循经取穴合血府逐瘀汤对瘀血阻络型胸痹心痛患者的临床疗效观察
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摘要
目的:观察循经取穴合血府逐瘀汤治疗瘀血阻络型胸痹心痛患者的临床疗效。方法:将符合纳入标准的60例瘀血痹阻型胸痹心痛患者随机分为对照组、血府逐瘀汤组和针刺协同组,每组20例。对照组给予常规西医治疗,血府逐瘀汤组在对照组治疗的基础上口服血府逐瘀汤,针刺协同组在血府逐瘀汤组基础上给予针刺治疗,比较治疗后各组间的疗效、24 h动态心电图、西雅图心绞痛量表,及cTnI、cTnT、BNP变化情况。结果:治疗后Holter显示,心肌缺血频率、心肌缺血时间及缺血总负荷方面比较,针刺协同组较血府逐瘀汤组和对照组具有统计学差异(P<0.05)。SAQ量表显示,躯体受限程度、心绞痛稳定状态,心绞痛发作情况,针刺协同组及血府逐瘀汤组较对照组比较均有统计学差异(P<0.01)。cTnI、cTnT、BNP变化情况针刺协同组与血府逐瘀汤组治疗后比较无统计学差异(P>0.05)。结论:循经取穴合血府逐瘀汤治疗瘀血阻络型胸痹心痛优于常规西医治疗,能明显改善心功能,提高患者生存质量。
Objective: To observe the clinical curative effect of acupuncture with acupoint selection along meridians combined with Xuefu Zhuyu Decoction in treating chest stuffiness and pains of blood stasis. Methods: 60 patients met the inclusion criteria were randomly divided into the control group(routine western medication, n=20), Xuefu Zhuyu Decoction group(routine western medication+Xuefu Zhuyu Decoction, n=20) and the combination group(routine western medication+Xuefu Zhuyu Decoction+Acupuncture, n=20). After the treatment, the curative effect, results of 24-hour Holter monitoring, scores of Seattle angina scale, and the changes of cTnI, cTnT and BNP were compared among the groups. Results: The results of 24-hour Holter monitoring showed that there were statistical differences in the frequency of myocardial ischemia, the time of myocardial ischemia and the total load of ischemia between the combination group and the other two groups after the treatment(P<0.05). SAQ scale showed that the physical limitation, stable state of angina pectoris and attack of angina pectoris were signficantly improved in the combination group and in Xuefu Zhuyu Decoction group compared to the control group(P<0.01). There were no statistical differences in the changes of cTnI, cTnT and BNP between the combination group and Xuefu Zhuyu Decoction group(P>0.05). Conclusion: The clinical effect of combined therapy of Xuefu Zhuyu Decoction and acupuncture with acupoint selection along meridians is superior to routine western medication in the treatment of chest stuffiness and pains of blood stasis. It can significantly improve cardiac function and improve life quality of the patients.
Objective: To observe the clinical curative effect of acupuncture with acupoint selection along meridians combined with Xuefu Zhuyu Decoction in treating chest stuffiness and pains of blood stasis. Methods: 60 patients met the inclusion criteria were randomly divided into the control group(routine western medication, n=20), Xuefu Zhuyu Decoction group(routine western medication+Xuefu Zhuyu Decoction, n=20) and the combination group(routine western medication+Xuefu Zhuyu Decoction+Acupuncture, n=20). After the treatment, the curative effect, results of 24-hour Holter monitoring, scores of Seattle angina scale, and the changes of cTnI, cTnT and BNP were compared among the groups. Results: The results of 24-hour Holter monitoring showed that there were statistical differences in the frequency of myocardial ischemia, the time of myocardial ischemia and the total load of ischemia between the combination group and the other two groups after the treatment(P<0.05). SAQ scale showed that the physical limitation, stable state of angina pectoris and attack of angina pectoris were signficantly improved in the combination group and in Xuefu Zhuyu Decoction group compared to the control group(P<0.01). There were no statistical differences in the changes of cTnI, cTnT and BNP between the combination group and Xuefu Zhuyu Decoction group(P>0.05). Conclusion: The clinical effect of combined therapy of Xuefu Zhuyu Decoction and acupuncture with acupoint selection along meridians is superior to routine western medication in the treatment of chest stuffiness and pains of blood stasis. It can significantly improve cardiac function and improve life quality of the patients.
引文
[1] 中华人民共和国卫生部医政司.中国常见心脑血管疾病诊治指南[M].北京:北京科学技术出版社,2000:59.
[2] 刘镇,徐海燕,古春花,等.血府逐瘀汤治疗心血瘀阻型胸痹对Lyapunov指数以及肌钙蛋白影响[J].辽宁中医药大学学报,2017,19(10):143-146.
[3] 许晓梅.血府逐瘀汤治疗冠心病心肌缺血患者的临床观察[J].中国中医药现代远程教育,2017,15(16):98-100.
[4] 朱中华,吴春平.吴春平教授运用血府逐瘀汤治疗胸痹的经验浅谈[J].黑龙江中医药,2017,46(2):27-28.
[5] 张勇.血府逐瘀汤合四君子汤治疗气虚血瘀型胸痹[J].光明中医,2017,32(3):379-381.
[6] 方哲奎.血府逐瘀汤加减治疗胸痹患者41例疗效观察[J].中医临床研究,2017,9(4):87-88.
[7] 徐文博,唐关敏,胡惠林,等.针刺预处理对缺血再灌注损伤大鼠心肌内质网应激的影响[J].中国中医药科技,2018,25(5):620-623.
[8] 朱怡,李毅,张楠,等.电针预处理对心肌缺血再灌注损伤大鼠“内关”穴区Toll样受体4髓样分化因子及核转录因子-κB基因表达的影响[J].针刺研究,2018,43(5):302-306+329.
[9] 刘文立,陈娟.益心舒胶囊联合单硝酸异山梨酯片治疗不稳定型心绞痛的疗效观察[J].中西医结合心脑血管病杂志,2016,14(6):627-629.
[10] 张玲.补肾化瘀豁痰法联合硝酸异山梨酯片对冠心病心绞痛痰浊阻痹证患者脂代谢及临床症状指标的影响[J].四川中医,2017,35(7):81-83.
[11] 孙增建,宫丽鸿.祛痰化瘀中药联合体外反搏治疗冠心病不稳定型心绞痛的临床研究[J].中国中医急症,2016,25(11):2112-2114.
[12] 袁华,胡国恒,陈亚.自拟化瘀祛瘀通脉治疗冠心病不稳定型心绞痛临床观察[J].中国中医急症,2015,24(11):2042-2044.
[13] 叶晓歌,范丽勇,周延平,等.银杏达莫注射液联合替格瑞洛治疗非ST段抬高型急性冠脉综合征的临床研究[J].现代药物与临床,2019,34(3):657-662.
[2] 刘镇,徐海燕,古春花,等.血府逐瘀汤治疗心血瘀阻型胸痹对Lyapunov指数以及肌钙蛋白影响[J].辽宁中医药大学学报,2017,19(10):143-146.
[3] 许晓梅.血府逐瘀汤治疗冠心病心肌缺血患者的临床观察[J].中国中医药现代远程教育,2017,15(16):98-100.
[4] 朱中华,吴春平.吴春平教授运用血府逐瘀汤治疗胸痹的经验浅谈[J].黑龙江中医药,2017,46(2):27-28.
[5] 张勇.血府逐瘀汤合四君子汤治疗气虚血瘀型胸痹[J].光明中医,2017,32(3):379-381.
[6] 方哲奎.血府逐瘀汤加减治疗胸痹患者41例疗效观察[J].中医临床研究,2017,9(4):87-88.
[7] 徐文博,唐关敏,胡惠林,等.针刺预处理对缺血再灌注损伤大鼠心肌内质网应激的影响[J].中国中医药科技,2018,25(5):620-623.
[8] 朱怡,李毅,张楠,等.电针预处理对心肌缺血再灌注损伤大鼠“内关”穴区Toll样受体4髓样分化因子及核转录因子-κB基因表达的影响[J].针刺研究,2018,43(5):302-306+329.
[9] 刘文立,陈娟.益心舒胶囊联合单硝酸异山梨酯片治疗不稳定型心绞痛的疗效观察[J].中西医结合心脑血管病杂志,2016,14(6):627-629.
[10] 张玲.补肾化瘀豁痰法联合硝酸异山梨酯片对冠心病心绞痛痰浊阻痹证患者脂代谢及临床症状指标的影响[J].四川中医,2017,35(7):81-83.
[11] 孙增建,宫丽鸿.祛痰化瘀中药联合体外反搏治疗冠心病不稳定型心绞痛的临床研究[J].中国中医急症,2016,25(11):2112-2114.
[12] 袁华,胡国恒,陈亚.自拟化瘀祛瘀通脉治疗冠心病不稳定型心绞痛临床观察[J].中国中医急症,2015,24(11):2042-2044.
[13] 叶晓歌,范丽勇,周延平,等.银杏达莫注射液联合替格瑞洛治疗非ST段抬高型急性冠脉综合征的临床研究[J].现代药物与临床,2019,34(3):657-662.