益气活血化痰养心汤辅助治疗不稳定型心绞痛临床研究

Clinical Study on Yiqi Huoxue Huatan Yangxin Decoction for Treatment of Unstable Angina Pectoris

目的观察益气活血化痰养心汤治疗不稳定型心绞痛的临床疗效及安全性。方法采用半随机法将165例患者分为观察组84例和对照组81例。2组均予常规治疗。观察组并予益气活血化痰养心汤,每日1剂,每日2次,口服。连续治疗4周,随访4周。观察2组治疗前后心绞痛分级、心电图疗效,检测全血黏度、纤维蛋白原、血清一氧化氮(NO)、超氧化物歧化酶(SOD)及血浆内皮素(ET)、血栓素B2(TXB2)、6-酮-前列腺素F1α(6-keto-PGF1α)水平,观察中医证候积分,评价不良反应与安全性。结果与本组治疗前比较,2组心绞痛分级显著降低(P<0.05)。观察组心电图总有效率为69.0%(58/84),对照组为65.4%(53/81),2组比较差异无统计学意义(P>0.05)。与本组治疗前比较,2组全血黏度和血浆纤维蛋白原及ET、TXB2水平下降,NO、6-keto-PGF1α水平升高(P<0.05);观察组治疗后全血黏度和血浆纤维蛋白原及ET、6-keto-PGF1α水平低于对照组,NO水平高于对照组,差异有统计学意义(P<0.05)。2组治疗前后中医证候积分比较差异无统计学意义(P>0.05),治疗及随访均未见肝、肾功能异常。结论益气活血化痰养心汤能明显缓解不稳定型心绞痛症状,且可维持血管收缩功能及血小板聚集作用的平衡。

Objective To observe the clinical efficacy and safety of Yiqi Huoxue Huatan Yangxin(IHHY)Decoction for treatment of unstable angina pectoris patients.Methods Totally165cases of patients with unstable angina pectoris were collected and divided into observation group(84groups)and control group(81patients)by semi-random method.Patients in both groups received western medical,and patients in observation group were added with IHHY Decoction,one dosage a day,twice a day,orally.The therapeutic course for both groups was4weeks,with4weeks follow up.Angina pectoris grade and ECG effect in both groups were observed.Blood viscosity,fibrinogen,serum NO,superoxide dismutase(SOD),plasma levels of endothelin(ET),thromboxane B2(TXB2),6-keto-PGF1α,were measured,and TCM syndrome score was observed.The incidence of all adverse reactions was recorded.Results After treatment,the angina pectoris grade of both groups were lower than before,with statistical significance(P<0.05).The total effective rate of ECG was69.0%(58/84)in the observation group and65.4%(53/81)in the control group,without statistical significance(P>0.05).Compared with before treatment,whole blood viscosity,plasma fibrinogen,levels of ET and TXB2decreased,while the levels of NO and6-keto-PGF1αincreased(P<0.05).Whole blood viscosity,plasma fibrinogen,levels of ET and TXB2in the observation group were lower than the control group after treatment,while the level of NO was higher than the control group,with statistical significance(P<0.05).There was no statistical significance in TCM syndrome before and after treatment in both groups.There was no abnormality in liver and kidney.Conclusion On the basis of routine treatment,IHHY Decoction can significantly relieve the symptoms of unstable angina and maintain the balance of vasoconstriction and platelet aggregation.