补脾通络法治疗冠状动脉微血管疾病的临床观察  

Clinical Observation of Bupi Tongluo Decoction in the Treatment of Coronary Microvascular Dysfunction

作　　者：魏月娟[1] 李娜[1] 纪立霞 韩琳 苏林英 Wei Yuejuan;Li Na;Ji Lixia;Han Lin;Su Linying(Cangzhou Hospital of Integrated Chinese and Western Medicine,Hebei,Cangzhou 061000,China)

机构地区：[1]河北省沧州中西医结合医院,河北沧州061000

出　　处：《中国中医急症》2024年第2期291-294,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2021298)。

摘　　要：目的观察补脾通络法治疗冠状动脉微血管疾病(CMVD)的临床效果。方法100例CMVD患者随机分为观察组与对照组各50例,对照组给予西医常规治疗,观察组给予西医常规联合中药补脾通络方,两组均持续治疗4周,比较两组临床疗效、中医证候积分、心电图疗效、心绞痛症状[西雅图心绞痛调查量表(SAQ)]、血管内皮功能[内皮细胞特异性分子-1(ESM-1)、内皮素-1(ET-1)、一氧化氮(NO)]炎性指标[白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、超敏C反应蛋白(hs-CRP)]水平。结果观察组治疗总有效率94.00%,高于对照组的80.00%(P<0.05);观察组治疗后中医证候胸闷、心胸隐痛、气短、神疲乏力、自汗、倦怠懒言评分低于对照组(P<0.05);观察组治疗后心电图改善优于对照组,心电图治疗总有效率为88.00%,高于对照组的72.00%(P<0.05);观察组治疗后心绞痛症状SAQ量表评分高于对照组(P<0.05);观察组治疗后血清ET-1、ESM-1水平低于对照组,NO水平高于对照组(P<0.05);观察组治疗后血清hs-CRP,IL-6,TNF-α水平低于对照组(P<0.05)。结论在常规治疗的基础上,联合使用补脾通络方治疗CMVD可有效降低患者中医症候评分,减轻心绞痛症状,提高心电图疗效,减轻血管内皮损伤和炎性损伤。Objective:To explore the clinical effect of Bupi Tongluo Decoction in the treatment of coronary microvascular dysfunction(CMVD).Methods:A total of 100 patients with CMVD were enrolled and randomly divided into observation group and control group,50 cases in each group.The control group was treated with routine western medicine,while observation group was additionally treated with Bupi Tongluo Decoction.All were continu-ously treated for 4 weeks.The clinical curative effect,scores of TCM syndromes,curative effect of electrocardio-gram,angina symptoms[Seattle angina questionnaire(SAQ)],vascular endothelial function[endothelial cell specific molecule-1(ESM-1),endothelin 1(ET-1),nitric oxide(NO)]and inflammatory indexes[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP)]in the two groups were com-pared.Results:The response rate of treatment was higher in observation group(94.00%)than the control group(80.00%)(P<0.05).After treatment,scores of TCM syndromes(chest tightness,dull heart pain,shortness of breath,fatigue,spontaneous sweating,burnout and laziness to speak)were lower in observation group than the control group(P<0.05).After treatment,improvement of electrocardiogram was better in the observation group than in the control group,and the response rate of electrocardiogram treatment in the observation group(88.00%)was high-er than that in the control group(72.00%)(P<0.05).After treatment,the SAQ score was higher in observation group(P<0.05).After treatment,levels of serum ET-1 and ESM-1 were lower in observation group than the control group,while NO was higher in observation group(P<0.05).After treatment,levels of serum hs-CRP,IL-6 and TNF-αwere lower in observation group than the control group(P<0.05).Conclusion:Bupi Tongluo Decoction combined with routine treatment can effectively reduce scores of TCM syndromes,relieve angina symp-toms,improve curative effect of electrocardiogram,reduce vascular endothelial injury and inflammatory injury in CMVD patients.

关 键 词：冠状动脉微血管疾病 补脾通络方 临床症状 心功能 

分 类 号：R543.5[医药卫生—心血管疾病]