穴位贴敷治疗稳定性心绞痛血瘀证的疗效观察  

Therapeutic efficacy of acupoint application in the treatment of instable angina pectoris with blood stasis pattern

作　　者：侯春蕾 符德玉[1] 周训杰[1] 姚磊[1] 芦波[1] 李建华[1] 王明珠 桂明泰[1] HOU Chunlei;FU Deyu;ZHOU Xunjie;YAO Lei;LU Bo;LI Jianhua;WANG Mingzhu;GUI Mingtai(Yueyang Hospital of Integrative Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《上海针灸杂志》2024年第9期979-986,共8页Shanghai Journal of Acupuncture and Moxibustion

基　　金：上海中医药大学产业发展中心医养结合科创项目(YYKC-2021-01-157)。

摘　　要：目的观察桃红通络贴穴位贴敷治疗稳定性心绞痛(stable angina pectoris,SAP)血瘀证的临床疗效。方法将96例SAP血瘀证患者随机分为治疗组和对照组,每组48例。两组均接受规范化西药治疗,治疗组加用桃红通络贴穴位贴敷治疗,对照组给予安慰剂贴穴位贴敷治疗。观察两组治疗前后心绞痛程度量表评分、西雅图心绞痛量表中躯体活动程度评分、中医证候量表各项评分(急躁易怒、胸闷、心悸、失眠评分及总分)、糖脂代谢指标[总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白(high density lipoprotein,HDL)、低密度脂蛋白(low-density lipoprotein,LDL)、空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting insulin,FINS)及胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)水平]、各项炎症因子[超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)及白介素6(interleukin 6,IL-6)]水平、焦虑自评量表(self-rating anxiety scale,SAS)评分及抑郁自评量表(self-rating depression scale,SDS)评分的变化情况,比较两组临床疗效。结果治疗组治疗后心绞痛程度量表评分、中医证候量表各项评分、各项炎症因子水平、SAS评分、SDS评分及TC、TG、FPG、FINS、HOMA-IR水平均较同组治疗前显著下降,躯体活动程度评分及HDL水平均显著上升,差异均具有统计学意义(P<0.01,P<0.05)。对照组治疗后中医证候量表各项评分、SDS评分及TC、hs-CRP、IL-6水平均较同组治疗前显著下降,HDL水平显著上升,差异均具有统计学意义(P<0.01,P<0.05)。治疗组治疗后心绞痛程度量表评分、中医证候量表部分评分(急躁易怒、胸闷、心悸、失眠评分)、SAS评分、SDS评分及HDL、FPG、FINS、HOMA-IR、IL-6水平均明显低于对照组,差异均具有统计学意义(P<0.01,P<0.05)。治疗组总有效率为70.5%,明显高于对照组的4Objective To observe the clinical efficacy of Taohong Tongluo patch acupoint application in the treatment of stable angina pectoris(SAP)with blood stasis pattern.Method Ninety-six SAP patients with blood stasis pattern were randomly divided into a treatment group and a control group,with 48 cases in each group.Both groups were treated with standardized western medicine,and the treatment group was treated with Taohong Tongluo patch acupoint application therapy and the control group was treated with placebo patch acupoint application therapy.Before and after treatment,the changes in the angina scale score,the physical activity score in Seattle angina scale,the Chinese medicine syndrome scale scores(irritability,chest tightness,palpitations,insomnia score and total score),glycolipid metabolism indexes[total cholesterol(TC),triglyceride(TG),high-density lipoprotein(HDL),low-density lipoprotein(LDL),fasting plasma glucose(FPG),fasting insulin(FINS),and homeostasis model assessment-insulin resistance(HOMA-IR)],inflammatory factors[hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),and interleukin 6(IL-6)],self-rating anxiety scale(SAS)score and self-rating depression scale(SDS)score were observed in the two groups.The clinical efficacy of the two groups was compared.Result In the treatment group,the angina pectoris scale score,the Chinese medicine syndrome scale scores,the levels of various inflammatory factors,SAS score,SDS score and TC,TG,FPG,FINS,HOMA-IR levels decreased significantly,and the physical activity score and HDL level increased significantly compared with those of the same group before the treatment,and the differences were statistically significant(P<0.01 and P<0.05,respectively).In the control group,all scores of Chinese medicine syndrome scale,SDS scores and levels of TC,hs-CRP and IL-6 decreased significantly and HDL levels increased significantly after treatment compared with those before treatment in the same group,and the differences were all statistically significant(P<0.0

关 键 词：穴位贴敷法 冠心病 心绞痛 血瘀证 糖脂代谢 炎症因子 

分 类 号：R246.1[医药卫生—针灸推拿学]