当归四逆汤合督脉灸治疗寒凝心脉型微血管性心绞痛疗效观察  

Clinical Observation of Danggui Sini Decoction(当归四逆汤)Combined with Governor Meridian Moxibustion in Treatment of Cold Coagulation in Heart Meridian Syndrome of Microvascular Angina Pectoris

作　　者：周盾 凌家艳[1] 余浩[1] 张忠阳 金恒[1] ZHOU Dun;LING Jiayan;YU Hao;ZHANG Zhongyang;JIN Heng(Wuhan Integrated Traditional Chinese and Western Medicine Hospital,Wuhan 430000,Hubei,China)

机构地区：[1]武汉市中西医结合医院,湖北武汉430000

出　　处：《中华中医药学刊》2024年第10期232-235,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：湖北省卫生和计划生育委员会中医药中西医结合科研一般项目(2017-20-13);武汉市中医药科研项目(WZ22C38)。

摘　　要：目的研究当归四逆汤合督脉灸治疗寒凝心脉型微血管性心绞痛的临床疗效。方法选取2022年6月—2022年12月医院诊治的寒凝心脉型微血管性心绞痛患者80例为研究对象,采用随机数字表法分为对照组和治疗组,每组40例。对照组进行常规治疗,治疗组在对照组基础上采用当归四逆汤合督脉灸治疗。治疗4周后观察两组患者的中医证候评分、心绞痛发作、运动平板试验、生化指标以评估疗效,并记录不良反应发生情况。结果依据中医证候评分进行疗效评定发现,治疗组总有效率(95.00%,38/40)显著高于对照组(80.00%,32/40)(P<0.05)。治疗前,两组患者心绞痛发作情况差异无统计学意义(P>0.05);治疗后,两组患者心绞痛发作次数明显减少、每次发作持续时间缩短、疼痛程度降低(P<0.05),治疗后治疗组疼痛程度显著低于对照组(P<0.05)。治疗前两组运动平板试验各项指标差异均无统计学意义(P>0.05);治疗后两组总运动时间、ST段压低0.1 mV时间均明显延长(P<0.05),ST段压低幅度降低(P<0.05),且治疗组以上各项指标显著优于对照组(P<0.05)。治疗前两组超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipaseA2,Lp-PLA2)差异无统计学意义(P>0.05),治疗后两组hs-CRP、Lp-PLA2水平显著降低(P<0.05),并且治疗组hs-CRP、Lp-PLA2水平显著低于对照组(P<0.05)。治疗组、对照组不良反应发生率分别为7.50%(3/40)、12.50%(5/40),组间差异无统计学意义(P>0.05)。结论当归四逆汤合督脉灸治疗寒凝心脉型微血管性心绞痛的临床疗效满意,能够有效改善患者各项中医证候,发挥镇痛抗炎作用,同时具有良好的安全性。Objective To study the curative effect of Danggui Sini Decoction(当归四逆汤)combined with governor meridian moxibustion in the treatment of cold coagulation in heart meridian syndrome of microvascular angina pectoris.Methods Eighty patients with cold coagulation in heart meridian syndrome of microvascular angina pectoris diagnosed and treated in the hospital from June 2022 to December 2022 were selected as the research objects and they were divided into control group and treatment group by random number table method,with 40 cases in each group.The control group was treated with conventional western medicine,and the treatment group was treated with Danggui Sini Decoction combined with governor meridian moxibustion on the basis of the control group.After 4 weeks of treatment,the TCM syndrome scores,angina pectoris attack,treadmill exercise test and biochemical indexes of the two groups were observed to evaluate the efficacy,and the occurrence of adverse reactions was recorded.Results According to the TCM syndrome scores,the total effective rate of the treatment group was 95.00%(38/40),which was significantly higher than that(80.00%,32/40)of the control group(P<0.05).After treatment,the frequency of angina pectoris attack,duration of each attack and pain in two groups were significantly decreased(P<0.05),and the pain in the treatment group was significantly lower than that in the control group(P<0.05).There was no significant difference in the indexes of treadmill exercise test between the two groups before treatment(P>0.05).After treatment,the total exercise time and ST segment depression 0.1 mV time of the two groups were significantly prolonged(P<0.05),and the ST segment depression amplitude was decreased(P<0.05),and the above indexes of the treatment group were significantly better than those of the control group(P<0.05).There was no significant difference in hypersensitive C-reactive protein(hs-CRP)or lipoprotein-associated phospholipase A2(Lp-PLA2)between the two groups before treatment(P>0.05).After trea

关 键 词：心绞痛 微血管 寒凝心脉 当归四逆汤 督脉灸 

分 类 号：R256.2[医药卫生—中医内科学] R245.8[医药卫生—中医学]