加味生丹蒌薤四逆方对冠心病抑郁症的临床干预研究

Study on clinical intervention of Jiawei Shengdan Louxie Sini Fang on coronary heart disease with depression

目的:研究以中医主要证候要素辨病辨证,以益气养阴、活血养心补肾、疏肝养肝化痰立法,以加味生丹蒌薤四逆方治疗冠心病抑郁症的疗效。方法:采用随机对照临床试验,选冠心病稳定性心绞痛合并抑郁症患者,分为中药干预组及西药对照组。维持冠心病基础西药治疗,中药干预组加服中药加味生丹蒌薤四逆方,西药对照组加服氟西汀。结果:在心绞痛疗效、证候疗效、HAMA量表评分方面,中药组优于对照组。症状积分比较,试验组在气短乏力、自汗、盗汗、失眠、夜尿频多、便秘、腹胀、善太息、咽中梗阻、唇色暗等方面优于对照组。结论:中药干预在改善冠心病心绞痛症状,同时可以改善患者全身其他症状,对伴发焦虑的患者能改善焦虑评分,使抑郁、焦虑对冠心病的影响减少。中医辨病辨证抓主要证候要素治疗具有明显的优势。

Objective： To study the differentiation of symptoms and signs of major syndrome factors of traditional Chinese med- icine and the efficacy of Jiawei Shengdan Louxie Sini Fang combined with methods for nourishing qi and yin, promoting blood circula- tion, nourishing heart and kidney, soothing and nourishing liver and reducing phlegm. Method： In the randomized controlled clinical trial, patients of coronary heart disease with stable angina and depression are selected and divided into the traditional Chinese medicine intervention group and the western medicine control group. Maintaining the basic treatment with western medicines for coronary heart disease, the Chinese traditional medicine group was administered with Jiawei Shengdan Louxie Sini Fang, while the western medicine control group fluoxetine. Result： Compared with the control group, the traditional Chinese medicine group was better in angina curative effect, syndrome curative effect and HAMA rating scale. In the comparison for sign and symptom score, the test group was better than the control group in short of breath, lack of power, self-sweat, night sweats, insomnia, frequent micturition in night, constipation, ab- dominal distension, frequent deep sigh, pharynx obstruction and dark color of lips. Conclusion ： Intervention with traditional Chinese medicine can ameliorate angina and other symptoms of whole body. It can also improve anxiety scores of patients in order to reduce the impact of depression and anxiety on coronary heart disease.