加味柴胡疏肝散辅助治疗冠脉痉挛心绞痛随机对照研究  

A Randomized Controlled Study of Modified Chaihu Shugan Powder(加味柴胡疏肝散)in Adjuvant Treatment of Coronary Artery Spasm Angina Pectoris

作　　者：李治兵 聂恒[2] 张萌[1] 王宁宁 黄斌[2] LI Zhibing;NIE Heng;ZHANG Meng;WANG Ningning;HUANG Bin(The Second Clinical College of Medicine of Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China;Department of Cardiology,Henan Hospital of Traditional Chinese Medicine,Zhengzhou 450000,Henan,China)

机构地区：[1]河南中医药大学第二临床医学院,河南郑州450000 [2]河南省中医院心病科,河南郑州450000

出　　处：《辽宁中医杂志》2024年第8期65-69,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项(2019JDZX017)。

摘　　要：目的探讨加味柴胡疏肝散辅助治疗冠脉痉挛心绞痛的疗效。方法随机将126例2019年10月—2022年8月河南中医药大学第二附属医院心内科收治的冠脉痉挛心绞痛患者分为对照组(63例)和试验组(63例)。对照组给予阿托伐他汀钙片、酒石酸美托洛尔缓释片、阿司匹林肠溶片、硝酸甘油片,试验组在此基础上加用加味柴胡疏肝散,两组均治疗4周。比较两组治疗4周后的疗效,对比两组治疗前和4周后的临床相关指标、中医症状评分、血脂水平、心功能及治疗期间的安全性。结果与对照组治疗4周后的总有效率(79.37%,50/63)比较,试验组总有效率更高[93.65%(59/63),P<0.05]。治疗4周后,两组心绞痛持续时间与治疗前比较均缩短,试验组短于对照组(P<0.05);两组心绞痛发作次数、硝酸甘油片用量与治疗前比较均减少,试验组少于对照组(P<0.05);两组胸闷胸痛、心烦急躁、心悸、口干口苦评分及血清低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、总胆固醇(total cholesterol,TC)、三酰甘油(triacylglycerol,TG)、心肌肌钙蛋白I(cardiac troponin I,CTnI)、缺血修饰蛋白(ischemic modification protein,IMA)、心脏型脂肪酸结合蛋白(cardiac fatty acid binding protein,H-FABP)水平与治疗前比较降低,试验组低于对照组(P<0.05);两组血清高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)水平及左心射血分数(left ventricular ejection fraction,LVEF)、心脏指数(cardiac index,CI)、心输出量(cardiac output,CO)与治疗前比较升高,试验组高于对照组(P<0.05)。试验组和对照组治疗期间的不良反应总发生率比较差异无统计学意义(P>0.05)。结论加味柴胡疏肝散辅助治疗冠脉痉挛心绞痛可有效调节患者血脂水平,改善心功能,进而可促进患者中医症状及临床症状的改善,提高疗效,且具有良好的安全性。Objective To investigate the effect of Modified Chaihu Shugan Powder(加味柴胡疏肝散)in the treatment of coronary artery spasm angina pectoris.Methods A total of 126 patients with coronary artery spasm angina pectoris admitted to the Department of Cardiology of The Second Affiliated Hospital of Henan University of Chinese Medicine from October 2019 to August 2022 were selected as the study subjects.They were randomly divided into the control group(63 cases)and the test group(63 cases).The control group was treated with atorvastatin calcium tablets,metoprolol tartrate sustained release tablets,aspirin enteric-coated tablets and nitroglycerin tablets.The test group was treated with Modified Chaihu Shugan Powder on the basis of the control group.Both groups were treated for 4 weeks.The curative effect after 4 weeks of treatment,the clinical related indexes,the scores of traditional Chinese medicine symptoms,the levels of blood lipids and the cardiac function before and after 4 weeks of treatment and the safety during treatment of the two groups were compared.Results Compared with the total effective rate of the control group after 4 weeks of treatment(79.37%,50/63),the total effective rate of the test group was higher[93.65%(59/63),P<0.05].After 4 weeks of treatment,the duration of angina pectoris in both groups was shorter than that before treatment,and the duration of the test group was shorter than that of the control group(P<0.05).The number of angina pectoris attacks and the amount of nitroglycerin tablets in the two groups decreased compared with those before treatment,and the number and the amount of the test group were less than those of the control group(P<0.05).The scores of chest tightness,chest pain,irritability,palpitation,dry mouth and bitter mouth and the levels of serum low density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triacylglycerol(TG),cardiac troponin I(CTnI),ischemic modification protein(IMA)and cardiac fatty acid binding protein(H-FABP)in the two groups decreased compared w

关 键 词：冠脉痉挛 心绞痛 加味柴胡疏肝散 中医症状 血脂 心功能 安全性 

分 类 号：R256.22[医药卫生—中医内科学]