健脾益气、化痰祛瘀法治疗痰浊瘀阻型稳定型心绞痛的临床观察

CLINICAL OBSERVATION OF STRENGTHENING SPLEEN AND INVIGORATING QI,ELIMINATING PHLEGM AND REMOVING STASIS IN TREATING STABLE ANGINA PECTORIS WITH PHLEGM STAGNATION AND STASIS TYPE

目的观察健脾益气、化痰祛瘀法治疗痰浊瘀阻型稳定型心绞痛的临床效果。方法选择2016年02月~2017年08月于临沂市中医医院、门诊及住院的冠状动脉粥样硬化性心脏病病人80例,随机分为治疗组40例和对照组40例。两组按指南规定,给予西药治疗,治疗组在常规治疗基础上给予健脾益气,化痰祛瘀中药口服。观察治疗后两组中医证候疗效、心绞痛症状疗效、超敏C反应蛋白和血脂的变化。结果治疗组中医证候疗效总有效率为87.5%,对照组总有效率为65%,差异有统计学意义(P<0.05);治疗后两组心绞痛缓解有效率分别为97.5%和85%,治疗组明显高于对照组(P<0.05);经过治疗,两组心绞痛发作频率、持续时间均较治疗前有显著好转(P<0.01),治疗组与对照组比较差异具有统计学意义(P<0.01);与治疗前相比较,治疗后两组血浆总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)含量均有明显降低,而高密度脂蛋白胆固醇(HDL-C)含量明显增加(P<0.01);治疗后治疗组血浆总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)与高密度脂蛋白胆固醇(HDL-C)含量与对照组对比差异有统计学意义(P<0.01或P<0.05)。治疗后两组CRP水平均较治疗前有明显下降(P<0.01),治疗后治疗组与对照组比较差异具有统计学意义(P<0.01)。结论黄连温胆汤合丹参饮加减治疗痰浊瘀阻型心绞痛能提高临床疗效,通过干预脂质代谢过程、调节高敏CRP表达,可以改善冠状动脉粥样硬化性心脏病心绞痛病人的临床症状。

Objective To observe the clinical effect of invigorating spleen and Invigorating Qi,eliminating phlegm and removing stasis in treating stable angina pectoris with phlegm stasis and stasis type.Methods From 2016 02 to 2017 08,80 patients with coronary heart disease in Linyi Hospital of traditional Chinese medicine were randomly divided into treatment group 40 cases and control group 40 cases.The two groups were given western medicine according to the guidelines.On the basis of routine treatment,the treatment group was given the spleen and Invigorating Qi,and eliminating phlegm and removing stasis of traditional Chinese medicine.After treatment,the effects of two groups of TCM syndromes,angina pectoris,hypersensitivity C reaction protein and blood lipid were observed.Results After the treatment,the treatment group of TCM syndrome total effective rate was 87.5%,control group total effective rate was 65%,the difference was statistically significant;two groups after the treatment,the remission rate of angina pectoris were 97.5%and 85%,the treatment group was significantly higher than the control group(P<0.05);after treatment,two groups of angina pectoris frequency and duration were significantly better than before treatment(P<0.01),after treatment,the treatment group compared with control group,the difference was statistically significant(P<0.01),compared with before treatment,after treatment,two groups of TC,TG and LDL-C content were significantly decreased,while HDL-C content was significantly increased(P<0.01);treatment after the treatment of TC,TG,LDL-C and HDL-C were compared with the control group,the difference was statistically significant(P<0.01 or P<0.05).After treatment,the levels of CRP in the two groups were significantly lower than those before treatment(P<0.01).There was a significant difference between the treatment group and the control group after treatment(P<0.01).Conclusion Huanglian Wendan Decoction and Salvia miltiorrhiza Decoction in the treatment of phlegm and stasis type angina pectoris can improve the clinical curative effect.It can improve the clinical symptoms of angina pectoris by intervening lipid metabolism and regulating the expression of CRP.