生脉散合四物汤加减治疗老年体位性低血压合并冠心病气虚血瘀证临床研究  

Clinical Study of Modified Shengmai Powder and Siwu Decoction for the Treatment of Orthostatic Hypotension Complicated with Coronary Heart Disease in Elderly Patients with Qi Deficiency and Blood Stasis Syndrome

作　　者：徐利亚 刘如秀[2] 李林光 蔡松 王秀娟[3] XU Liya;LIU Ruxiu;LI Linguang;CAI Song;WANG Xiujuan(Beijing Longfu Hospital,Beijing 100010,China;Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Capital Medical University,Beijing 100069,China)

机构地区：[1]北京市隆福医院,北京100010 [2]中国中医科学院广安门医院,北京100053 [3]首都医科大学,北京100069

出　　处：《中国中医药信息杂志》2023年第6期148-152,共5页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：薪火传承3+3工程-金世元名老中医传承工作室北京市隆福医院分站(2019年);第六批北京市级中医药专家学术经验继承工作项目(2022年);中国科协青年托举计划资助课题(49947)。

摘　　要：目的探析生脉散合四物汤加减对老年体位性低血压合并冠心病气虚血瘀证的临床疗效。方法采用双色球法将160例患者随机分为对照组和观察组各80例。2组均予西医常规治疗,观察组在此基础上予生脉散合四物汤加减,每日1剂,每日2次,水煎服。2组均连续治疗4周。观察2组临床疗效,比较2组治疗前后左室射血分数(LVEF)、左室舒张末期内径(LVDD)、血浆脑钠肽(BNP)和超敏C反应蛋白(hs-CRP),测量平卧位-站立位血压差和心绞痛发作频率、持续时间。结果观察组总有效率为93.75%(75/80),对照组为81.25%(65/80),2组比较差异有统计学意义(P<0.05)。与本组治疗前比较,2组治疗后收缩压差、舒张压差及心绞痛发作频率、持续时间明显降低,LVEF升高,LVDD及血浆BNP、hs-CRP降低(P<0.05);2组治疗后比较,观察组治疗后收缩压差、舒张压差及心绞痛发作频率、持续时间低于对照组,LVEF高于对照组,LVDD及血浆BNP、hs-CRP低于对照组,差异均有统计学意义(P<0.05)。对照组一过性低血压2例、头晕3例,观察组腹泻4例、恶心呕吐2例、皮疹1例。结论生脉散合四物汤加减可改善老年体位性低血压合并冠心病气虚血瘀证患者的心功能和生活质量,降低血浆BNP、hs-CRP,提高临床疗效。Objective To explore the clinical efficacy of Shengmai Powder and Siwu Decoction for the treatment of orthostatic hypotension complicated with coronary heart disease in elderly patients with qi deficiency and blood stasis syndrome.Methods Totally 160 patients were randomly divided into control group and observation group with 80 cases in each group using the two-color ball method.The observation group was treated with Shengmai Powder and Siwu Decoction,one dosage per day,twice a day,decocted in water,on the basis of conventional Western medicine treatment;the control group received conventional Western medicine treatment.The treatment for both groups lasted for 4 weeks.The clinical efficacy was observed.Left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVDD)and plasma brain natriuretic peptide(BNP)and hypersensitive C-reactive protein(hs-CRP)were compared before and after treatment.The blood pressure differences in the prone to standing position and prevalence and duration of angina pectoris were detected.Results The total effective rate of the observation group was 93.75%(75/80),and that of the control group was 81.25%(65/80).The difference between the two groups was statistically significant(P<0.05).Compared with before treatment,systolic blood pressure difference,diastolic blood presure difference,the frequency,and the duration of angina were significantly decreased,LVEF was increased,LVDD,and plasma BNP,hs-CRP decreased after treatment(P<0.05);there were significant differences in systolic blood pressure difference,diastolic blood pressure difference,angina attack frequency,angina pectoris duration,LVEF,LVDD,plasma BNP and hs-CRP between the two groups after treatment(P<0.05).During the treatment period,there were transient hypotension(2 cases),dizziness(3 cases)in the control group,diarrhea(4 cases),nausea and vomiting(2 cases),and rash(1 cases)in the observation group.Conclusion Shengmai Powder and Siwu Decoction can improve cardiac function and quality of life in orthostatic

关 键 词：生脉散 四物汤 气虚血瘀证 老年 体位性低血压合并冠心病 

分 类 号：R259.442[医药卫生—中西医结合]