温阳益气复脉汤治疗心肾阳虚证不稳定型心绞痛临床研究  

Clinical Study of Wenyang Yiqi Fumai Decoction(温阳益气复脉汤)in Treatment of Unstable Angina Pectoris of Heart-kidney Yang Deficiency Syndrome

作　　者：费松柏 陈小霞 马可忠 刘娟 龚芳 FEI Songbai;CHEN Xiaoxia;MA Kezhong;LIU Juan;GONG Fang(Yunxi County People’s Hospital,Shiyan 442600,China;Xiangyang Central Hospital,Affiliated Hospital of Hubei University of Arts and Science,Xiangyang 441021,China)

机构地区：[1]郧西县人民医院,湖北十堰442600 [2]湖北文理学院附属医院襄阳市中心医院,湖北襄阳441021

出　　处：《山东中医杂志》2021年第3期275-279,共5页Shandong Journal of Traditional Chinese Medicine

基　　金：湖北省自然科学基金项目(编号:2013CFB115)。

摘　　要：目的:探讨温阳益气复脉汤治疗心肾阳虚证不稳定型心绞痛的疗效及作用机制。方法:将纳入的70例患者按随机数字表法分为对照组和观察组各35例。对照组予常规西药治疗,观察组在此基础上予温阳益气复脉汤口服,均治疗4周。比较两组临床疗效,记录治疗前后心绞痛发作情况及治疗后两组Braunwald心绞痛分级情况,测定左心射血分数(LVEF)、每搏量(SV)等心功能指标,评定中医证候积分,测定患者血清同型半胱氨酸(HCY)、瘦素(LEP)水平。结果:总体疗效观察组明显高于对照组(P<0.05);治疗后,两组患者心绞痛发作频率、心绞痛持续时间均明显降低(P<0.05),且观察组均优于对照组(P<0.05);治疗后,观察组心绞痛分级优于对照组(P<0.05);治疗后,两组患者LVEF、SV均明显升高(P<0.05),且观察组均优于对照组(P<0.05);治疗后,观察组中医证候积分明显降低(P<0.05),且明显低于对照组(P<0.05);治疗后,观察组血清HCY、LEP水平明显降低(P<0.05),且低于对照组(P<0.05)。结论:温阳益气复脉汤治疗不稳定型心绞痛心肾阳虚证疗效确切,可明显减少心绞痛发作频次及持续时间,改善心绞痛分级及心功能,缓解临床症状,其机制可能与调节血清HCY、LEP水平有关。Objective:To explore the clinical efficacy and mechanism of Wenyang Yiqi Fumai Decoction(温阳益气复脉汤)in treatment of unstable angina pectoris of heart-kidney yang deficiency syndrome.Methods:A total of 70 cases were randomly divided into the control group(35 cases)and the treatment group(35 cases).The control group was given conventional western medicine treatment.Based on the western medicine treatment,the treatment group was given Wenyang Yiqi Fumai Decoction.Both groups were treated for four weeks.The curative efficacy of the two groups were compared.The general condition of unstable angina pectoris attack and Braunwald classification were recorded.Left ventricular ejection fraction(LVEF)and stroke volume(SV)were assessed.Traditional Chinese medicine(TCM)syndrome score was evaluated.The serum level of homocysteine(HCY)and leptin(LEP)was measured.Results:The effective rate in the treatment group was higher than that in the control group(P<0.05).After treatment,frequency of angina attacks and duration of angina pectoris in two groups were decreased(P<0.05).Frequency of angina attacks and duration of angina pectoris in the treatment group was better than that in the control group(P<0.05).Braunwald classification in the treatment group was better than that in the control group(P<0.05).After treatment,LVEF and SV in two groups were increased(P<0.05).LVEF and SV in the treatment group was better than that in the control group(P<0.05).After treatment,TCM syndrome score in the treatment group was decreased(P<0.05),and was lower than that in the control group(P<0.05).After treatment,the serum level of HCY and LEP in the treatment group was decreased(P<0.05),and was lower than that in the control group(P<0.05).Conclusions:The curative efficacy of Wenyang Yiqi Fumai Decoction on unstable angina pectoris of heart-kidney yang deficiency syndrome is definite.It can reduce the frequency of angina attacks and the duration of angina pectoris,improve Braunwald classification and cardiac function,and relieve clinical s

关 键 词：温阳益气复脉汤 心肾阳虚证 不稳定型心绞痛 胸痹 同型半胱氨酸 瘦素 心功能分级 

分 类 号：R259.414[医药卫生—中西医结合]