心痛宁颗粒治疗气虚痰瘀证非ST段抬高型急性冠脉综合征的临床研究  

Clinical study on Xintongning Granules in treating non-ST-segment elevation acute coronary syndrome with qi deficiency and phlegm stasis syndrome

作　　者：张超[1] 关敬树 姚成增[2] 李晓惠[1] 杜培朝 高山钟 梁冰尔 刘诗琪 李俊辉 熊旭东[2] ZHANG Chao;CUAN Jingshu;YAO Chengzeng;LI Xiaohui;DU Peizhao;GAO Shanzhong;LIANG binger;LIU Shiqi;LI Junhui;XIONG Xudong(Baoshan Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201999,China;Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China)

机构地区：[1]上海中医药大学附属宝山医院,上海201999 [2]上海中医药大学附属曙光医院,上海200021

出　　处：《上海中医药大学学报》2024年第6期19-25,共7页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(82104632);上海市卫健委卫生行业临床研究专项(202040398);上海市宝山区医学重点学(专)科重中之重学科项目(BSZK-2023-Z02)。

摘　　要：目的:观察心痛宁颗粒治疗气虚痰瘀证非ST段抬高型急性冠脉综合征(NSTE-ACS)的临床疗效。方法:研究采用随机双盲安慰剂对照的方法,将100例气虚痰瘀证NSTE-ACS患者分为治疗组(50例)和对照组(50例)。治疗组患者给予心痛宁颗粒联合西医常规治疗,对照组患者给予安慰剂颗粒联合西医常规治疗,疗程均为12周。治疗前及治疗4、8、12周后,比较两组患者的心绞痛症状积分和中医证候总积分;治疗4、8、12周后,评价两组患者的心绞痛疗效、中医证候疗效和硝酸甘油减停率;治疗12周后,比较两组患者的心电图疗效;治疗前及治疗12周后,检测并比较两组患者的左心室射血分数(LVEF)。结果:(1)治疗4、8、12周后,两组患者的心绞痛症状积分较治疗前均明显降低(P<0.01),且治疗8、12周后,治疗组患者的心绞痛症状积分低于对照组(P<0.05,P<0.01)。(2)治疗8、12周后,治疗组患者的心绞痛疗效均优于对照组(P<0.01),且硝酸甘油减停率明显高于对照组(P<0.05)。(3)治疗4、8、12周后,两组患者的中医证候总积分较治疗前均明显降低(P<0.01),且治疗8、12周后,治疗组患者的中医证候总积分明显低于对照组(P<0.01)。(4)治疗4、8、12周后,治疗组患者的中医证候疗效均优于对照组(P<0.05,P<0.01)。(5)治疗12周后,治疗组患者的心电图疗效优于对照组(P<0.05)。(6)治疗12周后,治疗组患者的LVEF水平较治疗前升高(P<0.01),且高于对照组(P<0.05)。结论:心痛宁颗粒结合西医常规疗法能够有效缓解气虚痰瘀证NSTE-ACS患者的临床症状,改善患者的心功能,提高临床疗效。Objective:To observe the clinical efficacy of Xintongning Granules in treating non-ST-segment elevation acute coronary syndrome(NSTE-ACS)with qi deficiency and phlegm stasis syndrome.Methods:A randomized,double-blind,placebo-controlled method was applied in this study.One hundred patients of NSTE-ACS with qi deficiency and phlegm stasis syndrome were divided into the treatment group(50 cases)and control group(50 cases).The patients in the treatment group were treated with Xintongning Granules combined with conventional western medicine,and the patients in the control group were treated with placebo granules combined with conventional western medicine,with a course of 12 weeks.Before treatment and after 4,8 and 12 weeks of treatment,the angina pectoris symptom scores and the total scores of traditional Chinese medicine(TCM)syndrome were compared between the two groups.After 4,8 and 12 weeks of treatment,the therapeutic efficacy of angina pectoris,the therapeutic efficacy of TCM syndrome,and the nitroglycerin reduction rate in both groups were evaluated.After 12 weeks of treatment,the therapeutic efficacy of electrocardiogram was compared between the two groups.Before treatment and after 12 weeks of treatment,the left ventricular ejection fraction(LVEF)of patients in the two groups was detected and compared.Results:(1)After 4,8 and 12 weeks of treatment,the symptom scores of angina pectoris in both groups were significantly decreased compared with those before treatment(P<0.01),and after 8 and 12 weeks of treatment,the symptom scores of angina pectoris in the treatment group were lower than those in the control group(P<0.05,P<0.01).(2)After 8 and 12 weeks of treatment,the therapeutic efficacy of angina pectoris in the treatment group was superior to the control group(P<0.01),and the nitroglycerin reduction rate was significantly higher than that in the control group(P<0.05).(3)After 4,8 and 12 weeks of treatment,the total scores of TCM syndrome in both groups were significantly decreased compared with those before

关 键 词：非ST段抬高型急性冠脉综合征 气虚痰瘀证 心痛宁颗粒 中西医结合 

分 类 号：R259[医药卫生—中西医结合]