补肾培元为主治疗绝经后冠心病的疗效观察

Efficacy Observation in Treating Patients with Postmenopausal Coronary Heart Disease by Bushen Peiyuan Principle

目的:观察补肾培元为主与激素替代治疗绝经后冠心病患者的疗效。方法:选择绝经5年以上者,无冠心病的健康人25例为第1组,50例有冠心病的患者,将其中伴有或曾有栓塞病、子宫肌瘤、乳腺肿瘤等雌激素使用禁忌症的25例设为第2组（采用补肾培元为主治疗）;对无以上伴发病的25例设为第3组（采用激素替代治疗）。第2、3组于实验前1个月停用降脂药,观察3.5个月,实验前后检测血雌二醇（E2）、血脂诸项指标。结果:治疗前第2、3组E2水平显著低于健康人组,血脂各项指标显著异常（P<0.01）,治疗后血脂诸指标均显著改善（P<0.05或P<0.01）;第3组治疗后E2水平显著升高（P<0.01）,<56岁者中90％表现撤退性出血;第2组治疗后E2水平轻度升高者没有发现撤退性出血,症状体征改善优于第3组。结论:采用补肾培元为主治疗绝经后冠心病患者,紊乱的血脂谱被纠正,临床症状体征明显改善,与激素替代治疗比较,E2水平只轻度增高,避免了因子宫内膜过度增生而癌变的可能。

Objective: To observe the effect of Bushen Peiyuan Principle (BSPY, a TCM principle for tonifying Kidney and nourishing primordial energy) in treating patients with postmenopausal coronary heart disease (PCHD) instead of hormone treatment. Methods: Twenty-five healthy women, who were monepaused for over 5 years but without CHD complication were allocated in Group A, 25 patients with PCHD complication suffered from estrogen contraindications such as embolism, hysteromyoma and mammary adenoma, were arranged in Group B, and 25 patients of PCHD without above-mentioned complications were divided into Group C. Group B and C was treated with BSPY and hormone replacement therapy respectively, and the drugs for hypolipidemics were withdrawn 1 month before the study. All the patients were observed for 3. 5 months, with their blood levels of estra-diol (E2) and lipids determined before and after treatment. Results: Before treatment, the level of E2 in the two treated groups was lower than that in the normal group significantly (P<0.01), and the parameters of blood lipids were abnormal in them. These abnormalities were improved after treatment significantly (P<0.05 or P <0.01). The level of E2 raised significantly (P<0.01) after treatment in patients of Group C, with withdrawal vaginal bleeding presented in 90% of less than 56 years in age. In the Group B after treatment, level of E2 showed a slight rising and withdrawal vaginal bleeding was not found but with improvement of symptoms and signs better than that in Group C. Conclusion: Using BSPY in treating PCHD displayed significant adjustment on disturbance of blood lipid spectrum and improvement on clinical manifestations. As compared with the therapeutic effect of hormone replacement therapy, the risk of carcinogenesis caused by endometrial hyperplasia could be avoided because the blood level of E2 is only slightly increased by BSPY.