中西医结合治疗稳定性冠心病30例临床观察

Clinical Observation of Stable Coronary Heart Disease Treated by Huanglian Wendan Decoction and Danshen Decoction Combined with Western Medicine: 30 Cases Report

目的观察黄连温胆汤合丹参饮治疗稳定性冠心病的临床疗效.方法 60例冠心病心绞痛或心肌梗死患者随机分为对照组（常规西药治疗）30例和治疗组（常规西药加中药治疗）30例,观察治疗前后心绞痛疗效、中医症候和心电图以及低密度脂蛋白胆固醇（LDL-C）和高敏C反应蛋白（HS-CRP）的改变.结果两组患者治疗后的心绞痛发作次数、持续时间和硝酸甘油用量均与治疗前有非常显著性差异（ P＜0.01）;但组间无显著性差异（ P＞0.05）.治疗后两组患者的胸闷痛、心悸等症状均较治疗前改善（ P＜0.05～0.01）,但治疗组胸闷痛改善好于对照组（ P＜0.05）.心电图改善总有效率对照组为53.3%,治疗组为73.3%,两组间无显著性差异.治疗后两组患者的HS-CRP和LDL-C均明显降低（ P＜0.01）,但治疗组降低的幅度大于对照组（ P＜0.05）.结论黄连温胆汤合丹参饮可明显缓解稳定性冠心病患者的临床症状,可能与降低血脂和减轻炎症损伤有关.

Objective To observe the effect of Huanglian Wendan decoction and Danshen decoction combined with Wester medicineon stable coronary heart disease. Methods 60 patients with angina or myocardial infarction were randomly divided into the control group and treatment group with 30 cases in each group. The patients of the control group were treated with routine medicine and those of the treatment group were added with traditional Chinese medicine （TCM） Huanglian Wendan decoction combined with Danshen decoction, The changes of angina, symptoms and signs of TCM, electrocardiogram （ECG）, low density lipoprotein cholesterol （LDL-C） and high sensitive C-reactive protein （HS-CRP） of all patients were observed before and after treatment. Results After treatment, the frequency and duration of angina, dose of notroglycerine of patients in two groups were significantly different from those before treatment （P〈0.01）, but there was no significant difference between two groups （P〉0.05）. The symptoms such as chest discomfort and palpitation of patients of two groups improved after treatment （ P〈0.05-0.01）, but the treatment group improved more obviously than the control group （P〈0.05）. The total effective rate showed by ECG were 53.3 % in the control group and 73.3% in the treatment group, there was no significant difference between two groups. HS-CRP and LDL-C of all patients decreased after treatment （ P 〈0.01）, but the treatment group was lower than the control group （ P〈0.05）. Conclusion Huanglian Wendan decoction combined with Danshen decoction can relief clinical symptoms of stable coronary heart disease, which may be related with lipid decrease and inflammation reduction.