摘要
目的观察心胃同治法调制Ⅳ方联合西药治疗痰阻心脉型冠心病(冠状动脉粥样硬化性心脏病)心绞痛的临床疗效。方法选取2020年1月至2021年6月在上海交通大学医学院附属第九人民医院黄浦分院中医内科门诊及住院治疗的痰阻心脉型冠心病心绞痛患者80例,按就诊先后顺序分为观察组和对照组,各40例。对照组采用西医标准化治疗,观察组在西医标准化治疗基础上联用心胃同治法调治Ⅳ方治疗,2组治疗4周后进行疗效评定。比较2组治疗前后心绞痛症状积分、心绞痛分级,治疗后心绞痛疗效、中医证候疗效、心电图疗效,治疗前后血脂水平和血清纤维蛋白原(FIB)水平。观察治疗过程中不良反应发生情况。结果对照组和观察组治疗后心绞痛症状积分均明显低于治疗前[(6.7±1.4)分比(10.7±2.0)分、(5.8±1.2)分比(10.1±2.2)分],且观察组治疗后心绞痛症状积分明显低于对照组,差异均有统计学意义(均P<0.05)。治疗后,2组心绞痛分级比较差异无统计学意义(P>0.05)。治疗后观察组心电图疗效显效率高于对照组[54.3%(19/35)比38.9%(14/36)](P<0.01),但心绞痛疗效、中医证候疗效、心电图疗效的总有效率与对照组比较差异均无统计学意义(均P>0.05)。观察组治疗后高密度脂蛋白胆固醇(HDL-C)水平高于对照组[(1.28±0.12)mmol/L比(1.22±0.11)mmol/L],低密度脂蛋白胆固醇(LDL-C)水平低于对照组[(2.5±0.4)mmol/L比(2.7±0.3)mmol/L],差异均有统计学意义(均P<0.05)。观察组治疗后FIB水平低于治疗前和对照组治疗后,差异均有统计学意义(均P<0.05)。治疗过程中所有患者均未出现恶心、呕吐、腹泻、皮疹等不良反应,血、尿常规及肝肾功能均未见明显异常。结论心胃同治法调治Ⅳ方联合西药治疗痰阻心脉型冠心病心绞痛,在心电图疗效,降低LDL-C水平,升高HDL-C水平方面以及对FIB的抑制方面优于单纯西药,且无明显不良反应。
Objective To observe the clinical efficacy of simultaneous treatment on heart and stomach modulationⅣformula combined with western medicine on angina pectoris with phlegm blocking heart pulse.Methods From January 2020 to June 2021,80 patients with angina pectoris with phlegm blocking heart pulse admitted to Internal Medicine of Traditional Chinese Medicine,Huangpu Branch of the Ninth People′s Hospital Affiliated to Medical College of Shanghai Jiaotong University were enrolled.They were divided into observation group and control group by visit order,with 40 cases in each group.The control group was treated with standardized western medicine,and the observation group was treated with simultaneous treatment on heart and stomach modulationⅣformula on the basis of standardized western medicine.The curative effect of the two groups was evaluated 4 weeks after treatment.The angina symptom score,angina pectoris grade,angina pectoris curative effect,traditional Chinese medicine syndrome curative effect,electrocardipgram(ECG)curative effect,and levels of blood lipid and serum fibrinogen(FIB)were compared between the two groups.The occurrence of adverse reactions during treatment were observed.Results The angina symptom scores in the control group and the observation group after treatment were significantly lower than those before treatment[(6.7±1.4)vs(10.7±2.0),(5.8±1.2)vs(10.1±2.2)],and the angina symptom scores in the observation group after treatment was significantly lower than that in the control group(all P<0.05).After treatment,there was no significant difference in angina pectoris grade between the two groups(P>0.05).The effective rate of ECG in the observation group was higher than that in the control group[54.3%(19/35)vs 38.9%(14/36)](P<0.01),but there were no significant differences in the total effective rate of angina pectoris curative effect,traditional Chinese medicine syndrome curative effect and ECG curative effect between the two groups(all P>0.05).After treatment,the level of high-density lipoprotein cholesterol(HDL-C)in the observation group was higher than that in the control group[(1.28±0.12)mmol/L vs(1.22±0.11)mmol/L],and the level of lwo-density lipoprotein cholesterol(LDL-C)was lower than that in the control group[(2.5±0.4)mmol/L vs(2.7±0.3)mmol/L](both P<0.05).The level of FIB in the observation group after treatment was lower than that before treatment and the control group after treatment(both P<0.05).During the treatment,all patients did not have adverse reactions such as nausea,vomiting,diarrhea and rash,and there were no obvious abnormalities in blood and urine routine and liver and kidney function.Conclusions The combination of western medicine and simultaneous treatment on heart and stomach modulationⅣformula in the treatment of angina pectoris with phlegm blocking heart pulse is superior to western medicine alone in ECG efficacy,reducing LDL-C level,increasing HDL-C level and inhibiting FIB,and there is no obvious adverse reaction.
作者
倪晖君
李威
任建素
Ni Huijun;Li Wei;Ren Jiansu(Internal Medicine of Traditional Chinese Medicine,Huangpu Branch of the Ninth People's Hospital Affiliated to Medical College of Shanghai Jiaotong University,Shanghai 200011,China)
出处
《中国医药》
2022年第7期1065-1069,共5页
China Medicine
基金
上海市黄浦区中医药骨干人才培养项目(ZY-2019RCTDPY-1022)。
关键词
心绞痛
痰阻心脉
心胃同治
中西医结合
Angina pectoris
Phlegm blocking heart pulse
Simultaneous treatment on heart and stomach
Combination of traditional Chinese and western medicine
