冠心汤治疗冠心病介入术后心绞痛的临床疗效及对患者脂代谢的影响  

Effect of Guanxin Decoction in coronary heart disease patients with angina pectoris after percutaneous coronary intervention and its influence on lipid metabolism

作　　者：李文大 刘金霞 王雪梅 张彩英 LI Wenda;LIU Jinxia;WANG Xuemei;ZHANG Caiying(Department of Cardiology,Tangshan Nanhu Hospital,Tangshan,Hebei 063000;Department of Traditional Chinese Medicine,Fourth People's Hospital of Langfang,Langfang,Hebei 065700;Department of Internal Medicine,Tangshan Guye Traditional Chinese Medicine Hospital,Tangshan,Hebei 063100)

机构地区：[1]河北省唐山南湖医院心内科,河北唐山063000 [2]河北省廊坊市第四人民医院中医科,河北廊坊065700 [3]河北省唐山市古冶区中医医院内科,河北唐山063100

出　　处：《河北中医》2023年第8期1269-1273,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2022年度中医药类科研计划课题(编号:2022578)。

摘　　要：目的观察冠心汤治疗冠心病介入术后心绞痛的临床疗效及对患者脂代谢的影响。方法将100例冠心病介入术后心绞痛患者按照随机数字表法分为2组,对照组50例予常规西药治疗,治疗组50例在对照组治疗基础上予冠心汤治疗,2组均治疗3个月。比较2组治疗前后中医证候评分、美国纽约心脏病协会(NYHA)心功能分级改善情况、西雅图心绞痛量表(SAQ)评分、Barthel指数(BI)评分、血脂指标[甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]水平、心功能指标[血清N末端脑钠肽前体(NT-proBNP)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)]水平,并统计2组临床疗效。结果治疗组总有效率92.00%(46/50),对照组总有效率76.00%(38/50),治疗组临床疗效优于对照组(P<0.05)。2组治疗后中医证候各项评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后NYHA心功能分级均较本组治疗前改善(P<0.05),且治疗组治疗后改善情况优于对照组(P<0.05)。2组治疗后SAQ、BI评分均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05)。2组治疗后TG、TC、LDL-C水平均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05);2组治疗后HDL-C水平均升高(P<0.05),且治疗组治疗后高于对照组(P<0.05)。2组治疗后血清NT-proBNP水平及LVESD、LVEDD均降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05);2组治疗后LVEF均升高(P<0.05),且治疗组治疗后高于对照组(P<0.05)。结论冠心汤治疗冠心病介入术后心绞痛患者临床疗效确切,可改善患者心绞痛病情、生活质量及中医临床证候,分析可能与其调节机体脂代谢及心功能有关,值得临床进一步研究与应用。Objective To analyze the curative effect of Guanxin Decoction in coronary heart disease(CHD)patients with angina pectoris after percutaneous coronary intervention(PCI)and its effect on lipid metabolism.Methods Totally 100 CHD patients with angina pectoris after PCI were randomly allocated to 2 groups,patients(n=50)in the control group were treated with conventional Western medicine,and patients(n=50)in the treatment group were additionally treated with Guanxin Decoction,and both groups were treated for 3 months.The scores of traditional Chinese medicine(TCM)syndromes,New York Heart Association(NYHA)classification,Seattle Angina Questionnaire(SAQ),Barthel index(BI),blood lipid indexes(triglyceride[TG],total cholesterol[TC],high-density lipoprotein cholesterol[HDL-C],low-density lipoprotein cholesterol[LDL-C]),cardiac function indexes(left ventricular end-systolic diameter[LVESD],left ventricular end-diastolic diameter[LVEDD],left ventricular ejection fraction[LVEF])were included as comparisons between the two groups before and after treatment,and the clinical efficacy of the two groups was counted.Results After treatment,the total effective rate in the treatment group was significantly higher than that in the control group(92.00%[46/50]vs 76.00%[38/50],P<0.05).The TCM syndromes scores were significantly lower in both groups,and the treatment group was more common than the control group(P<0.05).The NYHA classification in the two groups after treatment was significantly improved(P<0.05),and the improvement in the treatment group was better than that in the control group(P<0.05).The scores of SAQ and BI in the two groups were significantly increased(P<0.05),which were more pronounced in the treatment group than in the control group(P<0.05).Significantly decreased TG,TC,LDL-C levels,and significantly increased HDL-C were detected in both groups than those before treatment(all P<0.05).The differences were significant in TG,TC,LDL-C and HDL-C levels between the treatment group and the control group(P<0.05).After treatme

关 键 词：冠心病 心绞痛 介入治疗 术后 生活质量 中药疗法 

分 类 号：R541.420.531[医药卫生—心血管疾病]