双和散加减联合养心导引操对冠心病合并焦虑、抑郁患者生活质量的影响

Effects of Modified Shuanghe Powder (双和散) Combined with Yangxin Guiding Exercise on Coronary Heart Disease with Anxiety and Depression

目的观察双和散加减联合养心导引操治疗冠心病合并焦虑、抑郁的疗效以及对患者生活质量的影响。方法将78例冠心病合并焦虑、抑郁患者随机分为3组,每组26例。治疗1组应用双和散加减+养心导引操治疗;治疗2组应用双和散加减+常规体育锻炼治疗;对照组应用劳拉西泮片+常规体育锻炼治疗。试验周期3个月,分别于治疗前、治疗1个月末、3个月末测评各组患者简明生活质量量表[SF-36,包括生理机能(PF)、生理职能(RP)、躯体疼痛(BP)、一般健康状况(GH)、精力(VT)、社会功能(SF)、情感职能(RE)、精神健康(MH)、健康变化(MT)]和冠心病中医证候分级量化表评分,设各指标评分治疗1个月与治疗前比较的改变量为改变量1,治疗3个月与治疗前比较的改变量为改变量2,比较各组改变量并统计冠心病中医证候分级量化表疗效。结果 SF-36改变量1比较,PF、RP、GH、VT、RE、MH因子组间比较差异有统计学意义(P <0. 05);两两比较,PF和GH因子治疗1组优于对照组,RP和VT因子治疗1组优于治疗2组及对照组、治疗2组优于对照组,RE和MH因子治疗1组与治疗2组均优于对照组(P <0. 05)。SF-36改变量2比较,RP、VT、RE、MH因子组间比较差异有统计学意义(P <0. 05);两两比较,RP、VT、MH因子治疗1组优于对照组,RE因子治疗1组与治疗2组均优于对照组(P <0. 05)。冠心病中医证候分级量化表评分各组间改变量1及改变量2比较差异均具有统计学意义(P <0. 05),治疗1组与治疗2组均优于对照组(P <0. 05)。治疗1组、治疗2组、对照组冠心病中医证候分级量化表疗效总有效率分别为88. 5%、88. 5%、61. 5%,治疗1组与治疗2组疗效均明显优于对照组(P <0. 05)。结论双和散加减联合养心导引操治疗冠心病合并焦虑、抑郁的疗效确切,并可有效改善患者生活质量。

Objective To observe the efficacy of modified Shuanghe Powder(双和散)combined with Yangxin Guiding Exercise on coronary heart disease with modified Shuanghe Powder combined with anxiety and depression and the effects on quality of life.Methods A total of 78 patients were randomly and equally divided into 3 groups.The treatment group 1 was treated with Yangxin Guiding Exercise;The treatment group 2 was treated with modified Shuanghe Powder combined with regular physical exercise.The control group was treated with Lorazepam and regular physical exercise.The test cycle was 3 months.Brief quality of life scale SF-36,including physiological function(PF),role physical(RP),bodily pain(BP),general health(GH),vitality(VT),social function(SF),role emotion(RE),mental health(MH),and health change(MT)were assessed before treatment and at the end of 1 month’s treatment,at the end of 3 months’ treatment.The change of each index score between 1 month of treatment and before treatment was the change amount of 1,and the change of 3 months of treatment compared with before treatment was the change amount of 2.The change of each group was compared and the effect of TCM syndrome grading and quantification table of coronary heart disease was compared.Results Comparison of baseline changes of SF-36 scores of 3 groups after 1 month of treatment: There was a statistically significant difference in the baseline change of six factors(PF,GH,RP,VT,MH and RE)among 3 groups of subjects(P<0.05).Comparison of PF and GH factors,there was a significant difference between the treatment group 1 and the control group(P<0.05)and the treatment group 1 is better than the control group.Comparison of RP and VT factors,there was a significant difference between any two groups(P<0.05).The treatment group 1 was better than the treatment group 2 and the treatment group 2 was better than the control group.Comparison of MH and RE factor,there was a significant difference between the control group and the other two groups(P<0.05)and both treatment groups were better than the control group.Comparison of baseline changes of SF-36 scores of 3 groups after 3 month of treatment: There was a statistically significant difference in the baseline change of four factors(RP,VT,RE and MH)among 3 groups of patients(P<0.05).Comparison of RP,VT and MH factors,there was a significant difference between the treatment group 1 and the control group(P<0.05).The treatment group 1 was better than the control group.Comparison of RE factor,there was a significant difference between the control group and the other 2 groups(P<0.05).Both treatment groups were better than the control group.Comparison of baseline changes and efficacy of TCM syndrome classification and quantification table of coronary heart disease in 3 groups after 1 month and 3 months after treatment: There was a statistically significant difference in baseline changes in 3 months,in comparison between 3 groups(P<0.05).Both treatment group 1 and treatment group 2 were better than the control group(P<0.05).The total effective rate of TCM syndrome classification and quantification table of the treatment group 1,treatment group 2 and the control group was 88.5%,88.5% and 61.5% respectively,both treatment group showing bether result than the control(P<0.05).Conclusions modified Shuanghe Powder combined with Yangxin Guiding Exercise can improve quality of life and TCM symptoms.