血府逐瘀胶囊对冠心病心绞痛患者西雅图心绞痛量表评分影响的多中心前瞻性队列研究  

Seattle Angina Questionnaire Changes of Patients with Coronary Heart Disease and Angina Pectoris Treated by Xuefu Zhuyu Capsules(血府逐瘀胶囊):A Multicenter Prospective Cohort Study

作　　者：于鲁 李珠 王朔 王旭 李琳[1] 高杉[1] 于春泉[1] YU Lu;LI Zhu;WANG Shuo;WANG Xu;LI Lin;GAO Shan;YU Chunquan(Tianjin University of Traditional Chinese Medicine,Tianjin,301617;Tianjin Medical University;Tianjin Chest Hospital)

机构地区：[1]天津中医药大学,天津市301617 [2]天津医科大学 [3]天津市胸科医院

出　　处：《中医杂志》2023年第2期146-152,共7页Journal of Traditional Chinese Medicine

摘　　要：目的评价血府逐瘀胶囊治疗冠心病心绞痛的临床疗效。方法通过多中心前瞻性队列研究,共纳入冠心病心绞痛患者543例,根据冠心病心绞痛患者是否使用血府逐瘀胶囊分为治疗组262例和对照组281例。对照组给予西医常规药物治疗,治疗组在西医常规药物治疗的基础上给予口服血府逐瘀胶囊(每粒0.4 g),每次6粒,每日2次。两组疗程均为8周。治疗前后比较两组患者西雅图心绞痛量表(SAQ)评分[包括躯体运动受限情况(PL)、心绞痛平稳状况(AS)、心绞痛发生状况(AF)、医疗满意度(TS)和病情认知能力(DP)],并对两组患者治疗后SAQ评分影响因素进行多元线性回归分析。根据不同类型(稳定型心绞痛和不稳定型心绞痛)、性别(男/女)、年龄段(<65岁和≥65岁)和合并高血压病情况(是/否)进一步比较两组患者治疗后SAQ评分情况。结果研究过程中脱落41例,最终纳入分析治疗组253例,对照组249例。与本组治疗前比较,治疗后两组SAQ中PL、AS、AF、TS和DP评分均明显升高,且治疗组SAQ各项评分均优于对照组(P<0.05)。与对照组比较,治疗后治疗组不稳定型心绞痛患者治疗后SAQ各项目评分均明显升高(P<0.05);治疗组男性患者治疗后AS、TS、DP评分和女性患者治疗后PL、AF明显升高(P<0.05);治疗组≥65岁患者治疗后PL、AS、DP升高,<65岁患者治疗后AS、AF、TS、DP评分均明显升高(P<0.05);治疗组合并高血压病患者治疗后SAQ各项评分均明显高于对照组合并高血压病患者(P<0.05)。经多重线性回归分析校正年龄、性别、合并疾病及治疗用药等潜在混杂因素后,血府逐瘀胶囊联合西医常规治疗可明显改善SAQ评分(P<0.05)。结论在西医常规治疗基础上,应用血府逐瘀胶囊可改善冠心病心绞痛患者躯体运动、心绞痛发生状况,从而提高生活质量,可能在改善不稳定型心绞痛患者效果更佳,对合并高血压病患者亦有疗效。Objective To evaluate the clinical efficacy of Xuefu Zhuyu Capsule(血府逐瘀胶囊)in treating angina pectoris of coronary heart disease(CHD).Methods In this multicenter prospective cohort study,a total of 543 CHD patients with angina pectoris were included,and they were divided into treatment group(262 cases)and control group(281 cases)according to whether or not Xuefu Zhuyu Capsule was used.Both groups were given western medi⁃cine routine treatment,while the treatment group additionally received oral Xuefu Zhuyu Capsule(0.4 g each cap⁃sule),6 capsules each time,twice a day.The treatment course of both groups was 8 weeks.Before and after treat⁃ment,the scores of Seattle Angina Questionnaire(SAQ)including physical limitation(PL),angina stability(AS),angina frequency(AF),treatment satisfaction(TS),and disease perception(DP)were compared between the two groups,and the SAQ scores were analyzed by multiple linear regression.According to different types(stable angina pectoris or unstable angina pectoris),gender(male or female),age(<65 years old or≥65 years old)and hyperten⁃sion(yes or no),the SAQ scores of the two groups after treatment were further compared.Results During the study,41 cases fell off,and finally 253 cases in treatment group and 249 cases in the control group were included in the analysis.The scores of PL,AS,AF,TS and DP in SAQ of both groups significantly increased after treatment,and all SAQ scores in the treatment group were better than those in the control group(P<0.05).Compared to those in the control group,SAQ scores of patients with unstable angina pectoris in the treatment group were significantly in⁃creased after treatment(P<0.05);the scores of AS,TS and DP of male patients and PL and AF of female patients significantly increased(P<0.05);the PL,AS and DP of patients≥65 years old increased after treatment,as well as the scores of AS,AF,TS and DP of patients<65 years old(P<0.05).After treatment,all SAQ scores of pa⁃tients concomitant with hypertension were significantly higher

关 键 词：冠心病 心绞痛 血府逐瘀胶囊 西雅图心绞痛量表 

分 类 号：R541.4[医药卫生—心血管疾病]