辨证分型联合西药治疗心绞痛(气阴两虚/瘀血痹阻)随机平行对照研究
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摘要
[目的]观察辨证分型联合西药治疗心绞痛(气阴两虚/瘀血痹阻)疗效。[方法]使用随机平行对照方法,将118例门诊患者按就诊顺序号方法随机分为两组。对照组59例硝酸甘油,4次/d,1片/次,含服;硝酸异山梨酯,20mg/次,4次/d。治疗组59例,气阴两虚-活血益气汤(川芎8g,麦冬15g,红花、丹参各10g,黄芪20g,五味子10g);瘀血痹阻-血府逐瘀汤(地黄生10g,柴胡5g,桃仁、赤芍、当归、红花、牛膝、枳壳各10g,川芎、桔梗、甘草各5g),1剂/d,水煎500mL,2次/d;西药治疗同对照组。连续治疗30d为1疗程。观测临床表现、心绞痛持续时间、心绞痛发作次数、不良反应。治疗1疗程(30d),判定疗效。[结果]治疗组显效36例,有效20例,无效3例,总有效率94.927%;对照组显效25例,有效21例,无效13例,总有效率77.97%;治疗组疗效优于对照组(P<0.05)。心绞痛持续时间、心绞痛发作次数两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]辨证分型联合西药治疗心绞痛(气阴两虚/瘀血痹阻),疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of syndrome differentiation and typing combined with western medicine in the treatment of senile heart and coronary atherosclerotic heart disease(Qiyin Liangxu\Yuxue Bizu). [Method] 118 outpatients were randomly divided into two groups according to the order number of visits by randomized parallel control method. Control group 59 cases of nitroglycerin, 4 times a day, 1 tablet a time, taking; isosorbide nitrate, 20 mg a time, 4 times a day. 59 cases in the treatment group were deficient in both qi and yin-Huoxue Yiqi decoction(Chuanxiong 8 g, Maidong 15 g, Honghua,Danshen each 10 g,Huangqi 20 g, Wuweizi 10 g); Blood stasis obstruction-Xuefu Zhuyu decoction(Shengdihuang 10 g, Chaihu5 g, Taoren, Chishao, Danggui. Honghua, Niuxi, Zhiqiao each 10 g, Chuanxiong.Jiegeng,Gancao each 5 g), 1 dose/d, decoction 500 mL, twice a day; Wwestern medicine was the same as the control group Continuous treatment for 30 days is a course of treatment. Clinical manifestations, duration of angina pectoris, frequency of angina pectoris attacks and adverse reactions were observed. One course of treatment(30 days) was used to determine the curative effect. [Result] 36 cases were markedly effective in the treatment group, 20 cases were effective, 3 cases were ineffective, the total effective rate was 94.927%; 25 cases were markedly effective in the control group, 21 cases were effective, 13 cases were ineffective, the total effective rate was 77.97%;the curative effect of the treatment group was better than that of the control group(P<0.05). The duration of angina pectoris and the number of attacks of angina pectoris were improved in both groups(P<0.01), and the improvement in treatment group was better than that in control group(P<0.01). [Conclusion] Syndrome differentiation and typing combined with western medicine in the treatment of elderly patients with coronary atherosclerotic heart disease(deficiency of both Qi and Yin\ stagnation of blood stasis and obstruction), the curative effect is satisfactory, no serious adverse reactions, it is worth promoting.
[Objective] To observe the curative effect of syndrome differentiation and typing combined with western medicine in the treatment of senile heart and coronary atherosclerotic heart disease(Qiyin Liangxu\Yuxue Bizu). [Method] 118 outpatients were randomly divided into two groups according to the order number of visits by randomized parallel control method. Control group 59 cases of nitroglycerin, 4 times a day, 1 tablet a time, taking; isosorbide nitrate, 20 mg a time, 4 times a day. 59 cases in the treatment group were deficient in both qi and yin-Huoxue Yiqi decoction(Chuanxiong 8 g, Maidong 15 g, Honghua,Danshen each 10 g,Huangqi 20 g, Wuweizi 10 g); Blood stasis obstruction-Xuefu Zhuyu decoction(Shengdihuang 10 g, Chaihu5 g, Taoren, Chishao, Danggui. Honghua, Niuxi, Zhiqiao each 10 g, Chuanxiong.Jiegeng,Gancao each 5 g), 1 dose/d, decoction 500 mL, twice a day; Wwestern medicine was the same as the control group Continuous treatment for 30 days is a course of treatment. Clinical manifestations, duration of angina pectoris, frequency of angina pectoris attacks and adverse reactions were observed. One course of treatment(30 days) was used to determine the curative effect. [Result] 36 cases were markedly effective in the treatment group, 20 cases were effective, 3 cases were ineffective, the total effective rate was 94.927%; 25 cases were markedly effective in the control group, 21 cases were effective, 13 cases were ineffective, the total effective rate was 77.97%;the curative effect of the treatment group was better than that of the control group(P<0.05). The duration of angina pectoris and the number of attacks of angina pectoris were improved in both groups(P<0.01), and the improvement in treatment group was better than that in control group(P<0.01). [Conclusion] Syndrome differentiation and typing combined with western medicine in the treatment of elderly patients with coronary atherosclerotic heart disease(deficiency of both Qi and Yin\ stagnation of blood stasis and obstruction), the curative effect is satisfactory, no serious adverse reactions, it is worth promoting.
引文
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[8]刘烨,王耀彬,陈天金,等.CTA评价冠状动脉粥样硬化管腔狭窄程度及其高危因素的相关性[J].武警医学,2016,27(7):666-671.
[9]曹玉华.心脏性猝死的预防与急救[J].中外健康文摘,2009,6(19):50-51.
[10]靳文英,赵文娟,马玉良,等.冠心病心绞痛患者的临床表现与心率特点分析[J].中华心脏与心律电子杂志,2014,2(2):39-42.
[11]杨清霞,王伶,刘富强.硝酸甘油的药理作用及临床应用[J].药品评价,2006,3(3):214-216.
[12]李静,程务本.硝酸异山梨酯缓释剂的作用机制,耐药性及临床应用[J].中国临床药学杂志,1998,7(2):93-98.
[13]灵枢经[M].北京:人民卫生出版社,2012:59.
[14]高学敏.中药学[M].北京:中国中医药出版社,2007.
[15]邓中甲.方剂学[M].7版.北京:中国中医药出版社,2010:178.
[2]梁亚军.心绞痛与心肌梗塞危险因素的流行病学研究[D].苏州:苏州大学,2008.
[3]中华人民共和国卫生部.涉及人的生物医学研究伦理审查办法(试行)[S].(2007-03-26)[2017-02-01].http://www.moh.gov.cn/qjjys/s3581/200804/b9f1bfee4ab344ec892e68097296e2a8.shtml.
[4]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.慢性稳定性心绞痛诊断与治疗指南[J].中华心血管病杂志,2007,35(3):1-16.
[5]周仲瑛.中医内科学[M].北京:中国中医药出版社,2007:152-153.
[6]吕树铮.冠心病治疗指南更新[J].中国当代医药,2009,16(3):8-9.
[7]孙冰,孙少芳,刘秀珍.冠心病522例发病危险因素调查分析[J].齐鲁护理杂志,2008,14(9):109-110.
[8]刘烨,王耀彬,陈天金,等.CTA评价冠状动脉粥样硬化管腔狭窄程度及其高危因素的相关性[J].武警医学,2016,27(7):666-671.
[9]曹玉华.心脏性猝死的预防与急救[J].中外健康文摘,2009,6(19):50-51.
[10]靳文英,赵文娟,马玉良,等.冠心病心绞痛患者的临床表现与心率特点分析[J].中华心脏与心律电子杂志,2014,2(2):39-42.
[11]杨清霞,王伶,刘富强.硝酸甘油的药理作用及临床应用[J].药品评价,2006,3(3):214-216.
[12]李静,程务本.硝酸异山梨酯缓释剂的作用机制,耐药性及临床应用[J].中国临床药学杂志,1998,7(2):93-98.
[13]灵枢经[M].北京:人民卫生出版社,2012:59.
[14]高学敏.中药学[M].北京:中国中医药出版社,2007.
[15]邓中甲.方剂学[M].7版.北京:中国中医药出版社,2010:178.