冠心汤治疗气虚血瘀型冠心病介入术后残余病变心绞痛的临床研究
Clinical Study of Guanxin Decoction in the Treatment of Residual Lesions Angina Pectoris After Percutaneous Coronary Intervention in Coronary Heart Disease Patients with Qi Deficiency and Blood Stasis Pattern
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摘要: 目的 观察本院自制汤剂冠心汤对气虚血瘀型冠心病介入术（PCI）后残余病变心绞痛患者的临床治疗效果。方法 将100例气虚血瘀型冠心病介入术后残余病变心绞痛患者随机分为对照组和冠心汤组，对照组（50例）给予常规西药方案（阿司匹林、氯吡格雷、阿托伐他汀钙、美托洛尔、单硝酸异山梨酯等），冠心汤组（50例）在对照组用药基础上加服冠心汤，疗程3个月。比较治疗前后超敏C反应蛋白（hs-CRP）、脂代谢（TC、HDL-C、LDL-C）和心肌缺血总负荷（TIB）的水平，观察患者生活质量评分（SF-36）、心绞痛复发率、西雅图心绞痛量表（SAQ）、中医证候积分疗效变化。结果 治疗后2组患者在心绞痛复发率、西雅图心绞痛量表、生活质量评分、中医证候积分疗效等方面较前改善（P<0.05~0.01)，冠心汤组优于对照组（P<0.05~0.01)；治疗后冠心汤组的中医证候有效率较对照组高（P<0.01）。2组hs-CRP、TC、LDL-C均显著下降（P<0.05~0.01)，冠心汤组降低更明显（P<0.05~0.01)；2组HDL-C水平均高于治疗前（P<0.05)，但2组间比较无统计学差异（P>0.05）。2组TIB均较前降低（P<0.05~0.01)，冠心汤组降低更为显著（P<0.05)。结论 冠心汤可有效改善气虚血瘀型冠心病PCI后残余病变心绞痛患者的临床症状，减轻心肌缺血，调节血脂代谢，减少炎症反应，提高生活质量。Abstract: OBJECTIVE To observe the clinical effect of Guanxin Decoction in the treatment of residual lesions angina pectoris after percutaneous coronary intervention (PCI) in Percutaneous Coronary Intervention (CHD) patients with qi deficiency and blood stasis pattern. METHODS 100 CHD patients of qi deficiency and blood stasis pattern with residual lesions angina pectoris after PCI were randomly divided into the control group and Guanxin Decoction group. The control group (50 cases) was given conventional Western medicine， like aspirin， clopidogrel， atorvastatin calcium， metoprolol， isosorbide mononitrate， while Guanxin Decoction group (50 cases) was added with Guanxin Decoction on the basis of control group therapy. The therapeutic course was 3 months. The levels of hypersensitive C-reactive protein (hs-CRP)， lipid metabolism (TC， HDL-C， LDL-C) and total ischemia burden (TIB) were compared before and after treatment. The integral quality of life (SF-36)， recurrence rate and degree of angina pectoris， Seattle angina questionnaire (SAQ) and TCM syndrome scores were observed. The results were analyzed by SPSS 20.0. RESULTS The recurrence rate and degree of angina， SAQ， SF-36 and TCM syndrome scores of the two groups were improved after treatment (P<0.05， P<0.01)， and the effect of Guanxin Decoction group was better than that of the control group (P<0.05， P<0.01). The levels of hs-CRP， TC and LDL-C in the two groups were lower than those before treatment (P<0.05， P<0.01)， and the effect of Guanxin Decoction group was much more significant (P<0.05， P<0.01). The level of HDL-C in the two groups was higher than that before treatment (P<0.05)， but there was no difference between the two groups (P>0.05). The level of TIB in the two groups were lower than before (P<0.05， P<0.01)， and the decrease in Guanxin Decoction group was more significant (P<0.05). CONCLUSION Guanxin Decoction can effectively improve the clinical effect in treating residual lesions angina pectoris after PCI in CHD patients with qi deficiency and blood stasis syndrome， relieving myocardial ischemia， regulating blood lipid metabolism， reducing inflammatory response， and improving patients' quality of life.
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