加味丹参饮治疗冠心病心绞痛伴抑郁焦虑状态(气滞血瘀型)的临床随机对照试验  

Clinical Randomized Controlled Trial of Modified Danshen Decoction for the Treatment of Angina Pectoris of Coronary Heart Disease Complicated with Depression and Anxiety and Differentiated as Syndrome of Qi Stagnation and Blood Stasis

作　　者：董正 张羽嘉 陈会君[2] DONG Zheng;ZHANG Yu-Jia;CHEN Hui-Jun(Heilongjiang University of Chinese Medicine,Harbin 150040 Heilongjiang,China;The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150001 Heilongjiang,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第二医院,黑龙江哈尔滨150001

出　　处：《广州中医药大学学报》2021年第7期1329-1334,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：第四批全国中医(临床、基础)优秀人才研修项目(编号:J20184832009);黑龙江中医药大学优秀青年学术带头人支持计划(编号:2018RCD23)。

摘　　要：【目的】观察加味丹参饮治疗冠心病心绞痛伴抑郁焦虑状态(气滞血瘀型)患者的临床疗效。【方法】将60例冠心病心绞痛伴抑郁焦虑状态(气滞血瘀型)患者随机分为对照组和治疗组,每组各30例。2组患者均给予抗凝、降压、调血脂、扩张冠脉和抗抑郁等常规西医治疗,治疗组同时给予加味丹参饮治疗,疗程为4周。观察2组患者治疗前后中医证候积分、汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评分的变化情况,并评价2组患者的心绞痛疗效、HAMD和HAMA疗效及安全性。【结果】(1)心绞痛疗效方面:治疗4周后,治疗组的总有效率为93.33%(28/30),对照组为80.00%(24/30),组间比较,治疗组的心绞痛疗效明显优于对照组,差异有统计学意义(P<0.05)。(2)中医证候积分方面:治疗后,2组患者的中医证候积分均较治疗前明显降低(P<0.05),且治疗组的降低作用明显优于对照组,差异有统计学意义(P<0.05)。(3)HAMD和HAMA评分方面:治疗后,2组患者的HAMD和HAMA评分均较治疗前明显降低(P<0.05),且治疗组的降低作用均明显优于对照组,差异均有统计学意义(P<0.05)。(4)HAMD和HAMA疗效方面:治疗4周后,治疗组HAMD疗效和HAMA疗效的总有效率分别为90.00%(27/30)、83.33%(25/30),对照组分别为76.67%(23/30)、70.00%(21/30);组间比较,治疗组的HAMD疗效和HAMA疗效均优于对照组,差异均有统计学意义(P<0.05)。(5)安全性方面:试验组的不良反应发生率为3.33%(1/30),略低于对照组的16.67%(5/30),但组间比较,差异无统计学意义(P>0.05)。【结论】在常规西医治疗基础上联合加味丹参饮治疗冠心病心绞痛伴抑郁焦虑状态(气滞血瘀型)患者疗效确切,可有效缓解患者心绞痛症状,改善患者抑郁焦虑状态,其疗效优于常规西医治疗。Objective To observe the clinical effect of modified Danshen Decoction for the treatment of angina pectoris of coronary heart disease(CHD)complicated with depression and anxiety and differentiated as the syndrome of qi stagnation and blood stasis.Methods Sixty patients with CHD angina pectoris complicated with depression and anxiety and differentiated as the syndrome of qi stagnation and blood stasis were randomly divided into control group and treatment group,30 cases in each group.Both groups were given conventional western medicine treatment for counteracting coagulation,lowering blood pressure,regulating blood lipid level,dilating the coronary artery and relieving depression.In addition to the above treatment,the treatment group was given oral use of modified Danshen Decoction.The treatment course lasted 4 weeks.Before and after treatment,traditional Chinese medicine(TCM)syndrome scores,Hamilton Depression Scale(HAMD)scores,and Hamilton Anxiety Scale(HAMA)scores in the two groups were examined.Meanwhile,the clinical efficacy for angina pectoris,HAMD scores and HAMA scores and the clinical safety in the two groups were evaluated.Results(1)The total effective rate for angina pectoris in the treatment group was 93.33%(28/30)and that in the control group was 80.00%(24/30).The intergroup comparison showed that the treatment group had stronger efficacy for angina pectoris than the control group,and the difference was statistically significant(P<0.05).(2)After treatment,TCM syndrome scores of the two groups were much decreased in comparison with those before treatment(P<0.05),and the decrease of TCM syndrome scores in the treatment group was superior to that in the control group,the difference being statistically significant(P<0.05).(3)The HAMD scores and HAMA scores of the two groups were markedly decreased in comparison with those before treatment(P<0.05),and the decrease in the treatment group was superior to that in the control group,the difference being statistically significant(P<0.05).(4)After 4 weeks of trea

关 键 词：加味丹参饮 冠心病心绞痛 抑郁焦虑状态 气滞血瘀型 

分 类 号：R259.414[医药卫生—中西医结合]