颜氏益心汤改良方治疗冠心病稳定性心绞痛气虚血瘀证临床观察  

Clinical effect of modified YanshiYixin Decoction on coronary heart diseasepatients with stable angina pectoris

作　　者：费鸿翔[1] 范俊飞 张翔宇[1] 颜乾麟[1] 韩天雄[1] FEI Hongxiang;FAN Junfei;ZHANG Xiangyu;YAN Qianlin;HAN Tianxiong(Department of Traditional Chinese Medicine,Tenth People's Hospital of Tongji University,Shanghai 200072)

机构地区：[1]同济大学附属第十人民医院中医科,上海200072

出　　处：《河北中医》2022年第4期554-558,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局“第六批全国老中医药学术经验继承工作”项目(国中医药人教发〔2017〕29号);上海市进一步加快中医药事业发展三年行动计划(2018年-2020年)建设项目[编号:ZY(2018-2020)-CCCX-1003];上海市进一步加快中医药事业发展三年行动计划(2018年-2020年)建设项目[编号:ZY(2018-2020)-ZYBZ-23]。

摘　　要：目的观察颜氏益心汤改良方治疗冠心病稳定性心绞痛(SAP)气虚血瘀证的临床疗效。方法将82例SAP气虚血瘀证患者按照随机数字表法分为2组。对照组41例予常规西医治疗,治疗组41例在对照组治疗基础上加颜氏益心汤改良方。2组均治疗2个月后统计心电图疗效和中医证候疗效。比较2组治疗前、治疗4周及治疗2个月加拿大心血管病学会(CCS)心绞痛严重程度、美国纽约心脏病协会(NYHA)心功能分级及硝酸甘油用量变化。比较2组治疗前后中医证候评分、超敏C反应蛋白(hs-CRP)及血脂指标总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平变化。结果治疗4周,2组CCS心绞痛严重程度分级及NYHA心功能分级与本组治疗前比较差异均无统计学意义(P>0.05),且组间同期比较差异也均无统计学意义(P>0.05);治疗2个月,2组CCS心绞痛严重程度分级及NYHA心功能分级均较本组治疗前降低,且治疗组低于对照组,比较差异均有统计学意义(P<0.05)。治疗4周,治疗组硝酸甘油用量较本组治疗前及对照组同期减少(P<0.05);治疗2个月,2组硝酸甘油用量均较本组治疗前减少(P<0.05),且治疗组低于对照组(P<0.05)。治疗2个月,2组胸痛、气短、神疲乏力评分及总积分均较本组治疗前降低(P<0.05),且治疗组均低于对照组(P<0.05)。治疗2个月,2组hs-CRP、TC、LDL-C水平均较本组治疗前降低(P<0.05),且治疗组hs-CRP水平低于对照组(P<0.05)。治疗组心电图总有效率70.7%(29/41),中医证候总有效率92.7%(38/41),对照组分别为48.8%(20/41)、75.6%(31/41),治疗组心电图总有效率及中医证候总有效率均高于对照组(P<0.05)。结论颜氏益心汤改良方能明显改善冠心病SAP气虚血瘀证患者心绞痛等临床症状,改善患者心功能,降低hs-CRP,改善心电图疗效指标。Objective To observe the clinical effect of modified YanshiYixin Decoction on coronary heart disease(CHD)patients with stable angina pectoris(SAP)of qi deficiency and blood stasis.Methods Totally 82 CHD patients with SAP(qi deficiency and blood stasis)were randomly divided into two groups,41 cases in each group;in addition to conventional western medicine,and the treatment group received modified YanshiYixin Decoction based on the control group.Treated for 2 months,aiming to assess electrocardiogram(ECG)efficacy and traditional Chinese medicine(TCM)syndrome.The aim was to compare the severity of angina pectoris,New York Heart Association(NYHA)classification,nitroglycerin dosage(within 1 week before each time point)on day 0,week 4 and month 2;TCM syndrome score,high-sensitivity C-reactive protein(hs-CRP),blood lipid indexes(total cholesterol[TC],triglyceride[TG],high density lipoprotein-cholesterol[HDL-C],low density lipoprotein-cholesterol[LDL-C]).Results On week 4,the difference was not statistically significant in the severity of angina pectoris and NYHA classification in groups(P>0.05),and with no statistically significant difference between groups(P>0.05).The severity of angina pectoris and NYHA classification on month 2 in groups were decreased(P<0.05),the treatment group was more common(P<0.05).The nitroglycerin dosage on week 4 in the treatment group was decreased compared with the concurrent control group(P<0.05),nitroglycerin dosage on month 2 in groups was decreased,which was lower in the treatment group than in the control group(P<0.05).After treatment,the scores of chest pain,shortness of breath,fatigue in groups were decreased(P<0.05),the treatment group was more prevalent(P<0.05);hs-CRP,TC,LDL-C in groups were decreased(P<0.05),hs-CRP was decreased in the treatment group in comparison with the control group(P<0.05);The overall effective rate of ECG and TCM syndrome in the treatment group was better than that in the control group(70.7%[29/41]vs 48.7%[20/41],92.7%[38/41]vs 75.6%[31/41],[P<0.05],respec

关 键 词：心绞痛 稳定型 中药疗法 临床试验 

分 类 号：R541.420.531[医药卫生—心血管疾病]