基于“肝心同治”探讨软肝化纤汤治疗冠心病合并抑郁的临床疗效  

Clinical Efficacy of Ruangan Huaxian Decoction in Treating Coronary Heart Disease Complicated with Depression Based on the Principle of"Treating Liver and Heart Simultaneously"

作　　者：林志强[1] 赵福成[1] 韩艳茹 任伟华[1] 贾奎[1] LIN Zhiqiang;ZHAO Fucheng;HAN Yanru;REN Weihua;JIA Kui(The First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,China)

机构地区：[1]新乡医学院第一附属医院,河南新乡453100

出　　处：《中医药信息》2024年第6期55-59,共5页Information on Traditional Chinese Medicine

基　　金：河南省中医药青苗人才培养项目(210999904)。

摘　　要：目的:基于“肝心同治”理论探讨软肝化纤汤对冠心病合并抑郁患者的临床疗效。方法:选取符合纳入标准的冠心病合并抑郁患者123例,依据随机数字表随机分为对照组62例和治疗组61例。对照组给予常规西医治疗,治疗组在对照组的基础上口服软肝化纤汤治疗,两组均治疗8周。比较两组患者的临床有效率,治疗前后中医证候评分、汉密顿抑郁量表(HAMD)评分、血脂水平,血浆肾素、醛固酮、超敏C反应蛋白(hs-CRP)及清脑源性神经营养因子(BDNF)和胃促生长素(ghrelin)水平。结果:治疗组的心绞痛和抑郁临床有效率均高于对照组(P<0.05);两组患者治疗后总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白(LDL-C)水平均明显降低,其中治疗组TG、LDL-C明显低于对照组(P<0.05);两组患者治疗后血浆肾素水平升高(P<0.05),hs-CRP含量显著下降(P<0.05),且治疗组hs-CRP含量低于对照组(P<0.05);两组患者治疗后血浆BDNF、ghrelin含量均明显增高(P<0.05),且治疗组高于对照组(P<0.05)。结论:软肝化纤汤可显著改善抑郁、心绞痛等临床症状,其机制与抑制炎症因子、对抗肾素-血管紧张素-醛固酮系统(RAAS)过度活化、改善血管内皮损伤及降低交感神经兴奋性有关。Objective:Based on the theory of"treating liver and heart simultaneously",this study aimed to explore the clinical efficacy of Ruangan Huaxian Decoction(RHD)in patients with coronary heart disease complicated by depression.Methods:A total of 123 patients with coronary heart disease complicated by depression who met the inclusion criteria were selected and randomly divided into a control group of 62 cases and a treatment group of 61 cases using a random number table.The control group received routine Western medicine treatment,while the treatment group received the same plus oral administration of RHD.Both groups were treated for 8 weeks.The clinical efficacy,TCM syndrome score,Hamilton Depression Scale(HAMD)score,blood lipid levels,plasma renin,aldosterone,high-sensitivity C-reactive protein(hs-CRP),brain-derived neurotrophic factor(BDNF),and ghrelin levels were compared before and after treatment in both groups.Results:The clinical efficacy of angina and depression in the treatment group was higher than that in the control group(P<0.05).After treatment,the levels of total cholesterol(TC),triglycerides(TG),and low-density lipoprotein cholesterol(LDL-C)in both groups decreased significantly,with TG and LDL-C levels in the treatment group being significantly lower than those in the control group(P<0.05).Plasma renin levels increased(P<0.05),and hs-CRP levels decreased significantly(P<0.05)after treatment in both groups,with the hs-CRP levels in the treatment group being lower than those in the control group(P<0.05).Plasma BDNF and ghrelin levels increased significantly(P<0.05)after treatment in both groups,with levels in the treatment group being higher than those in the control group(P<0.05).Conclusion:Ruangan Huaxian Decoction can significantly improve clinical symptoms such as depression and angina,and its mechanism may be related to the inhibition of inflammatory factors,counteraction against excessive activation of the renin-angiotensin-aldosterone system(RAAS),improvement of vascular endothelial damage,and re

关 键 词：冠心病 抑郁 软肝化纤汤 血清脑源性神经营养因子 胃促生长素 

分 类 号：R259[医药卫生—中西医结合] R277.7[医药卫生—中医内科学]