小柴胡汤加减治疗经皮冠状动脉介入治疗后心绞痛气郁血瘀证的临床疗效及对血脂、血液流变学的影响  

Clinical observation of modified Xiaochaihu decoction on angina pectoris after percutaneous coronary intervention and its effect on blood lipid and hemorheology

作　　者：张学新[1] 刘艳军[1] 李权[1] ZHANG Xuexin;LIU Yanjun;LI Quan(Department of Cardiology,Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao,Hebei 066000)

机构地区：[1]河北省秦皇岛市中医医院心血管科,河北秦皇岛066000

出　　处：《河北中医》2020年第7期990-994,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2015年度中医药类科研计划课题(编号:2015066)。

摘　　要：目的观察小柴胡汤加减治疗经皮冠状动脉介入治疗(PCI)后心绞痛气郁血瘀证的临床疗效及对血脂、血液流变学的影响。方法将122例PCI后心绞痛患者按照随机数字表法分为2组。对照组61例予常规西药治疗,治疗组61例在对照组治疗基础上应用小柴胡汤加减治疗。2组均治疗3周。比较2组心电图疗效、硝酸甘油使用疗效;比较2组治疗前后血脂指标、血液流变学指标变化;比较2组治疗前后中医证候评分变化。结果治疗组心电图总有效率86.89%(53/61),对照组心电图总有效率57.38%(35/61),治疗组心电图疗效优于对照组(P<0.05)。治疗组硝酸甘油使用总有效率85.24%(52/61),对照组硝酸甘油使用总有效率59.02%(36/61),治疗组硝酸甘油使用疗效优于对照组(P<0.05)。2组治疗后总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后血浆黏度、全血黏度(低切)、全血黏度(高切)均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后各项中医证候评分及总评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。结论小柴胡汤加减治疗PCI后心绞痛,能提高心电图疗效,减少硝酸甘油用量,改善血脂、血液流变学指标。Objective To observe the effect of modified Xiaochaihu decoction on angina pectoris after percutaneous coronary intervention(PCI)and its effect on blood lipid and hemorheology.Methods 122 patients with angina pectoris after PCI were randomly divided into two groups according to the random number table method.61 cases in the control group were treated by conventional western medicine.61 cases in the treatment group were treated by Xiaochaihu decoction on the basis of the control group.Both groups were treated for 3 weeks.The ECG efficacy and nitroglycerin use effect of the two groups were compared.The changes of blood lipid indexes and hemorheology indexes before and after treatment were compared.The changes of TCM syndrome scores before and after treatment were compared between the two groups.Results The total effective rate of ECG in the treatment group was 86.89%(53/61),and that in the control group was 57.38%(35/61).The curative effect of the treatment group was better than that of the control group(P<0.05).The total effective rate of nitroglycerin in the treatment group was 85.24%(52/61),while that in the control group was 59.02%(36/61).The therapeutic effect of nitroglycerin in the treatment group was better than that in the control group(P<0.05).After treatment,total cholesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)in the two groups were lower than those before treatment(P<0.05),and the decrease in the treatment group was more obvious(P<0.05).The plasma viscosity,whole blood viscosity(low shear),whole blood viscosity(high shear)in the two groups after treatment were lower than those in the group before treatment(P<0.05),and the decrease in the treatment group was more obvious(P<0.05).After treatment,the TCM syndrome scores and total scores of the two groups were lower than those before treatment(P<0.05),and the decrease in the treatment group was more obvious(P<0.05).Conclusion The modifid Xiaochaihu decoction in the treatment of angina pectoris after PCI can improve the effect

关 键 词：心绞痛 小柴胡汤 血管成形术 气囊 冠状动脉 支架 

分 类 号：R541.42[医药卫生—心血管疾病] R289.5[医药卫生—内科学]