温胆汤联合氟哌噻吨美利曲辛对冠心病PCI术后焦虑患者血清BDNF水平、WMSI指数及SAS评分的影响

Effects of Wendan Decoction Combined with Flupentixol-Melitracen on Serum BDNF,WMSI and SAS Score in Patients with Anxiety after Percutaneous Coronary Intervention for Coronary Heart Disease

目的探讨温胆汤联合氟哌噻吨美利曲辛对冠心病经皮冠状动脉介入术(Percutaneous transluminal coronary intervention,PCI)术后焦虑患者血清脑源性神经营养因子(Brain-derived neurotrophic factor,BDNF)水平、室壁运动记分指数(Wall motion score index,WMSI)及焦虑自评量表(Self-rating anxiety scale,SAS)评分的影响。方法选取2018年11月—2019年12月期间廊坊市中医医院收治的80例冠心病PCI术后焦虑患者,按照随机数字表法分为对照组和治疗组,每组各40例。对照组在常规西药治疗基础上应用氟哌噻吨美利曲辛片治疗,治疗组在对照组基础上联合温胆汤治疗。治疗6周后,观察比较两组患者临床疗效、治疗前后中医证候积分、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、SAS评分、血清BDNF水平及WMSI指数。结果治疗后治疗组治疗总有效率95.00%(38/40)明显高于对照组80.00%(32/40),差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分、HAMA、SAS评分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组中医证候积分、HAMA、SAS评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清BDNF水平均较治疗前升高,差异有统计学意义(P<0.05);且治疗组血清BDNF水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者WMSI指数均较治疗前降低,差异有统计学意义(P<0.05);且治疗组WMSI指数明显低于对照组,差异有统计学意义(P<0.05)。结论对冠心病PCI术后焦虑患者实施温胆汤联合氟哌噻吨美利曲辛治疗,其疗效较为理想,可明显改善临床症状、焦虑状况及WMSI,有效上调血清BDNF水平。

Objective To investigate the effects of Wendan Decoction combined with flupentixol-melitracen on the level of serum brain-derived neurotrophic factor(BDNF),ventricular wall motion score index(WMSI)and Self-Rating Anxiety Scale(SAS)score in patients with anxiety after percutaneous coronary intervention(PCI)for coronary heart disease.Methods A total of 80 patients with anxiety after PCI for coronary heart disease in Langfang Traditional Chinese Medicine Hospital from November 2018 to December 2019 were selected and divided into two groups according to the random number table.The control group(40 cases)was treated with flupentixol melitracen tablets on the basis of conventional western medicine treatment,while the treatment group(40 cases)was given Wendan Decoction on the basis of the control group.After 6 weeks of treatment,the clinical efficacy,traditional Chinese medicine(TCM)syndrome score,Hamilton Anxiety Scale(HAMA)and SAS scores,serum BDNF level and WMSI were compared between the two groups.Results The total effective rate of the treatment group was 95.00%(38/40)higher than 80.00%(32/40)of the control group(P<0.05).After treatment,the TCM syndrome score,HAMA and SAS scores and WMSI of the two groups were lower while the serum BDNF level was higher than those before treatment(all P<0.05);the treatment group had more decrease or increase than the control group(P<0.05).Conclusion Wendan Decoction combined with flupentixol-melitracen in the treatment of patients with anxiety after PCI for coronary heart disease had a desirable curative effect,which could significantly improve the clinical symptoms,anxiety status and WMSI,and increase the serum BDNF level.