瓜蒌薤白半夏汤合丹参饮治疗冠心病临床研究  

Clinical Study on Trichosanthes and Chinese Chive and Pinellia Decoction Combined with Salvia Beverage in the Treatment of Patients with Coronary Heart Disease

作　　者：唐鸣鸣 关键 TANG Ming-ming;GUAN Jian(Xixia Hospital of Traditional Chinese Medicine,Xixia,Henan,China,474500)

机构地区：[1]西峡县中医院,河南西峡474500

出　　处：《河南中医》2022年第7期982-986,共5页Henan Traditional Chinese Medicine

基　　金：河南省医学科技攻关项目(201702292)。

摘　　要：目的:观察瓜蒌薤白半夏汤合丹参饮治疗冠状动脉粥样硬化性心脏病(简称冠心病)的临床疗效。方法:将94例冠心病患者按照随机数字表法分为对照组与观察组,每组各47例。对照组口服阿司匹林肠溶片和硝酸异山梨酯片,观察组在对照组治疗的基础上给予瓜蒌薤白半夏汤合丹参饮治疗。比较两组患者的临床疗效及治疗前后中医证候积分、颈动脉血流动力学指标[收缩期最大血流速度(peak systolic velocity,PSV)、舒张末期血流速度(end-diastolic velocity,EDV)、阻力指数(resistance index,RI)以及搏动指数(pulsatility index,PI)]、心肌损伤标志物[肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)、心肌肌钙蛋白(cardiac troponin,cTn)、脑钠肽(brain natriuretic peptide,BNP)]、左心室功能[左心室射血分数(left ventricular ejection fraction,LVEF)、每搏指数(stroke index,SI)及心排量(cardiac output,CO)]等指标变化情况。结果:对照组有效率为76.60%,观察组有效率为91.49%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后各项中医证候积分均低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后PSV、EDV及PI高于本组治疗前,RI低于本组治疗前,且治疗后观察组PSV、EDV及PI均高于对照组,RI低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后CK-MB、cTn及BNP低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后LVEF、SI、CO高于本组治疗前,且治疗后观察组高于对照组,差异具有统计学意义(P<0.05)。结论:瓜蒌薤白半夏汤合丹参饮加减治疗冠心病,可有效缓解患者临床症状,改善颈动脉血流动力指标和左心室功能,降低心肌损伤。Objective:To observe the clinical efficacy of Trichosanthes and Chinese Chive and Pinellia Decoction combined with Salvia Beverage on coronary atherosclerotic heart disease(coronary heart disease).Methods:A total of 94 patients with coronary heart disease were randomly divided into the control group and and observation group,with 47 cases in each group.The control group was treated with Aspirin Enteric Coated Tablets and Isosorbide Nitrate Tablets,while the observation group was treated with Trichosanthes and Chinese Chive and Pinellia Decoction combined with Salvia Beverage on the basis of the treatment of the control group.The clinical efficacy,the changes of TCM syndrome score,carotid hemodynamic indexes[including peak systolic velocity(PSV),end diastolic velocity(EDV),resistance index(RI)and pulsatility index(PI)],myocardial injury markers[including creatine kinase isoenzyme(CK-MB),cardiac troponin(cTn),brain natriuretic peptide(BNP)],left ventricular function indexes[including left ventricular ejection fraction(LVEF),stroke index(SI)and cardiac output(CO)],etc.before and after treatment were compared between the two groups.Results:The effective rate was 76.60%in the control group and 91.49%in the observation group.There was significant difference between the two groups(P<0.05).The TCM syndrome scores of the two groups after treatment were lower than those before treatment,and the index of the observation group after treatment was lower than that of the control group,and the difference was statistically significant(P<0.05).After treatment,PSV,EDV and PI in the two groups were higher than those of the same group before treatment,while RI was lower than that of the same group before treatment,and PSV,EDV and PI in the observation group were higher than those in the control group,while RI was lower than that in the control group,and all the differences were statistically significant(P<0.05).After treatment,CK-MB,cTn and BNP of the two groups were lower than those of the same group before treatment,and the above

关 键 词：冠状动脉粥样硬化性心脏病 瓜蒌薤白半夏汤 丹参饮 阿司匹林肠溶片 硝酸异山梨酯片 中西医结合疗法 《金匮要略》 张仲景 

分 类 号：R259.414[医药卫生—中西医结合]