益气通痹胶囊联合西药治疗稳定型心绞痛气虚血瘀证临床研究  

Clinical Study on Yiqi Tongbi Capsules Combined with Western Medicine for Stable Angina Pectoris with Qi Deficiency and Blood Stasis Syndrome

作　　者：林海宁 郭进建[1] 李中政 LIN Haining;GUO Jinjian;LI Zhongzheng(The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou Fujian 350003,China)

机构地区：[1]福建中医药大学附属第二人民医院,福建福州350003

出　　处：《新中医》2024年第22期34-40,共7页New Chinese Medicine

基　　金：福建中医药大学重大科技创新“揭榜挂帅”专项项目(XJB2022003-1);福建中医药大学校管课题临床专项(XB2024031)。

摘　　要：目的:观察益气通痹胶囊联合西药治疗稳定型心绞痛(SAP)气虚血瘀证的临床疗效。方法:选取72例SAP气虚血瘀证患者,按随机数字表法分为治疗组和对照组,每组36例。治疗组剔除2例、对照组剔除3例,最终完成研究治疗组34例、对照组33例。对照组予西药治疗,治疗组在对照组治疗基础上加用益气通痹胶囊,2组均治疗4周。比较2组中医证候疗效、心绞痛症状疗效、硝酸甘油停减情况、西雅图心绞痛量表(SAQ)评分、二维斑点追踪成像(2D-STI)指标、炎症指标及血脂指标。结果:治疗组中医证候疗效、心绞痛症状疗效及硝酸甘油停减情况均优于对照组(P<0.05)。治疗后,2组躯体活动受限程度(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(DP)评分均较治疗前升高(P<0.05);治疗组PL、AS、AF、TS评分均高于对照组(P<0.05);2组DP评分比较,差异无统计学意义(P>0.05)。治疗后,2组整体纵向应变(GLS)、整体圆周应变(GCS)值均较治疗前改善(P<0.05),治疗组GLS、GCS值均优于对照组(P<0.05)。治疗后,2组单核细胞与高密度脂蛋白胆固醇(HDL-C)比值(MHR)及超敏C-反应蛋白(hs-CRP)、补体C1q肿瘤坏死因子相关蛋白1(CTRP1)水平均较治疗前降低(P<0.05),治疗组MHR及hs-CRP、CTRP1水平均低于对照组(P<0.05)。治疗后,2组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平均较治疗前降低(P<0.05),HDL-C水平均较治疗前升高(P<0.05);治疗组TC、LDL-C水平均低于对照组(P<0.05),HDL-C水平高于对照组(P<0.05);2组TG水平比较,差异无统计学意义(P>0.05)。结论:益气通痹胶囊联合西药治疗SAP气虚血瘀证,可以缓解心绞痛症状,改善生活质量,减轻炎症反应,调节血脂水平,促进局部缺血心肌血运恢复,且安全性好。Objective:To observe the clinical efficacy of Yiqi Tongbi Capsules combined with western medicine on stable angina pectoris(SAP)with qi deficiency and blood stasis syndrome.Methods:A total of 72 cases of SAP patients with qi deficiency and blood stasis syndrome were selected and divided into the treatment group and the control group according to the random number table method,with 36 cases in each group.Two cases from the treatment group and three cases from the control group were excluded,leaving 34 cases in the treatment group and 33 cases in the control group for the final study.The control group was treated with western medicine,and the treatment group was additionally given Yiqi Tongbi Capsules in addition to the treatment of the control group.Both groups were treated for four weeks.The efficacy of traditional Chinese medicine(TCM)syndromes and angina pectoris symptom,discontinue and reduction of Nitroglycerin,Seattle Angina Questionnaire(SAQ)scores,two-dimensional speckle tracking imaging(2D-STI)indexes,inflammation indexes,and blood lipid indexes were compared between the two groups.Results:The efficacy of TCM syndromes and angina pectoris symptom as well as the discontinue and reduction of Nitroglycerin in the treatment group were better than those in the control group(P<0.05).After treatment,the scores of physical activity limitation(PL),stable angina status(AS),angina attack(AF),treatment satisfaction(TS),and disease perception(DP)in both groups were increased when compared with those before treatment(P<0.05);the scores of PL,AS,AF,and TS in the treatment group were higher than those in the control group(P<0.05);there was no significant difference in DP scores between the two groups(P>0.05).After treatment,the values of global longitudinal strain(GLS)and global circumferential strain(GCS)in both groups were improved when compared with those before treatment(P<0.05),and the values of GLS and GCS in the treatment group were better than those in the control group(P<0.05).After treatment,the levels of monoc

关 键 词：稳定型心绞痛 气虚血瘀证 益气通痹胶囊 二维斑点追踪成像 生活质量 炎症 血脂 

分 类 号：R541.4[医药卫生—心血管疾病]