理气化瘀祛痰法辅助曲美他嗪对稳定性心绞痛气滞血瘀兼痰湿证患者心功能及血清炎症因子的影响  

Effect of LiqiHuayuQutan Assisted with Trimetazidine on Cardiac Function and Serum Inflammatory Factors in Patients with Stable Angina Pectoris of Qi Stagnation,Blood Stasis and Phlegm-dampness Syndrome

作　　者：赖振岸 林泽辉[2] 王明霞 徐雪怡 郑育秀 LAI Zhen-an;LIN Ze-hui;WANG Ming-xia;XU Xue-yi;ZHENG Yu-xiu(Department of Medical Rehabilitation,Hainan ProvincialAnning Hospital,The Fourth People′s Hospital of Hainan,Haikou Hainan 570000;Emergency Department of Hainan Traditional Chinese MedicineHospital,Haikou Hainan 570100;Department of Neurology,Hainan ProvincialAnning Hospital,The Fourth People′s Hospital of Hainan,Haikou Hainan 570000;The Second Affiliated Hospital of Hainan Medical University,Haikou Hainan 570311)

机构地区：[1]海南省安宁医院,海南省第四人民医院医学康复科,海南海口570000 [2]海南省中医院急诊科,海南海口570100 [3]海南省安宁医院,海南省第四人民医院神经内科,海南海口570000 [4]海南医学院第二附属医院,海南海口570311

出　　处：《世界中西医结合杂志》2022年第9期1837-1842,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：海南省科学技术厅重点研发计划项目(zdyf2018169)。

摘　　要：目的观察理气化瘀祛痰之法辅助曲美他嗪治疗稳定性心绞痛气滞血瘀兼痰湿证临床价值。方法选取2018年10月—2020年12月期间海南省安宁医院收治的104例气滞血瘀兼痰湿型稳定性心绞痛患者作为研究对象,采用随机数字表法分为对照组和治疗组,每组各52例。两组均给予常规基础治疗,在此基础上,对照组给予盐酸曲美他嗪片治疗,治疗组给予理气化瘀祛痰之法辅助曲美他嗪治疗。治疗8周后,观察比较两组患者临床疗效、中医证候疗效、硝酸甘油减停率、治疗安全性及治疗前后中医证候积分、心功能[左室收缩末期容积(Left ventricular end systolic volume,LVESV)、左室舒张末期容积(Left ventricular end diastolic volume,LVEDV)、左室射血分数(Left ventricular ejection fraction,LVEF)]、血清炎症因子[白细胞介素-1β(Interleukin-1β,IL-1β)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)]水平变化。结果治疗后治疗组总有效率为92.31%(48/52)明显高于对照组78.43%(40/51),差异有统计学意义(P<0.05)。治疗后两组患者主症、次症、总分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组主症、次症、总分明显低于对照组,差异有统计学意义(P<0.05)。治疗后治疗组中医证候疗效总有效率92.31%(48/52)高于对照组69.63%(35/51),差异有统计学意义(P<0.05)。治疗后两组患者LVESV、LVEDV均较治疗前降低,LVEF均较治疗前升高,差异有统计学意义(P<0.05);且治疗组LVESV、LVEDV明显低于对照组,LVEF明显高于对照组,差异有统计学意义(P<0.05)。治疗后治疗组硝酸甘油减停率94.23%(49/52)明显高于对照组78.43%(40/51),差异有统计学意义(P<0.05)。治疗后两组患者血清IL-1β、TNF-α水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组血清IL-1β、TNF-α水平明显低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者血常规、尿常规、便常规及肝肾功�Objective To explore the clinical value of LiqiHuayuQutan assisted withtrimetazidine in the treatment of stable angina pectoris of qi stagnation,blood stasis and phlegm-dampness syndrome.Methods A total of 104 patients with stable angina pectoris of qi stagnation,blood stasis and phlegm-dampness syndrome admitted to Hainan Provincial Anning Hospital from October 2018 to December 2020 were selected as the study objects,and were divided into control group(52 cases)and treatment group(52 cases)by random number table.Both groups received conventional basic treatment.On this basis,the control group was given trimetazidine hydrochloride tablets,andthe treatment group was given LiqiHuayuQutan assisted with trimetazidine.After 8 weeks of treatment,the disease efficacy,traditional Chinese medicine(TCM)syndrome efficacy,nitroglycerin discontinuation rate,treatment safety,TCM syndrome score before and after treatment,cardiac function[left ventricular end systolic volume(LVESV),left ventricular end diastolic volume(LVEDV),left ventricular ejection fraction(LVEF)]and serum inflammatory factor[interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)]were compared between the two groups.Results(1)Completion:One case in the control group was lost to follow-up without clear reasons,and it was determined as falling off and was excluded.Finally,51 cases were included in the control group and 52 in the treatment group.(2)Disease efficacy:The total effective rate of the treatment group was 92.31%(48/52)higher than 78.43%(40/51)of the control group(P<0.05).(3)TCM syndrome score:After treatment,the major symptoms,minor symptoms and total scores of the two groups were lower than those before treatment(P<0.05),and the treatment group had more reduction than the control group(P<0.05).(4)TCM syndrome efficacy:The total effective rate of the treatment group was 92.31%(48/52)higher than 69.63%(35/51)of the control group(P<0.05).(5)Cardiac function:After treatment,LVESV and LVEDV of the two groups were lower and LVEF was higher than those

关 键 词：稳定性心绞痛 气滞血瘀兼痰湿证 理气化瘀祛痰之法 曲美他嗪 心功能 炎症因子 

分 类 号：R541.4[医药卫生—心血管疾病]