疏肝解郁安神法联合“双心医学”模式治疗气滞血瘀型胸痹临床研究

Clinical Observation of Shugan Jieyu Anshen Therapy Combined with“ Psycho-Cardiology” in Treating Patients with Thoracic Obstruction of Qi Stagnation and Blood Stasis Type

目的:观察疏肝解郁安神法联合"双心医学"模式治疗气滞血瘀型胸痹患者的临床疗效。方法:选择气滞血瘀型胸痹伴焦虑和(或)抑郁的患者,共150例,随机分为对照组、双心组及中药组,每组50例。3组均给予冠心病规范化治疗,双心组在规范化治疗基础上口服盐酸帕罗西汀片,同时给予健康教育、心理治疗、运动疗法等非药物干预;中药组在双心组治疗基础上服用疏肝解郁安神中药膏剂,3组疗程均为8周。比较3组治疗前后临床症状、心绞痛发作频率及最长持续时间、焦虑自评量表(SAS)评分或抑郁自评量表(SDS)评分的变化,评估临床疗效。结果:治疗8周后,总有效率中药组86.0%,双心组62.0%,对照组24.0%。中药组、双心组总有效率均高于对照组,差异均有统计学意义(P<0.01);中药组总有效率高于双心组,差异有统计学意义(P<0.01)。中药组、双心组心绞痛发作频率及最长持续时间均较治疗前减少和缩短,差异均有统计学意义(P<0.01);中药组、双心组2项指标值均低于对照组,差异均有统计学意义(P<0.01);中药组2项指标均优于双心组,差异均有统计学意义(P<0.05)。中药组、双心组SAS、SDS评分均较治疗前下降,差异均有统计学意义(P<0.01);中药组、双心组SAS、SDS评分均低于对照组,差异均有统计学意义(P<0.01);中药组2项评分值均低于双心组,差异均有统计学意义(P<0.05)。结论:疏肝解郁安神法联合"双心医学"模式可明显缓解气滞血瘀型胸痹伴焦虑和(或)抑郁患者的心绞痛疼痛程度,减少发作次数,缩短发作持续时间,改善患者的焦虑、抑郁状态,提高临床疗效。

To observe clinical effect of Shugan Jieyu Anshen therapy combined with ＂Psycho-Cardiology＂ in treating patients with thoracic obstruction of qi stagnation and blood stasis type. Methods. Selected 150 patients with thoracic obstruction of qi stagnation and blood stasis type merged anxiety or depression, and divided them into the control group,psycho-cardiology group and Chinese medicine group, 50 cases in each. The three groups were given standardized treatment of coronary heart disease, and psycho-cardiology group were additionally given paroxetine hydrochloride tablets, and health education, psychotherapy, exercise therapy and other intervention. Chinese medicine group was given Shugan Jieyu Anshen cream formula on the basis of the treatment of psycho-cardiology group. Treatment for the three groups lasted for eight weeks. Compared change of clinical symptom, frequency of angina pectoris, and the longest duration of seizures, self-rating anxiety scale（SAS） score, and self-rating depression scale（SDS）, evaluated the clinical effect. Results= After 8 weeks of treatment, the total effective rate was 86.0% in Chinese medicine group, 62.0% in psycho-cardiology group and 24.0% in the control group, that of Chinese medicine group and psycho-cardiology group being higher than that of the control group（P〈0.01）, that of Chinese medicine group also being higher than that of psycho-cardiology group（P〈0.01）. Frequency and duration of seizures of angina pectoris in Chinese medicine group and psycho-cardiology group were less and shorten than those before treatment and those of the control group（P 〈0.01）, the two indexes of Chinese medicine group and psycho-cardiology group were lower than those of the control group（P 〈 0.01）, while the two indexes of Chinese medicine group were better than those of psycho-cardiology group（P 〈 0.05）. SAS scores and SDS scores of Chinese medicine group and psycho-cardiology group were lower than those before treatment and those of the control group（P〈 0.01）; SAS score and SDS scores of Chinese medicine group were lower than those of psycho-cardiology group（P 〈0.05）. Conclusion= Shugan Jieyu Anshen therapy combined with ＂ Psycho-Cardiology＂ can effectively relieve angina pectoris degree of patients with thoracic obstruction merged anxiety or depression, reduce seizures, shorten duration of seizures, improve anxiety and depression of patients and the clinical effect.