中西医结合治疗不稳定性心绞痛的疗效分析

Analysis of efficacy of integrated Chinese and western medicine in the treatment of unstable angina

目的:评估中西医结合治疗不稳定性心绞痛(unstable angina,UA)的临床疗效。方法:选取UA患者69例,随机分为观察组35例和对照组34例,均予以西医常规治疗,观察组在此基础上增加中药桂枝加附子汤合参附汤,疗程为14 d。观察两组临床疗效及心电图(ECG)改善情况,比较治疗前后两组各项中医症状评分、每周硝酸甘油用量、每周心绞痛持续时间、C反应蛋白(CRP)和纤维蛋白原(FIB)水平以及不良反应的发生情况。结果:观察组总有效率及ECG改善情况均优于对照组(P<0.05)。两组治疗后各项中医症状评分较治疗前明显改善(P<0.05或P<0.01),但观察组治疗后在气短、自汗、倦怠乏力、畏寒肢冷等方面的评分均优于对照组(P<0.05或P<0.01)。两组治疗后每周硝酸甘油用量较治疗前明显减少,每周心绞痛持续时间明显缩短(P<0.01),但观察组改善程度优于对照组(P<0.05)。两组治疗前后CRP、FIB水平比较差异无统计学意义(P>0.05)。治疗期间,两组均未见严重不良反应发生。结论:中西医结合治疗UA疗效显著,可改善心绞痛症状,减少硝酸甘油用量,且安全性良好。

Objective: To explore the clinical efficacy of integrated Chinese and western medicine in the treatment of unstable angina(UA).Methods: A total of 69 patients with UA were selected and randomly divided into observation group(n = 35) and control group(n = 34).Both groups were treated with routine western medicine,on which basis observation group was added with Guizhi Plus Fuzi Decoction plus Shenfu Decoction,for 14d in total.The clinical efficacy and improvement of electrocardiogram(ECG) were observed in both groups,the traditional Chinese medicine(TCM) symptom scores,the dosage of nitroglycerin per week,the persistent duration of angina pectoris per week,the levels of C-reactive protein(CRP) and fibrinogen(FIB),and the occurrence rates of adverse reactions were compared before and after treatment between two groups.Results: Observation group was markedly better than control group in clinical efficacy and the improvement of ECG(P < 0.05).TCM symptom scores were improved notably after treatment than treatment before(P < 0.05 or P < 0.01),but observation group was notably better than control group in the scores of short breath,spontaneous sweating,fatigue and aversion to cold(P < 0.05 or P < 0.01).The dosage of nitroglycerin per week decreased and the persistent duration of angina pectoris per week were shortened evidently after treatment than treatment before in both groups(P < 0.01),which were improved more significantly in observation group than that in control group(P < 0.05).There was insignificant difference in the levels of CRP and FIB in both groups before and after treatment(P > 0.05).During treatment,no serous adverse reaction was found in either group.Conclusion: Application of integrated Chinese and western medicine has excellent clinical efficacy and can improve the symptoms of angina pectoris and reduce the dosage of nitroglycerin with favorable safety in the treatment of patients with UA.