养心通脉汤治疗冠状动脉粥样硬化性心脏病不稳定型心绞痛35例临床观察

Report of unstable angina with coronary artery disease treated by Yangxintongmai decoction

目的观察养心通脉汤治疗冠状动脉粥样硬化性心脏病(以下简称冠心病)不稳定型心绞痛的临床疗效。方法将69例冠心病不稳定型心绞痛患者随机分为2组。对照组34例予肠溶阿司匹林100mg,每日1次口服;单硝酸异山梨酯片20mg,每日2次口服。治疗组35例在对照组治疗基础上加服养心通脉汤,每日1剂,水煎取汁300mL,分2次服。2组均15日为1个疗程,连续治疗2个疗程。观察2组治疗前后血脂、同型半胱氨酸(Hcy)的变化,中医证候疗效及临床疗效,并检测血、尿常规等安全性指标。结果治疗组中医临床证候、心绞痛及心电图总有效率分别为94.29%、88.57%、85.71%,对照组分别为73.53%、76.47%、70.59%,2组比较差异均有统计学意义(P<0.05);治疗组治疗后血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)均降低,高密度脂蛋白胆固醇(HDL-C)升高,与本组治疗前及对照组治疗后比较差异均有统计学意义(P<0.05),但Hcy改善不明显(P>0.05)。结论养心通脉汤对不稳定型心绞痛疗效确切,并能降低TC、TG及LDL-C。

Objective To the effect of Yangxintongmai decoction on the treatment of unstable angina with coronary artery disease. Methods 69 cases with unstable angina with coronary arteay disease were randomly divided into two groups. Patients in conrol group （ n = 34） were treated by enteric coated aspirin （ 100mg, once a day）, Isosorbide mononitrate （20 mg, twice a day）. Patients in treatment group were treated by Yangxintongmai decoction （a dose, twice a day） combined with enteric coated aspirin and Isosorbide mononitrate. The course was 15 days in both groups. The changes of blood lipid and homocysteic acid were measured before and after treatment. Results Total effective rate of clinical symptoms improvement, angina remittence and ECG improvement in treatment group were separatelly 94.29%, 88.57% and 85.71%. They were 73.53%, 76.47% and 70.59% in control group. There were significant differences between treatment group and control group on total effective rate （ P 〈0.05）. TG,TC and LDL- C in serum posttreatment in treatment group significantly decreased compared with those in control group and before treatment （ P 〈 0.05）. Conclusion Yangxintongmai decoction has definite effect on the treatment of unstable angina with coronary artery disease, can decrease TG. TC and LDL- C in serum.