参苓白术散联合瓜蒌薤白半夏汤加减治疗胸痹临床观察

Clinical observation of Shenlingbaizhu powder combined with Gualou Xiebai Banxia Decoction in the treating of thoracic obstruction

目的：观察参苓白术散联合瓜蒌薤白半夏汤加减治疗胸痹的临床疗效。方法：将40例痰浊闭阻型胸痹患者随机分为2组，对照组20例给予吸氧，阿司匹林肠溶片100 mg 每日1次抗血小板聚集，单硝酸异山梨脂片20 mg 每日2次扩张冠状动脉改善心肌缺血，辛伐他汀10 mg 每晚睡前1次调脂稳定斑块等治疗。观察组20例在对照组治疗方案的基础上给予参苓白术散合瓜蒌薤白半夏汤加减。观察2组症状积分、心电图改善率、临床疗效及血脂变化。结果：2组患者治疗后除对照组疲乏无力积分无变化外，其余各项症状积分均较治疗前降低（P〈0.05~P〈0.01），观察组除胸痛积分与对照组差异无统计学意义（P〉0.05）外，其余效果均优于对照组（P〈0.05~P〈0.01）。2组治疗后观察组血清总胆固醇、三酰甘油及低密度脂蛋白胆固醇水平均较治疗前明显下降（P〈0.01），高密度脂蛋白胆固醇较治疗前无明显升高（P〉0.05）；观察组血清总胆固醇和低密度脂蛋白胆固醇水平均低于对照组（P〈0.01和P〈0.05），高密度脂蛋白胆固醇高于对照组（P〈0.01）。结论：参苓白术散联合瓜蒌薤白半夏汤加减治疗痰浊闭阻型胸痹疗效确切，值得临床推广。

Objective：To observe the clinical effects of Shenlingbaizhu powder combined with Gualou Xiebai Banxia Decoction in the treatment of thoracic obstruction. Methods：Forty patients with phlegm closed resistance type thoracic obstruction were randomly divided into the control group and observation group（20 cases each group）. The control group were treated with oxygen,100 mg of Aspirin Enteric-coated tablets 1 time daily for anti-platelet aggregation,20 mg of isosorbide mononitrate tablet twice a day for expanding and improving myocardial ischemia and 10 mg of simvastatin before sleep every night for stabling the lipid plaque. The observation were additionally treated with Shenlingbaizhu powder combined with Gualou Xiebai Banxia Decoction based on the control group treatment. The symptom score, electrocardiogram improvement rate, clinical curative effects andblood lipid between two groups were analyzed. Results：Except the lassitude score in control group,the symptoms scores in two groups after treatment were lower than those in before treatment（P〈0. 05 to P〈0. 01）. The treatment effects,except the chest pain score,in observation group were better than those in control group（P 〈0. 05 to P 〈0. 01）. Compared with those before treatment,the levels of low density lipoprotein cholesterol, triglyceride and total cholesterol in the two observation groups after treatment are significantly decreased（P〈0. 01）,and the level of high density lipoprotein cholesterol isdid not significantly elevatedincrease（P〉0. 05）. The levels of low density lipoprotein cholesterol and total cholesterol in the observation group are were lower than those in the control group（P〈0. 01 and P〈0. 05）,and the level of high density lipoprotein cholesterol of the in observation group iswas higher than that of the control group after treatment（P〈0. 01）. Conclusions：The clinical effects of Shenlingbaizhu powder combined with Gualou Xiebai Banxia Decoction in the treatment of thoracic obstruction are good,which is worthy of clinical promotion.