宁心通痹汤联合穴位贴敷治疗冠心病不稳定型心绞痛临床观察

Clinical Observation of Ningxin Tongbi Decoction Combined with Acupoint Application on Unstable Angina of Coronary Heart Disease

目的观察宁心通痹汤联合穴位贴敷治疗冠心病不稳定型心绞痛的临床疗效并探讨其作用机制。方法120例患者随机分为治疗组和对照组各60例。对照组给予冠心病二级预防药物治疗。治疗组在常规西医治疗基础上予宁心通痹汤联合穴位贴敷(内关、心俞、膻中、至阳)治疗,疗程均为4周,观察两组中医证候疗效、心绞痛发作频率、持续时间、硝酸甘油用量、心电图变化情况。结果治疗组中医证候疗效总有效率91.67%高于对照组的81.67%(P<0.05)。治疗组心电图总有效率86.67%高于对照组的75.00%(P<0.05)。两组治疗7、14 d后心绞痛发作频率、心绞痛持续时间、硝酸甘油用量均明显减少(均P<0.05),且治疗组治疗7、14 d后心绞痛发作频率、心绞痛持续时间、硝酸甘油用量均低于对照组(均P<0.05)。两组在治疗前后测肝肾功能、电解质、三大常规检查均未出现异常。结论宁心通痹汤联合穴位贴敷治疗冠心病可有效提高患者生活质量,减少心绞痛发作频率、持续时间,减少硝酸甘油用量,明显改善心肌缺血,从而有效改善患者症状。

Objective:To observe the clinical effect of Ningxin Tongbi Decoction combined with acupoint application on unstable angina pectoris of coronary heart disease.Methods:120 patients were randomly divided into the treatment group and the control group,60 cases in each group.The control group was treated with aspirin,atorvastatin calcium tablets,nitroglycerin and other conventional secondary preventive drugs;the treatment group was treated with Ningxin Tongbi Decoction plus acupoint application(Neiguan,Xinshu,Danzhong,Zhiyang)on that basis.The treatment courses were 4 weeks.The clinical efficacy,frequency of angina attack,duration,nitrate and the changes of acid glycerin dosage and ST-T in ischemic ECG were observed.Results:The total effective rate in the treatment group was higher than that in the control group(P<0.05).After treatment,the frequency,duration of angina pectoris and the amount of nitroglycerin in both groups were decreased(P<0.05),and the treatment group was better than the control group;the myocardial ischemia was effectively improved after treatment(P<0.05),and the treatment group was better than the control group.There were no serious adverse reactions in clinical observation in both groups.Conclusion:Ningxin Tongbi Decoction combined with acupoint application remarkably improves the quality of life of patients,reduce the frequency,duration and pain degree of angina pectoris,reduce the amount of nitroglycerin,significantly improve myocardial ischemia,and thus effectively improve the symptoms of patients.