通脉降浊颗粒辅助干预冠脉血运重建术后再发心绞痛患者临床疗效及对生活质量的影响  

Clinical efficacy of Tongmai Jiangzhuo Granule(通脉降浊颗粒)in Adjuvant Treatment of Patients with Recurrent Angina Pectoris after Coronary Revascularization and Its Influence on Quality of Life

作　　者：何璠玙 王凤荣[2] 王帅[2] 史海蛟[2] 陈维[2] 杨荣来 王金梁[2] 景雅婷 HE Fanyu;WANG Fengrong;WANG Shuai;SHI Haijiao;CHEN Wei;YANG Ronglai;WANG Jinliang;JING Yating(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China;Liaoning Traditional Chinese Medicine of Jiahe,Shenyang 110000,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110032 [3]辽宁中医嘉和医院,辽宁沈阳110000

出　　处：《中华中医药学刊》2022年第4期154-158,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81874415);国家中医药管理局重大疑难疾病中西医临床协作项目(国中医药办医政发[2018]3号);辽宁省中医药临床学(专)科能力建设项目(LNZYXZK201908)。

摘　　要：目的观察通脉降浊颗粒治疗冠脉血运重建术后再发心绞痛患者的临床有效性及生活质量的影响。方法采用多中心、区组随机、双盲、安慰剂对照方法,选取120例2019年8月—2020年6月就诊于辽宁省内4家三甲医院心内科的冠脉血运重建术后再发心绞痛患者,分为治疗组和对照组各60例。在西医标准化治疗的基础上,治疗组予以通脉降浊颗粒,对照组予以通脉降浊颗粒模拟剂,比较0周、12周两组患者心绞痛疗效、血脂、左室射血分数(LVEF)、室间隔厚度(IVS)、中医证候积分与不良事件发生率,并观察0周、12周及20周两组患者SAQ量表评分变化。结果治疗后治疗组与对照组临床有效率比较差异有统计学意义(P<0.05),总有效率为85.00%(51/60);治疗组心绞痛疗效积分明显下降,持续时间改善,优于对照组(P<0.05);治疗组血清TC、对照组血清TC与LDL-C均有所降低,差异具有统计学意义(P<0.05);治疗组患者LVEF显著提升,与对照组比较差异有统计学意义(P<0.05),IVS减低,与对照组比较差异无统计学意义(P>0.05);中医证候在眩晕、肢麻沉重方面,治疗组明显优于对照组(P<0.01),治疗组中医证候积分(12周)为11.48±6.81,明显低于对照组(P<0.05);治疗组患者SAQ评分提升,与对照组比较PL、AS、AF维度差异有统计学意义(P<0.01),TS、DS维度差异有统计学意义(P<0.05)。结论通脉降浊颗粒能有效缓解冠脉血运重建术后患者的心绞痛症状,改善患者痰浊血瘀中医证候,提升预后生活质量。Objective To observe the effect of Tongmai Jiangzhuo Granules(通脉降浊颗粒)on the clinical efficacy and quality of life of patients with angina pectoris after coronary revascularization.Methods A total of 120 patients with coronary revascularization who were admitted to the department of cardiology in 4 class A hospitals in Liaoning province from August 2019 to June 2020 were selected by multi-center randomized control method.The patients were randomly divided into treatment group and control group with 60 cases in each group.On the basis of standardized treatment of western medicine,the treatment group was treated with Tongmai Jiangzhuo Granule.The control was treated with Tongmai Jiangzhuo Granule Simulated Medicine.The angina pectoris curative effect,blood lipid,left ventricular ejection fraction(LVEF),thickness of interventricular septum(IVS),TCM syndrome integral and the incidence of adverse events of two group in the 0 and 12 weeks were compared.The SAQ rating scale changes in both groups of 0,12 and 20 weeks were observed.Results After treatment,there was a significant difference in clinical effective rate between the treatment group and the control group(P<0.05).The total effective rate was 85.00%(51/60).The curative effect score of angina pectoris in the treatment group was significantly decreased,and the duration of angina pectoris in treatment group was improved,which was better than that in the control group(P<0.05).The serum TC of the treatment group and the serum TC and LDL-C of the control group were decreased,and the difference was statistically significant(P<0.05);LVEF in the treatment group was significantly increased compared with that of the control group(P<0.05),and IVS was decreased,but there was no significant difference compared with that of the control group(P>0.05).The TCM syndromes(vertigo,heavy limb numb)in the treatment group were significantly better than those in the control group(P<0.01)(P<0.05).The TCM syndromes score in the treatment group(12 weeks)was 11.48±6.81,which was

关 键 词：冠脉血运重建术后再发心绞痛 通脉降浊颗粒 随机对照实验 临床疗效 生活质量 

分 类 号：R259.414[医药卫生—中西医结合]