逍遥散合枳术丸加减方治疗肝郁脾虚型非阻塞性缺血性冠状动脉疾病的效果  

Effect of Xiaoyao Powder combined with Zhizhu Pills on non-obstructive ischemic coronary artery disease of liver depression and spleen deficiency type

作　　者：倪晨 任晓飞 王璐扬 宋光伟 王从龙 NI Chen;REN Xiaofei;WANG Luyang;SONG Guangwei;WANG Conglong(Department of Cardiovascular Disease,the Second Affiliated Hospital of Hebei University of Chinese Medicine,Baoding 073000,China;Department of Emergency,the Second Affiliated Hospital of Hebei University of Chinese Medicine,Baoding 073000,China;Department of Medical Affairs,the Second Affiliated Hospital of Hebei University of Chinese Medicine,Baoding 073000,China)

机构地区：[1]河北中医药大学第二附属医院心血管病科,保定073000 [2]河北中医药大学第二附属医院急诊科,保定073000 [3]河北中医药大学第二附属医院医务科,保定073000

出　　处：《西北药学杂志》2025年第2期112-118,共7页Northwest Pharmaceutical Journal

基　　金：2024年度河北省中医药类科学研究课题计划项目(编号:2024303)。

摘　　要：目的探讨逍遥散合枳术丸加减方治疗肝郁脾虚型非阻塞性缺血性冠状动脉疾病的效果。方法选取2023年1月—2023年12月收治的80例肝郁脾虚型非阻塞性缺血性冠状动脉疾病患者作为研究对象,用随机数字表法分为对照组和治疗组,每组40例。对照组给予阿司匹林、阿托伐他汀、酒石酸美托洛尔治疗,治疗组在对照组治疗的基础上加用逍遥散合枳术丸加减方治疗。2组均治疗3个月。统计2组血管内皮功能、心肌梗死溶栓试验(thrombolysis in myocardial infarction,TIMI)血流分级、心功能、西雅图心绞痛量表(seattle angina questionnaire,SAQ)、冠状动脉微循环指标(治疗前和治疗3个月后),主要的心血管不良事件(major adverse cardiovascular events,MACE)发生情况(治疗3个月后)。结果治疗3个月后与治疗前比较,2组TIMI血流等级3级患者的比例增加,TIMI血流等级0级患者的比例下降,且治疗组TIMI血流等级3级患者的比例更高,SAQ各个评分、血清血管内皮生长因子、一氧化氮水平、冠状动脉血流储备值均升高,且治疗组更高,2组血清内皮素-1水平、左室后壁舒张末期厚度、室间隔舒张末期厚度、微循环阻力指数值均降低,且治疗组更低(P<0.05)。治疗3个月后,2组MACE总发生率比较,差异无统计学意义(P>0.05)。结论逍遥散合枳术丸加减方联合常规西医治疗肝郁脾虚型非阻塞性缺血性冠状动脉疾病,可有效提高患者的血管内皮功能,改善患者的心功能、冠状动脉微循环指标及TIMI血流分级情况,在不提升MACE发生率的前提下,保证了患者的生活质量。Objective To explore the effect of Xiaoyao Powder combined with Zhizhu Pills on non-obstructive ischemic coronary artery disease of liver depression and spleen deficiency type.Methods 80 patients with non-obstructive ischemic coronary artery disease of liver depression and spleen deficiency type from January 2023 to December 2023 were enrolled and randomly divided into control group and treatment group,with 40 cases in each group.The control group was treated with aspirin,atorvastatin and metoprolol tartrate,while the treatment group was treated with Xiaoyao Powder and Zhizhu Pills on the basis of the control group.Both groups were treated for 3 months.The vascular endothelial function,blood flow classification of thrombolysis in myocardial infarction(TIMI),cardiac function,seattle angina questionnaire(SAQ),coronary microcirculation indexes(before and after treatment for 3 months)of the 2 groups were counted.The occurrence of major adverse cardiovascular events(MACE)(after 3 months of treatment)was recorded.Results After 3 months of treatment,compared with before treatment,the proportion of patients with TIMI blood flow grade 3 increased,while the proportion of patients with TIMI blood flow grade 0 decreased,and the proportion of patients with TIMI blood flow grade 3 was higher in the treatment group.All SAQ scores,serum vascular endothelial growth factor,nitric oxide level and coronary blood flow reserve increased,and the treatment group was higher,serum endothelin-1 level,left ventricular posterior wall end-diastolic thickness,interventricular septum end-diastolic thickness and microcirculation resistance index decreased,and the treatment group was even lower(P<0.05).After 3 months of treatment,there was no significant difference in the total incidence of MACE between the 2 groups(P>0.05).Conclusion Xiaoyao Powder and modified Zhizhu Pills combined with routine western medicine can effectively improve the vascular endothelial function,cardiac function,coronary microcirculation index and TIMI blood flow classifi

关 键 词：冠状动脉疾病 缺血性 非阻塞性 肝郁脾虚型 逍遥散合枳术丸 加减方 

分 类 号：R972[医药卫生—药品]