丹蒌片对痰瘀互结型非血运重建急性冠脉综合征患者中医证候影响

The Clinical observation of Danlou Tablet in Non- revascularization Patients With Acute Coronary Syndrome and Phlegm and Blood Stasis Syndrome Type about Traditional Chinese Medicine Clinical Syndrome

目的观察丹蒌片对痰瘀互结型非血运重建急性冠脉综合征患者的临床疗效。方法选择因各种原因未能行血运重建治疗的中医辨证为痰瘀互结型的ACS患者70例,随机分配至对照组和治疗组,对照组给予单纯的标准化西医治疗,治疗组在标准化西医治疗基础上加用中成药丹蒌片(每次1.5g,一日3次),疗程一个月。观察治疗前后两组患者心绞痛发作情况(程度、频率、持续时间)、硝酸甘油使用情况(用量、使用后心绞痛缓解时间)及心绞痛积分,并对治疗前后中医临床证候(包括:胸闷、胸痛及其发作频率和持续时间、心悸、气短、乏力及证候总评分)进行评分。比较两组患者心绞痛疗效及中医临床证候评分改变情况。结果治疗组心绞痛总有效率(85.29%)显著优于对照组(48.48%)(P<0.01)。与该组治疗前相比,两组患者治疗后的心绞痛发作频率、持续时间、服用硝酸甘油后心绞痛缓解时间、硝酸甘油使用量、心绞痛积分、中医临床证候评分及证候总评分均显著降低(P<0.01)。两组治疗后相比,治疗组心绞痛发作频率、持续时间、服用硝酸甘油后心绞痛缓解时间、硝酸甘油使用量、中医临床证候总评分(P<0.05)及心绞痛积分(P<0.01)均显著低于对照组。治疗组中医临床证候改善情况(证候评分总有效率79.41%)显著优于对照组(证候评分总有效率45.45%)(P<0.01)。结论丹蒌片对痰瘀互结型非血运重建急性冠脉综合征患者的心绞痛及中医临床证候有显著改善作用。

Objective To investigate the clinical efficacy of Danlou tablet in non- revascularization patients with acute coronary syndrome( ACS) and phlegm and blood stasis syndrome type( PBSST). Methods 70 ACS patients with PBSST for various reasons failed revascularization therapy were randomly assigned to the control group and the treatment group. The control group was given a standardized western medicine treatment and the treatment group was given Danlou tablets( every time 1. 5g,3 times a day) based on standardized western medicine treatment,treatment for a month. It was observed in the two groups of patients before and after treatment that angina episodes( intensity,frequency,duration),nitroglycerin use( consumption,angina relief time after taking nitroglycerin) and the score of angina,and the score were recorded that traditional Chinese Medicine( TCM) clinical syndrome( including: chest pain or tightness and its frequency and duration,palpitations,shortness of breath,fatigue and total syndrome score). The clinical efficacy of angina and the score of TCM clinical syndrome were compared in the two groups of patients. Results The total effective rate of angina( 85. 29%) was significantly better than the control group( 48. 48%),( P <0. 01). Compared with the same group before treatment,the frequency and duration of angina,the angina relief time after taking nitroglycerin,the amount of nitroglycerin,the score of angina and TCM clinical syndromes and the total score of syndrome,all these were significantly lower( P <0. 01) in the two groups of patients after treatment. Compared to the control group,the frequency and duration of angina,the angina relief time after taking nitroglycerin,the amount of nitroglycerin,the total score of TCM clinical syndrome( P <0. 05) and the score of angina( P <0. 01) were significantly lower in the treatment group after treatment. The improvement of TCM clinical syndromes in the treatment group( the total efficiency of syndrome score was 79. 41%) was significantly better than the control group( the total efficiency of syndrome score was 45. 45%)( P <0. 01). Conclusion Danlou tablet have a significant improvement to angina and TCM clinical syndromes in non- revascularization patients with ACS and PBSST.