柴胡疏肝散联合单硝酸异山梨酯片治疗冠心病心绞痛伴抑郁障碍40例

Forty Cases of Angina due to Coronary Atherosclerotic Heart Disease Combined with Depressive Disorder Treated with Bupleurum Liver-Soothing Powder in Combination with Isosorbide Mononitrate Tablets

目的:总结冠状动脉粥样硬化心脏病(冠心病)心绞痛伴抑郁障碍的症状、体征分布规律,根据其证候特征进行辨证论治,观察柴胡疏肝散联合单硝酸异山梨酯片治疗冠心病心绞痛的临床疗效。方法:选取冠心病心绞痛伴抑郁障碍患者80例,分析症状、体征分布规律,然后将80例患者随机分为对照组和治疗组,每组各40例。对照组给予单硝酸异山梨酯片联合盐酸氟西汀,治疗组给予单硝酸异山梨酯片柴胡疏肝散加味。比较两组患者心绞痛疗效、中医证候疗效及治疗前后汉密尔顿抑郁(HAMA)量表、抑郁自评量表(SDS)评分。结果:心绞痛疗效:治疗组有效率为92.50%,对照组有效率为75.00%,两组患者心绞痛疗效比较,差异具有统计学意义(P<0.05)。中医证候疗效:治疗组有效率为95.00%,对照组有效率为72.50%,两组患者中医证候疗效比较,差异具有统计学意义(P<0.05)。两组患者治疗后HAMA和SDS评分均低于治疗前,且治疗组低于对照组,差异具有统计学意义(P<0.05)。结论:柴胡疏肝散加味治疗心绞痛伴抑郁障碍患者,不仅能够明显改善患者的心绞痛症状以及全身其他症状,同时还能减轻患者的抑郁症状。

Objective： To sum up the symptoms and signs distribution of angina due to coronary atherosclerotic heart disease（ coronary heart disease） combined with depressive disorder,treat it based on syndrome differentiation according to its syndrome characteristics,and observe the clinical curative effect of Bupleurum Liver-Soothing Powder in combination with Isosorbide Mononitrate Tablets on angina due to coronary atherosclerotic heart disease. Methods： Eighty cases of angina due to coronary atherosclerotic heart disease combined with depressive disorder were selected,the distribution of symptoms and signs were analyzed. Then80 patients were randomly divided into the control group and the treatment group,with 40 cases in each group. The ones in the control group were given Isosorbide Mononitrate Tablets combined with fluoxetine hydrochloride,and the ones in the treatment group were given Isosorbide Mononitrate Tablets combined with Bupleurum Liver-Soothing Powder. The efficacy of angina pectoris,TCM syndrome efficacy,Hamilton Depression（ HAMA） scale and self rating Depression Scale（ SDS） before and after the treatment were compared between the two groups. Results： The curative effect of angina： the effective rate in the treatment group was 92. 50% and that of the control group was 75%. The difference of angina in the two groups was statistically significant（ P〈 0. 05）. The curative effect of syndrome： the effective rate in the treatment group was 95%,and that of the control group was 72.50%,and the difference of the two groups was statistically significant（ P〈 0. 05）. The scores of HAMA and SDS of the two groups were lower than those before the treatment,and the treatment group was lower than the control group,the differences were statistically significant（ P〈 0. 05）. Conclusion： Flavored Bupleurum Liver-Soothing Powder can not only improve the symptoms of angina and other symptoms of the body,but also relieve the depressive symptoms of the patients.