枳实薤白桂枝汤对冠心病痰瘀痹阻证疗效的随机对照研究

Curative effect of Zhishi Xiebai Guizhi Tang(Immature Bitter Orange-Macrostem Onion-Cassia Twig Decoction) on coronary heart disease-phlegm-stasis obstruction pattern: a randomized controlled study

目的通过观察枳实薤白桂枝汤治疗冠状动脉粥样硬化性心脏病(冠心病)痰瘀痹阻证患者的临床疗效,验证经方原方的临床价值。方法连续入选2018年2月至2018年10月收治于无锡市中医医院心血管科的冠心病心绞痛患者108例,随机分为试验组和对照组。两组均给予冠心病西医基础治疗,试验组在基础治疗上加用枳实薤白桂枝汤,两组患者均共连续治疗4周。4周后通过比较西雅图心绞痛量表(SAQ量表)、健康调查简表(SF-36)评分、基于中医症候积分的有效率、血瘀积分、安全性等评估枳实薤白桂枝汤对冠心病痰瘀痹阻证的临床疗效。结果通过SAQ评分、SF-36评分、血瘀证积分的比较,试验组治疗4周后评分均较治疗前提高,且高于对照组,差异均有统计学意义(P均<0.05)。在中医症候积分方面,试验组治疗有效率为94.44%,对照组有效率为83.33%,两者有效率比较差异有统计学意义(P<0.05)。结论枳实薤白桂枝汤配合冠心病西医基础治疗可更好的改善冠心病患者临床症状,提高患者生活质量,可以作为临床冠心病心绞痛可选择的治疗方法。

Objective To verify the clinical value of original classic formula through observing the clinical efficacy of Zhishi Xiebai Guizhi Tang(Immature Bitter Orange-Macrostem Onion-Cassia Twig Decoction)on coronary heart disease(CHD)-phlegm-stasis obstruction pattern.Methods The patients(n=108)were chosen from Department of Cardiovascular Medicine in Hospital of Traditional Chinese Medicine of Wuxi City from Feb.2018 to Oct.2018,and the divided randomly into test group and control group.The two groups were all given basic Western therapies for CHD and test group was additionally given Zhishi Xiebai Guizhi Tang for 4 weeks.The clinical efficacy of Zhishi Xiebai Guizhi Tang on CHD-phlegm-stasis obstruction pattern was reviewed after 4 weeks through comparing the scores of Seattle Angina Questionnaire(SAQ)and the MOS 36-item Short Form Health Survey(SF-36),effective rate based on pattern integrals of Traditional Chinese Medicine(TCM),blood stasis integrals and safety.Results The comparison in SAQ and SF-36 scores and blood stasis integrals showed that the scores improved and were higher in test group than those in control group after 4-week treatment(all P<0.05).In terms of TCM pattern integrals,the effective rate was 94.44%in test group and 83.33% in control group(P<0.05).Conclusion Zhishi Xiebai Guizhi Tang combined with basic Western therapies for CHD can effectively relieve clinical symptoms and improve quality of life in patients with CHD-phlegm-stasis obstruction pattern,which can be used as an alternative therapy for CHD angina pectoris.