解郁化痰饮对冠状动脉粥样硬化性心脏病患者PCI术后痰火内扰型焦虑、抑郁的影响研究  

Effects of Dispel Melancholy and Reduce Phlegm Decoction on Coronary Heart Disease Patients with Anxiety and Depression of Phlegm-fire Internal Disturbance After Percutaneous Coronary Intervention

作　　者：牛燕运[1] 王海霞[1] 秦晓敏 李瑞芳[1] 武珊珊 赵自冰 NIU Yanyun;WANG Haixia;QIN Xiaomin;LI Ruifang;WU Shanshan;ZHAO Zibing(Department of Cardiovascular Medicine,Handan City Hospital of Traditional Chinese Medicine,Handan Hebei 056001,China)

机构地区：[1]河北省邯郸市中医院心血管内科,河北邯郸056001

出　　处：《华南国防医学杂志》2022年第11期896-900,共5页Military Medical Journal of South China

基　　金：河北省中医药管理局科研计划项目(2021467)。

摘　　要：目的探讨解郁化痰饮对冠状动脉粥样硬化性心脏病经皮冠状动脉介入治疗术(percutaneous coronary intervention,PCI)术后痰火内扰型焦虑、抑郁患者中医证候、髓过氧化物酶(myeloperoxidase,MPO)、脂氧素A4(lipoxinA4,LXA4)、皮质醇(cortisol,COR)及5-羟色胺(5-hydroxytryptamine,5-HT)的影响。方法选择2020-09/2021-06月作者医院接诊的冠状动脉粥样硬化性心脏病PCI术后痰火扰心型焦虑、抑郁症患者86例,以双色球法分为对照组和观察组,各43例。对照组行常规西医治疗,观察组在对照组治疗方案的基础上加以解郁化痰饮。比较两组患者临床疗效、中医证候、焦虑抑郁情况、MPO、LXA4、COR、5-HT及不良反应发生情况。结果观察组临床疗效总有效率为95.35%,较对照组的79.07%更高(P<0.05)。治疗后两组中医证候评分、医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)焦虑、抑郁得分均低于治疗前(P均<0.05),且观察组均较对照组更低(P均<0.05)。治疗后,两组患者MPO、COR均低于治疗前(P均<0.05),且观察组较对照组更低(P均<0.05);LXA4、5-HT均高于治疗前(P均<0.05),且观察组较对照组更高(P均<0.05)。对照组共出现3例(6.98%)不良反应,观察组出现4例(9.30%),两组比较无统计学差异(P>0.05)。结论常规西医治疗基础上加以解郁化痰饮较常规西医治疗可提高PCI术后痰火内扰型焦虑、抑郁患者疗效,改善中医证候及MPO、LXA4等血象指标,且不增加不良反应发生率。Objective To explore the effects of dispel melancholy and reduce phlegm decoction on the traditional Chinese medicine syndromes,myeloperoxidase(MPO),lipoxinA4(LXA4),cortisol(COR)and 5-hydroxytryptamine(5-HT)of coronary heart disease patients with anxiety and depression of phlegm-fire internal disturbance after percutaneous coronary intervention(PCI).Methods A total of 86 patients with anxiety and depression of phlegm-fire internal disturbance after PCI in author′s hospital from September 2020 to June 2021 were divided into two groups with 43 cases in each by the two-color ball method.The control group was treated with conventional western medicine,and the observation group was treated with dispel melancholy and reduce phlegm decoction on the basis of the treatment in the control group.The clinical efficacy,traditional Chinese medicine syndromes,anxiety,depression,MPO,LXA4,COR,5-HT and the occurrence of adverse reactions were compared between the two groups of patients.Results The total clinical effective rate of the observation group was 95.35%,which was higher than the 79.07%of the control group(P<0.05).After treatment,the scores of traditional Chinese medicine syndromes,anxiety and depression score of hospital anxiety and depression scale(HADS)in the two groups were lower than those before(all P<0.05),and the observation group was lower than the control group(all P<0.05).After treatment,the levels of MPO and COR in the two groups were lower than those before treatment(all P<0.05),and the observation group was lower than the control group(all P<0.05);LXA4 and 5-HT were higher than those before(all P<0.05),and the observation group was higher than the control group(all P<0.05).There were 3 cases(6.98%)of adverse reactions in the control group and 4 cases(9.30%)in the observation group,and there was no significant difference between the two groups(P>0.05).Conclusion Compared with conventional western medicine,dispel melancholy and reduce phlegm decoction on the basis of routine western medicine treatment can imp

关 键 词：解郁化痰饮 冠状动脉粥样硬化性心脏病 经皮冠状动脉介入治疗术 焦虑 抑郁 

分 类 号：R521.7[医药卫生—内科学]