柴胡加龙骨牡蛎汤加减联合西药治疗冠心病合并焦虑症(少阳不和)随机平行对照研究

Randomized Parallel Controlled Study on Chaihu plus Longgu Muli Decoction Combined with Western Medicine in Treatment of Coronary Heart Disease Complicated with Anxiety Disorder( Shaoyang Disharmony Syndrome)

目的观察柴胡加龙骨牡蛎汤加减治疗冠心病合并焦虑症(少阳不和证)的临床疗效。方法使用随机平行对照方法,将60例住院及门诊患者按随机数字表法随机分为两组;对照组采用西医常规治疗,治疗组在常规西医治疗的基础上予柴胡加龙骨牡蛎汤加减,比较两组患者治疗前后心绞痛症状疗效、中医证候积分及汉密尔顿焦虑量表(HAMA)积分。结果连续治疗4周,心绞痛症状疗效治疗组总有效率90. 0%(27/30)优于对照组50. 0%(15/30)(P<0. 05);中医临床症状疗效治疗组有效率86. 6%,对照组有效率23. 3%,有显著统计学差异(P <0. 05)。对照组HAMA量表得分治疗前(17. 60±1. 96)与治疗后(17. 30±4. 20)对比差异无明显统计学意义,治疗组治疗前HAMA量表得分(18. 30±2. 60)较治疗后得分(7. 30±1. 35)明显改善,具有统计学意义(P <0. 05),治疗组治疗后的HAMA量表得分明显低于对照组,具有统计学意义(P <0. 05)。结论柴胡加龙骨牡蛎汤加减对冠心病合并焦虑症(少阳不和证)患者疗效显著,可有效缓解患者心绞痛及焦虑症状,改善中医症候,为"双心"疾病的诊疗提供了新思路、新方法,值得临床推广应用。

Objective To observe the clinical effect of Chaihu plus Longgu Muli Decoction on patients with coronary heart disease complicated with anxiety disorder (Shaoyang disharmony syndrome). Methods Sixty inpatients and outpatients were randomly divided into two groups according to the random number table. The control group received conventional western medicine treatment,while the treatment group received Chaihu plus Longgu Muli Decoctionon the basis of conventional western medicine treatment,and we compared the effect of angina symptoms,TCM syndrome scores and Hamilton anxiety scale (HAMA) scores before and after treatment in the two groups. Results After 4 weeks of continuous treatment,the total effective rate of the treatment group was 90% (27/30),higher than that of the control group (P < 0. 05). The effective rate was 86. 6% (5/30) in the TCM treatment group and 23. 3% in the control group and there was a significant statistical difference (P < 0. 05).The control group’s HAMA scale score was 17. 60 ± 1. 96 before treatment and 17. 30 ± 4. 20 after treatment and there was no obvious difference. The HAMA scale score of the treatment group before treatment was 18. 30 ± 2. 60 and 7. 30 ± 1. 35 after treatment and there was a statistical significance (P < 0. 05). The treatment group’s HAMA scale scores after treatment was significantly lower than that of the control group (P < 0. 05). Conclusion Chaihu plus Longgu Muli Decoction has a significant effect on patients with coronary heart disease complicated with anxiety disorder (Shaoyang disharmony syndrome),which can effectively relieve angina pectoris and anxiety symptoms of patientsand improve TCM symptoms,providing new ideas and new methods for the diagnosis and treatment of " psycho-cardiology" disease,which is worthy of clinical application.