冠心通脉贴膏结合西医常规疗法治疗冠心病心绞痛痰瘀互结证临床研究  

Clinical observation of Guanxin Tongmai plaster combined with medicine in the treatment of stable angina pectoris of coronary heart disease

作　　者：唐晶 姜钧文[1] 肖蕾[1] 陈智慧 刘悦[1] 潘嘉祥 孔德昭[1] 孟繁丽 王琪格 张哲 Tang Jing;Jiang Junwen;Xiao Lei;Chen Zhihui;Liu Yue;Pan Jiaxiang;Kong Dezhao;Meng Fanli;Wang Qige;Zhang Zhe(Internal Medicine-Cardiovascular Department,the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China;Major Scientific Research Platform,Liaoning University of Traditional Chinese Medicine,Shenyang 110847,China)

机构地区：[1]辽宁中医药大学附属医院心内科,沈阳110032 [2]辽宁中医药大学重大科研平台,沈阳110847

出　　处：《国际中医中药杂志》2022年第3期257-262,共6页International Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81603504, 81703970);辽宁省教育厅科学技术研究项目(L201722)。

摘　　要：目的评价冠心通脉贴膏结合西医常规疗法治疗冠心病心绞痛痰瘀互结证临床疗效。方法将符合入选标准的2020年2-8月辽宁中医药大学附属医院心内科患者60例, 按随机数字表法分为2组, 每组30例。2组均给予西医常规疗法治疗, 治疗组在此基础上穴位贴敷冠心通脉贴膏, 对照组贴敷安慰剂贴膏。分别于治疗前后进行中医证候评分, 从心绞痛发作频次、持续时间、疼痛程度3个方面进行心绞痛积分评估, 采用酶定量法检测血清TG、TC、LDL-C、HDL-C, 酶循环法检测同型半胱氨酸(Hcy);行心电图检测, 记录硝酸甘油停减率, 行安全性指标检测, 评价心电图疗效。结果治疗期间, 治疗组脱落2例, 对照组脱落3例, 最终治疗组28例, 对照组27例进入疗效统计。治疗组心电图疗效总有效率为67.9%(19/28)、对照组为48.1%(13/27), 2组比较差异有统计学意义(χ^(2)=4.46, P=0.040)。治疗组治疗后中医证候评分、心绞痛积分均低于对照组(t值分别为9.12、4.45, P值分别为0.004、0.042);治疗组硝酸甘油停减率为82.1%(23/28)、对照组为55.6%(15/27), 2组比较差异有统计学意义(χ^(2)=4.72, P=0.030)。治疗后, 治疗组血清TG、TC、LDL-C水平低于对照组(t值分别为4.17、6.57、6.52, P<0.05或P<0.01), HDL-C水平高于对照组(t=7.07, P=0.010);血清Hcy水平低于对照组(t=6.70, P=0.012)。2组肝、肾及凝血功能组内及组间比较, 差异均无统计学意义(P>0.05)。结论冠心通脉贴膏结合西医常规疗法可有改善冠心病心绞痛患者的临床症状, 降低血脂及Hcy水平, 提高临床疗效。Objective To evaluate the clinical effect of Guanxin Tongmai plaster combined with conventional western medicine in the treatment of phlegm and blood stasis syndrome of coronary heart disease and angina pectoris.Methods A total of 60 patients in the Department of Cardiology of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine(TCM)from February to August 2020 who met the inclusion criteria were randomly divided into two groups with 30 in each group.Both groups were treated with conventional western medicine.On this basis,Guanxin Tongmai plaster was applied at the acupoints in the treatment group and placebo plaster was applied in the control group.TCM syndrome score was performed before and after treatment,angina score was evaluated from three aspects of angina attack frequency,duration and pain degree,and blood lipid TG,TC,LDL-C and HDL-C were detected by enzyme quantitative method.The blood homocysteine(Hey)was detected by enzyme circulation method,the ECG and the nitroglycerin reduction rate were recorded,and the safety index was detected according to the ECG changes.Results In the treatment period,2 patients in the treatment group fell off,3 in the control group.A total of 28 patients in the treatment group and 27 in the control group were analyzed.The total effective rate of ECG efficacy in the treatment group was 67.9%(19/28]and the control group was 48.1%(13/27).There was significant difference between the two groups(χ^(2)=4.46,P=0.040].After treatment,the TCM syndrome score and angina score in the treatment group were significantly lower than those in the control group(t values were 9.12 and 4.45,P values were 0.004 and 0.042,respectively).The reduction rate of nitroglycerin in the treatment group was 82.1%(23/28)and 55.6%(15/27)in the control group.There was significant difference between the two groups Q^=4.72,P=0.030).After treatment,the plasma TG,TC,LDL-C in the treatment group were significantly lower than those in the control group(t values were 4.17,6.57 and 6.52,P<0.05

关 键 词：心绞痛 稳定型 穴位贴敷疗法 冠心通脉贴膏 随机对照试验 

分 类 号：R541.4[医药卫生—心血管疾病]