益气化痰活血法治疗急性冠脉综合征的临床研究  

Clinical Effect of Yiqi Huatan Huoxue Method on Acute Coronary Syndrome

作　　者：庄杰钦 戴杏珍 蔡海荣[1] 陈燕虹 金子淋 张浩波 陈伯钧 Zhuang Jieqin;Dai Xingzhen;Cai Hairong(Guangzhou University of Traditional Chinese Medicine,Guangdong,Guangzhou 510405,China)

机构地区：[1]广州中医药大学,广东广州510405 [2]广州中医药大学第二附属医院,广东广州510006

出　　处：《中国中医急症》2019年第9期1509-1512,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81273961)

摘　　要：目的观察运用益气化痰活血法治疗急性冠脉综合征患者的临床疗效,并探讨其作用机制。方法90例患者随机分为治疗组与对照组各45例。治疗组在指南规范的西医诊疗方案的基础上加经验性的益气化痰活血类中药治疗,对照组遵循指南单纯给予规范的西医诊疗,治疗时间各为14d。观察两组患者治疗前后心功能分级、西雅图心绞痛量表评分(SAQ)、中医症状总评分、超敏肌钙蛋白(cTnT)与脑钠肽前体(NT-proBNP)、超敏C反应蛋白(hs-CRP)的变化情况,出院后再随访6个月,记录再住院率及主要心血管不良事件发生率。结果两组治疗前心功能级别差异无统计学意义(均P>0.05)。两组治疗后心功能Ⅰ级例数较治疗前增加,心功能Ⅱ级例数较治疗前下降(均P<0.05);且治疗组优于对照组(P<0.05)。两组治疗前SAQ评分、中医症状总评分比较,均差异无统计学意义(均P>0.05)。治疗14d后,观察组SAQ评分高于对照组(P<0.05),观察组中医症状总评分低于对照组(P<0.05)。两组治疗前cTnT、NT-proBNP和血清hs-CRP水平比较,差异无统计学意义(均P>0.05)。两组治疗后cTnT与NT-proBNP、血清hs-CRP与治疗前比较均下降(均P<0.05),且治疗组治疗后cTnT与NT-proBNP、血清hs-CRP水平下降较对照组明显(均P<0.05)。在14d治疗期间内,两组不良反应发生率比较,差异无统计学意义(P>0.05)。随访6个月,治疗组再住院、再次心梗、顽固性心绞痛、心源性死亡发生均低于对照组(均P<0.05)。结论益气化痰活血法中医药对气虚痰瘀型ACS患者在减轻炎症反应、改善心肌缺血、心功能、心绞痛症状、生活质量及预后有明显疗效。Objective:To observe the clinical efficacy of Yiqi Huatan Huoxue Method on acute coronary syndrome(ACS).Methods:90 patients were randomly divided into the treatment group and the control group,45 cases in each.The control group was given standard Western medicine treatment.The treatment group was treated with traditional Chinese medicine of Yiqi Huatan Huoxue on that basis.The treatment last for 14 days.The changes of cardiac function grade,SAQ,TCM symptom total score,cTnT,nt-probnp and hs-CRP before and after treatment were observed.And the rate of readmission and the incidence of MACE were recorded in 6 months of followup after discharge.Results:There was no significant difference in cardiac function between the two groups before treatment(P > 0.05).After treatment,the number of patients with grade I of cardiac function increased and the number of patients with grade II of cardiac function decreased(all P < 0.05),and the treatment group was better than the control group(P < 0.05).Before treatment,there was no significant difference in SAQ score and total score of TCM symptoms between the two groups(P > 0.05).After 14 days of treatment,the SAQ score of the treatment group was higher than that of the control group(P < 0.05),and the total score of TCM symptoms of the treatment group was lower than that of the control group(P < 0.05).The levels of cTnT,NT-proBNP and hs-CRP in serum were not significantly different between the two groups before treatment(all P > 0.05).After treatment,those of both groups decreased compared with before treatment(all P < 0.05),and the decrease in treatment group was more obvious than that in control group(all P < 0.05).During 14 days of treatment,there was no significant difference in the incidence of adverse reactions between the two groups(P > 0.05).After 6 months of follow-up,the incidence of re-hospitalization,re-infarction,intractable angina pectoris and cardiogenic death in the treatment group were lower than those in the control group(all P < 0.05).Conclusion:Yiqi Huatan Huoxue

关 键 词：急性冠脉综合征 心绞痛 益气化痰活血法 中医药 

分 类 号：R541.4[医药卫生—心血管疾病]