and the control group were 76.4% （42/55） and 78.2% （43/55）. The difference was statistically significant between the two groups （χ2=4.251, 4.681, P〈0.05）. Conclusions Traditi

关 键 词：心绞痛 稳定型 气虚血瘀证 参芪通脉汤 可溶性细胞间黏附分子-1 可溶性血管细胞间黏附分子-1 

分 类 号：R541.4[医药卫生—心血管疾病]