温针灸与血府逐瘀汤联合常规疗法治疗冠心病心绞痛临床研究

Clinical Study on Warming Acupuncture and Moxibustion and Xuefu Zhuyu Tang Combined with Routine Therapy for Angina Pectoris in Coronary Heart Disease

目的:观察在常规疗法基础上加用温针灸与血府逐瘀汤治疗冠心病心绞痛的疗效以及对心功能的影响。方法:纳入156例心血瘀阻型冠心病心绞痛患者,按照随机数字表法分为观察组和对照组各78例,2组患者均给予现代医学常规治疗,观察组加温针灸联合血府逐瘀汤治疗。2组均以10 d为1个疗程,连续治疗3个疗程。对比2组的心绞痛疗效、中医证候疗效及心电图疗效,记录并对比心功能指标[左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)及左室射血分数(LVEF)]与血管内皮功能指标[内皮素(ET)、血栓素B2(TXB2)、6-酮-前列腺素F1α(6-keto-PGF1α)]。结果:治疗后,观察组心绞痛疗效总有效率96.15%,对照组总有效率78.21%,2组比较,差异有统计学意义(P<0.01)。观察组中医证候疗效总有效率98.72%,对照组总有效率69.23%,2组比较,差异有统计学意义(P<0.01)。观察组心电图疗效总有效率89.74%,对照组总有效率52.56%,2组比较,差异有统计学意义(P<0.01)。2组LVEF、LVEDD、LVESD均较治疗前有所改善,观察组LVEF、LVEDD均低于对照组,LVESD高于对照组,差异均有统计学意义(P<0.05)。2组ET、TXB2均较治疗前下降,6-keto-PGF1α均较治疗前上升,差异均有统计学意义(P<0.05)。观察组ET、TXB2均低于对照组,6-keto-PGF1α高于对照组,差异均有统计学意义(P<0.05)。结论:在常规疗法基础上加用温针灸联合血府逐瘀汤治疗冠心病心绞痛可有效缓解心绞痛,提高中医证候疗效,且能有效改善患者的心功能及血管内皮功能,临床效果显著。

Objective:To observe the curative effect of warming acupuncture and moxibustion combined with Xuefu Zhuyu tang based on routine therapy for angina pectoris in coronary heart disease and the effect on the heart function.Methods:A total of 156 cases of patients with angina pectoris in coronary heart disease of heart blood stasis obstruction type were divided into the observation group and the control group according to the random number table method,78 cases in each group.Both groups were given routine therapy of modern medicine,and the observation group was additionally given warming acupuncture and moxibustion combined with Xuefu Zhuyu tang.Both groups were continuously treated for three courses,with 10 days as a course.The curative effect of angina pectoris,Chinese medicine syndromes and electrocardiogram in the two groups were compared.The heart function indexes including left ventricular end-systolic dimension(LVESD),left ventricular end-diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)and the indexes of vascular endothelial function including endothelin(ET),thromboxane B2(TXB2)and 6-keto-prostaglandin F1α(6-ketoPGF1α)were recorded and compared.Results:After treatment,the total effective rate of angina pectoris was 96.15%in the observation group and 78.21%in the control group,the difference being significant(P<0.01).The total effective rate of Chinese medicine syndromes was 98.72%in the observation group and 69.23%in the control group,the difference being significant(P<0.01).The total effective rate of electrocardiogram was 89.74%in the observation group and 52.56%in the control group,the difference being significant(P<0.01).The indexes of LVEF,LVEDD and LVESD in the two groups were improved when compared with those before treatment(P<0.05).The indexes of LVEF and LVEDD in the observation group were lower than those in the control group,and the index of LVESD was higher,differences being significant(P<0.05).The indexes of ET and TXB2 in the two groups were decreased when compared with those before treatment,the index of6-keto-PGF1αin the two groups were incresed,differences being significant(P<0.05).The indexes of ET and TXB2 in the observation group were lower than those in the control group,and the inder of 6-keto-PGF1αwas higher,differences being significant(P<0.05).Conclusion:The additional application of warming acupuncture and moxibustion combined with Xuefu Zhuyu tang based on routine therapy has significant clinical effect in treating angina pectoris in coronary heart disease,which can effectively relieve angina pectoris,enhance the curative effect of Chinese medicine syndromes,and effectively improve the heart function and vascular endothelial function of patients.