舒心祛风汤对冠状动脉支架术后患者心肌功能和生存质量的影响

Effects of Shuxin Qufeng Decoction(舒心祛风汤) on Myocardial Function and Quality of Life in Patients after Coronary Artery Stenting

目的观察舒心祛风汤辅助治疗冠状动脉支架术后患者的临床疗效。方法将冠状动脉支架植入术后患者61例随机分为治疗组30例及对照组31例,对照组给予西医规范治疗,治疗组在此基础上加服舒心祛风汤,两组疗程均为6周。治疗前后观察患者心脏超声指标、心绞痛发作频率及持续时间,并分别采用简明健康调查表[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)]、西雅图量表[躯体活动受限程度(PL)、心绞痛稳定状态(AS)、心绞痛发作情况(AF)、治疗满意程度(TS)、疾病认知程度(DP)]、汉密尔顿焦虑量表、汉密尔顿抑郁量表评分评价患者生存质量及精神健康状态,治疗后统计患者中医症状各等级分布情况并判定中医证候疗效。结果治疗组中医证候总有效率76.67%,对照组为41.94%,治疗组中医证候疗效优于对照组(P<0.05)。治疗组治疗后中医症状等级分布与对照组比较均明显改善(P<0.05或P<0.01)。两组治疗后心绞痛发作频率与持续时间均较治疗前明显降低,且治疗组均较对照组明显减少(P<0.05)。两组治疗后左室射血分数、每搏输出量、中间段和基底段的收缩期峰值速度(m-Vs)和心尖方向峰值位移(m-Ds)较治疗前均有改善,且治疗组中间段和基底段m-Vs、m-Ds的改善程度优于对照组(P<0.05)。两组治疗后BP、GH、SF、RE、MH、AS、AF、TS、DP评分均较治疗前提高,且治疗组BP、GH、MH、AS、TS、DP评分均高于对照组(P<0.05或P<0.01);治疗组治疗后汉密尔顿焦虑量表评分较治疗前明显下降,且较对照组下降明显(P<0.05)。治疗过程中无不良反应发生。结论舒心祛风汤辅助治疗冠状动脉支架术后患者安全有效,可减少患者心绞痛发作、促进心肌功能康复、改善中医证候及生存质量。

Objective To observe clinical effects of adjuvant therapy of Shuxin Qufeng Decoction（ 舒心祛风汤）on patients after coronary artery stenting. Methods Sixty-one patients after coronary artery stenting were randomly divided into a treatment group（ 30 cases） and a control group（ 31 cases）. Both two groups were treated with standard western medicine. On this basis,the treatment group also was given Shuxin Qufeng Decoction. Course of treatment for both groups were 6 weeks. Before and after treatment,echocardiographic indexes as well as attack frequency and duration of angina of patients were observed. Concise health questionnaires [physiological function（ PF）,role physical（ RP）,body pain（ BP）,general health（ GH）,vitality（ VT）,social function（ SF）,role emotional（ RE）,and mental health（ MH） ],Seattle Scale [physical limitation（ PL）,anginal stability（ AS）,anginal frequency（ AF）,treatment satisfaction（ TS）,and disease perception（ DP） ],Hamilton Anxiety Scale and Hamilton Depression Scale were used to evaluate patients’ quality of life and mental health status. After treatment,distribution of patients’ Chinese medical symptoms was ranked,and curative effects on Chinese medical syndromes were evaluated. Results Total effectiveness of Chinese medical syndromes was 76. 67% in the treatment group and 41. 94% in the control group. Curative effect of Chinese medical syndromes in the treatment group was better than that in the control group（ P 〈 0. 05）. Compared with in the control group,distribution rank of Chinese medical symptoms significantly improved in the treatment group after treatment（ P 〈 0. 5 or P 〈 0. 01）. After treatment,attack frequency and duration of angina in both groups significantly decreased compared with those before treatment（ P 〈 0. 05）,especially in the treatment group（ P 〈 0. 05）. After treatment,left ventricular ejection fraction,stroke volume,mean values of systolic peak velocity（ m-Vs） and mean displacement towards apex（ m-Ds） in intermediate,and basal segment in both groups improved compared with those before treatment,especially m-Vs and m-Ds in intermediate and basal segment in the treatment group（ P 〈 0. 05）. After treatment,scores of BP,GH,SF,RE,MH,AS,AF,TS,and DP were higher in both groups than those before treatment,especially scores of BP,GH,MH,AS,TS,and DP in the treatment group（ P 〈 0. 05 or P 〈 0. 01）. Score of Hamilton Anxiety Scale significantly decreased in the treatment group after treatment compared with that before treatment in the same group and that after treatment in the control group（ P 〈 0. 05）. No adverse effect occurred during the treatment. Conclusion It is a safe and effective adjuvant therapy using Shuxin Qufeng Decoction for patients after coronary artery stenting. It can reduce attack frequency of angina,promote recovery of myocardial function,and improve Chinese medical syndromes and quality of life.