调卫和营宣痹方辅助干预冠心病PCI术后再发心绞痛的临床疗效观察  

Clinical Observation of Tiaowei Heying Xuanbi Prescription in Adjuvant Intervention of Recurrent Angina Pectoris After Percutaneous Coronary Intervention for Coronary Heart Disease

作　　者：吴健 程珍[1] 陈智龙[1] 吴正国[1] WU Jian;CHENG Zhen;CHEN Zhi-Long;WU Zheng-Guo(Huangshi Traditional Chinese Medicine Hospital,Huangshi 435000 Hubei,China)

机构地区：[1]黄石市中医医院,湖北黄石435000

出　　处：《广州中医药大学学报》2024年第8期2009-2015,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：湖北省自然科学基金创新发展联合基金项目(编号:2022CFD074)。

摘　　要：【目的】观察调卫和营宣痹方与常规西药联合治疗对冠心病经皮冠状动脉介入(PCI)术后再发心绞痛的治疗效果。【方法】将90例冠心病PCI术后再发心绞痛寒凝心脉证患者随机分为对照组和治疗组,每组各45例。对照组给予常规西药治疗,治疗组在对照组的基础上联合调卫和营宣痹方治疗,疗程为12周。观察2组患者治疗前后中医证候积分、心绞痛疗效积分、西雅图心绞痛量表(SAQ)评分以及左心室射血分数(LVEF)、室间隔厚度(IVS)的变化情况,并评定2组患者的临床疗效和用药安全性。【结果】(1)脱落情况方面,研究过程中,对照组和治疗组各有1例患者脱落,最终对照组和治疗组各有44例患者纳入疗效统计。(2)疗效方面,治疗12周后,治疗组的总有效率为93.18%(41/44),对照组为81.82%(36/44),组间比较(χ2检验),治疗组的疗效明显优于对照组(P<0.05)。(3)心绞痛疗效积分方面,治疗后,2组患者的心绞痛发作次数评分、持续时间评分、疼痛程度评分、硝酸甘油使用量评分及总积分均较治疗前明显降低(P<0.05),且治疗组治疗后的各项评分及总积分均明显低于对照组(P<0.05)。(4)SAQ评分方面,治疗后,2组患者SAQ量表的身体活动受限程度(PL)、心绞痛稳定状态(AS)、心绞痛发作情况(AF)、治疗满意程度(TS)、疾病认知程度(DS)评分均较治疗前明显升高(P<0.05),且治疗组治疗后SAQ量表的各项评分均明显高于对照组(P<0.05)。(5)中医证候积分方面,治疗后,2组患者的胸痛、胸闷、气短、乏力、口唇紫暗等证候积分均较治疗前明显降低(P<0.05),且治疗组治疗后的各项中医证候积分均明显低于对照组(P<0.05)。(6)心脏彩超指标方面,治疗后,2组患者的LVEF均较治疗前有所改善(P<0.05),而2组患者的IVS治疗前后均无明显变化(P>0.05);治疗后组间比较,治疗组的LVEF改善幅度明显优于对照组(P<0.05)。(7)安全性方面,治疗过程中,治Objective To observe the therapeutic effect of Tiaowei Heying Xuanbi Prescription combined with conventional western medicine on the recurrence of angina pectoris after percutaneous coronary intervention(PCI)for coronary heart disease(CHD).Methods Ninety patients with recurrent angina pectoris of congealing cold in the heart vessel type after PCI for CHD were randomly divided into a control group and a treatment group,with 45 patients in each group.The control group was treated with conventional western medicine,and the treatment group was additionally treated with Tiaowei Heying Xuanbi Prescription on the basis treatment for the control group.The course of treatment for the two groups covered 12 weeks.The changes of traditional Chinese medicine(TCM)syndrome score,angina efficacy score,Seattle Angina Questionnaire(SAQ)score,left ventricular ejection fraction(LVEF)and interventricular septal thickness(IVS)in the two groups were observed before and after the treatment.And after treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)Both of the control group and treatment group had one case dropped out during the trial,and eventually 44 patients in each of the two groups were included in the efficacy statistics.(2)After 12 weeks of treatment,the total effective rate of the treatment group was 93.18%(41/44),and that of the control group was 81.82%(36/44).The intergroup comparison(tested by chi-square test)showed that the curative effect of the treatment group was significantly superior to that of the control group(P<0.05).(3)After treatment,the scores of angina attack score,duration of angina,pain level,and nitroglycerin dosage as well as the overall angina efficacy scores in the two groups were significantly lower than those before treatment(P<0.05),and the scores of each item as well as overall angina efficacy scores of the treatment group were significantly lower than those of the control group after treatment(P<0.05).(4)After treatment,the SAQ item scores of physical limitation(PL),

关 键 词：冠心病 经皮冠状动脉介入(PCI)术后 心绞痛 寒凝心脉证 调卫和营宣痹方 左心室射血分数(LVEF) 

分 类 号：R259.414[医药卫生—中西医结合]