二陈汤合血府逐瘀汤治疗痰瘀互结型冠状动脉粥样硬化性心脏病心绞痛的临床效果

Clinical effect of Erchen decoction combined with Xuefu Zhuyu decoction on intermingled phlegm and blood stasis type of coronary atherosclerotic heart disease with angina pectoris

目的观察二陈汤合血府逐瘀汤治疗痰瘀互结型冠状动脉粥样硬化性心脏病(冠心病)心绞痛的临床效果。方法选择2016年1—12月首都医科大学附属北京安贞医院门诊或住院治疗的痰瘀互结型冠心病心绞痛患者80例,完全随机分为观察组和对照组,每组40例。对照组给予常规西药控制心室率、抗凝、调脂等治疗。观察组在对照组基础上加用二陈汤合血府逐瘀汤治疗。2组均观察4周。观察2组治疗前后的中医症状缓解情况、心绞痛改善、心电图改善、血脂、血液流变学指标变化。观察不良反应发生情况。结果观察组胸痛、胸闷、心悸、乏力、气短方面的总有效率高于对照组,差异均有统计学意义(均P <0. 05)。观察组心绞痛治疗总有效率高于对照组[90. 0%(36/40)比75. 0%(30/40)],差异有统计学意义(P <0. 05)。观察组心电图改善总有效率高于对照组,差异有统计学意义(P <0. 05)。治疗后观察组总胆固醇、三酰甘油、低密度脂蛋白胆固醇水平低于对照组,高密度脂蛋白胆固醇水平高于对照组,差异均有统计学意义(均P <0. 05)。治疗后观察组全血黏度、血浆黏度、红细胞比容、血小板聚集率低于对照组[(5. 3±1. 8) mPa·s比(6. 2±1. 6) mPa·s、(8. 1±2. 9) mPa·s比(9. 9±2. 3) mPa·s、(1. 4±0. 4) mPa·s比(1. 7±0. 3) mPa·s、(40. 9±3. 4)%比(45. 2±2. 6)%、(34±10)%比(49±12)%],差异均有统计学意义(均P <0. 05)。结论二陈汤合血府逐瘀汤治疗痰瘀互结型冠心病心绞痛效果良好,能有效改善患者的临床症状,改善患者的心电图情况,起到降血脂的作用。

Objective To observe the clinical effect of Erchen decoction combined with Xuefu Zhuyu decoction on intermingled phlegm and blood stasis type of coronary atherosclerotic heart disease with angina pectoris.Methods A total of 80 patients with intermingled phlegm and blood stasis type of coronary atherosclerotic heart disease with angina pectoris were randomly divided into control group and observation group,with 40 cases in each group.The control group was given conventional western medicine for ventricular rate regulation,anticoagulation and lipid regulation.The observation group was treated with Erchen decoction and Xuefu Zhuyu decoction on the basis of western medicine.Both groups were treated for 4 weeks.Remission of traditional Chinese medicine(TCM)symptoms and angina pectoris attack,improvement of electrocardiogram,blood lipids and hemorheological indices and occurrence of adverse reactions were analyzed.Results Effective rates of chest pain,chest tightness,palpitation,fatigue and shortness of breath in observation group were significantly higher than those in control group(all P<0.05).Effective rate of angina pectoris in observation group was significantly higher than that in control group[90.0%(36/40)vs 75.0%(30/40)](P<0.05).Effective rate of electrocardiogram improvement in observation group was significantly higher than that in control group(P<0.05).After treatment,levels of total cholesterol,triglyceride and low density lipoprotein cholesterol in observation group were significantly lower and high density lipoprotein cholesterol was higher than those in control group(all P<0.05).After treatment,whole blood viscosity,plasma viscosity,erythrocyte specific volume and platelet aggregation rate in observation group were significantly lower than those in control group[(5.3±1.8)mPa·s vs(6.2±1.6)mPa·s,(8.1±2.9)mPa·s vs(9.9±2.3)mPa·s,(1.4±0.4)mPa·s vs(1.7±0.3)mPa·s,(40.9±3.4)%vs(45.2±2.6)%,(34±10)%vs(49±12)%](all P<0.05).Conclusion Erchen decoction combined with Xuefu Zhuyu decoction is effective in treating intermingled phlegm and blood stasis type of coronary atherosclerotic heart disease with angina pectoris;it can effectively ameliorate clinical symptoms,improve electrocardiogrphic manifestations and lower blood lipids.