小柴胡汤合通窍活血汤加减治疗心脏神经官能症血行郁滞证临床研究

Clinical study of Xiaochaihu Decoction combined with Tongqiao-Huoxue Decoction in the treatment of cardiac neurosis with syndrome of blood stasis

目的观察小柴胡汤合通窍活血汤加减治疗心脏神经官能症血行郁滞证患者的疗效及对血清炎性细胞因子水平的影响。方法将2016年12月-2018年12月本院符合入选标准的84例患者采用随机数字表法分为2组,每组42例。对照组口服倍他乐克与谷维素片,观察组在对照组基础上服用小柴胡汤合通窍活血汤加减。2组均连续治疗4周。采用汉密顿抑郁量表(Hamilton Depression Scale, HAMD)、汉密顿焦虑量表(Hamilton Anxiety Scale, HAMA)分别评价抑郁、焦虑程度,采用ELISA法测定血清超敏C反应蛋白(hypersensitive C-reactive protein, hs-CRP)和TNF-α水平,评价临床疗效。结果观察组总有效率为95.2%(40/42)、对照组为75.6%(31/41),2组比较差异有统计学意义(χ^2=4.973,P=0.026)。治疗后,观察组HAMD、HAMA评分均低于对照组(t值分别为6.579、8.941,P值均<0.01),性情急躁、头痛、失眠健忘、胸胁疼痛评分均低于对照组(t值分别为7.888、8.777、8.836、9.964,P值均<0.01);观察组治疗后血清hs-CRP和TNF-α水平均低于对照组(t值分别为5.847、8.453,P值均<0.01)。结论小柴胡汤合通窍活血汤加减可改善心脏神经官能症血行郁滞证患者的症状,降低血清hs-CRP、TNF-α水平。

Objective To observe the efficacy of Xiaochaihu Decoction combined with Tongqiao-Huoxue Decoction in the treatment of cardiac neurosis with syndrome of blood stasis and the effect on serum levels of inflammatory cytokines.Methods A total of 84 patients with cardiac neurosis,who were admitted to Zhongtieshanqiao Group Hospital,were randomly devided intoto the observation group(42 cases)and the control group(42 cases)withthe random number table method.The control group received Betalog and Glutamine tablet.The observation group took Xiaochaihu Decoction combined with Tongqiao-Huoxue Decoction orally on the basis of the control group.Both groups were treated for 4 weeks.Hamilton depression scale(HAMD)was used to evaluate the degree of depression,Hamilton anxiety scale(HAMA)was used to evaluate the degree of anxiety,and hypersensitive c-reactive protein(hs-CRP)and tumor necrosis factor-alpha(TNF-α)were measured by ELISA,and the clinical efficacy was evaluated.Results The total effective rate of the observation group was 95.24%(40/42)andthe control group was 75.61%(31/41).The difference between the two groups was statistically significant(χ^2=4.973,P=0.026).After the treatment,scores of HAMD and HAMA of the observation group were signifcantly lower than that of the control group(t values were 6.579,8.941,respectively,all Ps<0.01),and scores of impatience,headache,insomnia,forgetfulness,and chest and rib pain were significantly lower than those of the control group(t values were 7.888,8.777,8.836,9.964,respectively,all Ps<0.01).After the treatment,serum levels of hs-CRP and TNF-a in the observation group were significantly lower than that of the control group(t values were 5.847,8.453,respectively,all Ps<0.01).Conclusions Xiaochaihu Decoction combined with Tongqiao-Huoxue Decoction can relieve the clinical symptoms of cardiac neurosis,and down-regulate serum levels of hs-CRP and TNF-α.