疏肝豁痰化瘀法及其组方治疗冠心病不稳定型心绞痛的临床疗效观察

Clinical Study of the Formula with Soothing the Liver Reduce Phlegm and Absorb Clots Methods on Patients with Unstable Angina Pectoris

目的：观察疏肝豁痰化瘀法及其组方“心痛方”治疗不稳定型心绞痛（UAP）的临床疗效以及对血脂和血液流变学的影响与安全性。方法：共入选60例UAP患者，将所有患者随机分入治疗组（中药＋西药）和对照组（单用西药），每组各30例，连续用药治疗4周后进行比较并随访1月内急性心血管事件的发生率。结果：①治疗后两组患者的临床证候、心电图、血液流变学等指标均有明显改善（P〈0．01—0．05）；②治疗组对心绞痛、中医证候的治疗效果明显优于对照组（P〈0．01—0．05），在改善血脂方面与对照组比较亦有较好的效果（P〈0．05）；③随访发现治疗组急性心血管事件发生率少于对照组（6．67％比13．33％）。结论：疏肝豁痰化瘀法（心痛方）治疗UAP有良好疗效，能明显改善临床症状，改善血液流变学，降低血脂，近期随访发现急性心血管事件发生率减少，提示其可能具有一定的稳定斑块作用，对预防急性冠脉综合征（ACS）的发生、发展具有一定的临床意义。

Objective： In order to observe the clinical effects of the formula with soothing the liver,reduce phlegm and absorb clots methods（ Xintongfang decoction）in treating patients with UAP. Methods： 60 cases of patients with UAP were randomly divided into treatment group （ western medicine combined with Xintongfang decoction） and control group （simply with western medicine）. All clinical data were compared after 4 weeks＇ treatment. Results： （1） After treatment, the clinical symptoms, electrocardiogram（ECG） and hemorrheology were significantly improved in all cases （ P 〈 0.01 - 0.05 ）. （2） The differences of the clinical symptoms of angina pectoris and TCM between the groups were significant（ P 〈 0.01 -0.05）, the blood lipid was also better improved in the treatment group compared with the control group（ P 〈0. 05）. （3）During following - up, the incidence of acute cardiac events in the treatment group was lower than that of control group（6.67% to 13.33% ）. Conclusion： Combined with soothing the liver,reduce phlegm and absorb clots methods （ Xintongfang decoction）has good curative effect on patients with UAP, and the incidence of acute cardiac events also decreased, prompting that it maybe has an effect on stabilitating atherosclerosis plaques,preventing and curing the evolution of acute coronary syndrome（ACS）.