瓜蒌薤白半夏汤加味联合美托洛尔治疗不稳定型心绞痛患者的效果  

Effects of modified Gualou Xiebai Banxia decoction combined with Metoprolol in treatment of patients with unstable angina pectoris

作　　者：姚雷杰 YAO Leijie(Department of Cardiovascular Geriatrics of Zhengzhou West Area Hospital of TCM,Zhengzhou 450000 Henan,China)

机构地区：[1]郑州西区中医院心血管老年病科,河南郑州450000

出　　处：《中国民康医学》2025年第4期78-81,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察瓜蒌薤白半夏汤加味联合美托洛尔治疗不稳定型心绞痛患者的效果。方法:选取2021年3月至2023年3月该院收治的60例不稳定型心绞痛患者进行前瞻性研究,按照随机数字表法将其分为研究组和对照组各30例。对照组采用美托洛尔治疗,研究组在对照组基础上联合瓜蒌薤白半夏汤加味治疗,比较两组临床疗效,治疗前后心功能指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)]、心肌损伤标志物[肌酸激酶同工酶(CK-MB)、生长分化因子-15(GDF-15)、和肽素(CPP)、N-末端脑钠肽前体(NT-proBNP)、可溶性白细胞分化抗原40配体(sCD40L)]水平、临床症状改善情况(心绞痛发作持续时间、心绞痛发作次数)、中医证候积分,以及不良反应发生率。结果:研究组治疗总有效率为93.33%(28/30),高于对照组的73.33%(22/30),差异有统计学意义(P<0.05);治疗后,两组LVEF水平均高于治疗前,且研究组高于对照组,两组LVESD、LVEDD水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);治疗后,两组GDF-15、CK-MB、NT-proBNP、CPP、sCD40L水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组心绞痛发作持续时间均短于治疗前,且研究组短于对照组,两组心绞痛发作次数均少于治疗前,且研究组少于对照组,差异有统计学意义(P<0.05);两组心胸隐痛、胸胁胀满、气短乏力等中医证候积分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:瓜蒌薤白半夏汤加味联合美托洛尔治疗不稳定型心绞痛患者可提高治疗总有效率,改善心功能指标水平,以及降低心肌损伤标志物水平和中医证候积分,其效果优于单纯美托洛尔治疗。Objective:To observe effects of modified Gualou Xiebai Banxia decoction combined with Metoprolol in treatment of patients with unstable angina pectoris.Methods:A prospective study was conducted on 60 patients with unstable angina pectoris admitted to the hospital from March 2021 to March 2023.According to the random number table method,they were divided into study group and control group,30 cases in each group.The control group was treated with Metoprolol,while the study group was treated with modified Gualou Xiebai Banxia decoction on the basis of that of the control group.The clinical efficacy,the levels of cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular endsystolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)]and myocardial injury markers[creatine kinase isoenzyme(CK-MB),growth differentiation factor-15(GDF-15),copeptin(CPP),N-terminal pro-brain natriuretic peptide(NT-proBNP),soluble leukocyte differentiation antigen 40 ligand(sCD40L)],the improvement of clinical symptoms(duration of angina pectoris,number of angina pectoris attacks),and the TCM syndrome score before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the study group was 93.33%(28/30),which was higher than 73.33%(22/30)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the LVEF levels of the two groups were higher than those before the treatment,and that in the study group was higher than that in the control group;the levels of LVESD and LVEDD in the two groups were lower than those before the treatment,and those in the study group were lower than those in the control group;and the differences were statistically significant(P<0.05).After the treatment,the levels of GDF-15,CK-MB,NT-proBNP,CPP and sCD40 L in the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statisti

关 键 词：瓜蒌薤白半夏汤加味 美托洛尔 不稳定型心绞痛 心肌损伤标志物 心功能 不良反应 中医证候积分 

分 类 号：R541.4[医药卫生—心血管疾病]