益气活血法治疗不稳定型心绞痛PCI术后支架内再狭窄临床研究

Clinical Research on Restenosis After PCI in Patients with Unstable Angina by Supplementing Qi and Activating Blood

目的:观察益气活血法治疗不稳定型心绞痛气虚血瘀证经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后支架内再狭窄的临床疗效。方法:选取不稳定型心绞痛行PCI术后中医辨证为气虚血瘀证患者80例,随机分为对照组和治疗组,每组40例。对照组给予氯吡格雷、阿司匹林、他汀类和硝酸酯类药物,合并有糖尿病、高血压,则加用降血糖药、降血压药治疗。治疗组在对照组治疗基础上加用六君子汤合丹参饮(党参15 g,白术15 g,茯苓15 g,甘草6 g,陈皮6 g,半夏6 g,丹参12 g,檀香12 g,砂仁12 g)。两组患者均治疗3个月。比较两组患者的临床疗效,治疗前后证候积分、气虚积分、血瘀积分及支架内再狭窄率等情况。结果:两组患者治疗后中医证候积分明显下降,且治疗组明显优于对照组,差异有统计学意义(P<0.05);治疗组有效率为95.0%,对照组有效率为87.5%,两组比较,差异有统计学意义(P<0.05);治疗组在治疗后气虚证积分明显降低,与治疗前比较,差异有统计学意义(P<0.05),而对照组治疗前后比较,差异无统计学意义(P>0.05),治疗后治疗组与对照组比较,差异有统计学意义(P<0.05);两组患者治疗后血瘀证积分明显下降,且治疗组明显优于对照组,差异有统计学意义(P<0.05);治疗后治疗组支架内再狭窄率明显低于对照组,差异有统计学意义(P<0.05)。结论:益气活血法治疗不稳定型心绞痛气虚血瘀证PCI术后支架内再狭窄疗效显著。

Objective： To observe the clinical effect on the restenosis after PCI in patients with unstable angina（ UA） by Supplementing Qi and activating blood. Methods： 80 patients with UA were randomly divided into control group and treated group,the control group were given general treatment after PCI,and the treated group were given Supplementing Qi and activating blood and general treatment. Changes of clinical symptoms,Qi deficiency score; blood stasis syndrome score and the rate of restenosis were compared between the two groups before and after treatment. Results：（1）The syndrome score of the two groups was significantly decreased after treatment（ P〈0. 05）,the treated group was better than the control group（ P〈0. 05）; the total effective rate of treated group was significantly higher than the control group（ P〈0. 05）;（2）Qi deficiency syndrome score was significantly lower in the treated group after treatment（ P〈0. 05）,but the control group was no difference after treatment（ P〈0. 05）; blood stasis score of the two groups was decreased significantly after treatment（ P〈0. 05）,and the treated group was better than the control group（ P〈0. 05）;（3）the rate of restenosis was significantly lower than the control group（ P〈0. 05）. Conclusion： the method of Supplementing Qi and activating blood is effective in the treatment of restenosis after PCI in patients with unstable angina.