炙甘草汤加减治疗老年冠心病的临床研究

Clinical study onZhigancao decoction for the treatment of senile coronary heart disease

目的 评价炙甘草汤加减治疗老年冠心病的临床疗效.方法 将符合纳入标准的 174 例60岁以上的冠心病患者按随机数字表法分为2组各87例.对照组采用西医常规疗法治疗,观察组采用炙甘草汤加减治疗.观察2组患者的临床疗效及治疗前后血液流变学指标的变化.结果 治疗后,观察组、对照组心绞痛疗效总有效率分别为89.7%（78/87）、67.8%（59/87）,2组比较差异有统计学意义（χ2=11.122, P=0.001）;心电图疗效总有效率分别为80.5%（70/87）、62.1%（45/87）,2组比较差异有统计学意义（χ2=14.771,P值〈0.01）.观察组血浆黏度[（1.48±0.31）mPa·s比（1.61±0.29）mPa·s,t=2.856]、全血黏度低切[（6.01±0.85）mPa·s 比（6.42±1.34）mPa·s , t=2.410]、全血黏度高切[（4.03±0.45）mPa·s 比（4.47±0.36）mPa·s,t=7.122]）、红细胞压积[（39.75±4.09）%比（43.98±4.17）%,t=6.755]、纤维蛋白原[（3.21±0.38）g/L比（4.05±0.42）g/L,t=13.833]均明显低于对照组（P〈0.01或P〈0.05）.结论 炙甘草汤加减可改善老年冠心病患者的血液流变学,且不良反应小.

Objective To discuss the feasibility and clinical efficacy of zhigancao decoction for the treatment of senile coronary heart disease.Methods 174 cases aged more than 60 of Liaocheng municipal hospital of Traditional Chinese Medicine were divided into a control group and an observation group by the random number table method from April 2012 to April. 2014. 87 cases in the control group were treated with conventional western medicine, while 87 cases in the observation group were takenzhigancaodecoction. The clinical efficacy, changes of hemorheology in both groups were observed and compared.Results The total effective rate of angina was 67.8% in the control group and 89.7% in the observation group, with obvious difference （χ2=11.122,P=0.001）. The total effective rate of electrocardiogram was 62.1% in the control group and 80.5% in the observation group, with obvious difference （χ2=14.771,P〈0.01）. The change of hemorheology blood viscosity （1.48 ± 0.31 mPa·s vs. 1.61 ± 0.29 mPa·s,t=2.856）, whole blood viscosity ow cut （l 6.01 ± 0.85 mPa·s vs. 6.42 ± 1.34 mPa·s, t=2.410） and high cut （4.03 ± 0.45 mPa·svs. 4.47 ± 0.36 mPa·s,t=7.122）, excess inventory of red blood cells（39.75 % ± 4.09 %vs.43.98 % ± 4.17 %, t=6.755）, fibrinogen（3.21 ± 0.38 g/Lvs. 4.05 ± 0.42 g/L,t=13.833） in the observation group were obviously lower than the control group after treatment （P〈0.05 or P〈0.01）.Conclusions The combination ofzhigancao decoction can obviously improve hemorheology of senile coronary heart disease. It has obvious effect with less adverse reactions, which is worth of spreading in clinic.