温通针法治疗阳虚血瘀型稳定型心绞痛疗效观察

Therapeutic Observation of Warming-unblocking Needling for Stable Angina Pectoris of Yang-deficiency and Blood-stagnation Pattern

目的观察温通针法治疗阳虚血瘀型稳定型心绞痛的临床疗效,以期为针灸治疗稳定性心绞痛提供新方法、开拓新思路。方法收集116例阳虚体质的阳虚血瘀型稳定型心绞痛患者,采用随机数字表法分为对照组、治疗组,每组58例。对照组采用常规西药治疗,治疗组在常规西药治疗基础上采用温通针法,通过对比两组患者心绞痛的发作次数及持续时间,胸闷、胸痛、心悸、畏寒怕冷4个主要中医证候积分下降程度,疼痛视觉模拟量表(visual analogue scale,VAS)对治疗前后两组的临床疗效进行评价。结果治疗组治疗后心绞痛的发作次数及持续时间较对照组显著降低(P<0.05);治疗组胸闷、胸痛、心悸、畏寒怕冷4个主要中医证候积分低于对照组(P<0.05);两组治疗后VAS评分低于治疗前(P<0.05),且治疗组低于对照组(P<0.05)。治疗组总有效率(87.9%)高于对照组(70.7%)(P<0.05)。结论在常规西药治疗基础上采用温通针法可改善阳虚血瘀型稳定型心绞痛患者的临床症状及体征,有效预防急性冠脉事件的发生。可作为稳定型心绞痛治疗的辅助手段。

Objective To observe the clinical efficacy of warming-unblocking needling method in treating stable angina pectoris(SAP)of yang-deficiency and blood-stagnation pattern,and to provide novel method and develop new ideas for acupuncture-moxibustion treatment of SAP.Method A total of 116 patients of yang deficiency constitution diagnosed with SAP of yang-deficiency and blood-stagnation pattern were recruited and divided into a control group and a treatment group using the random number table method,with 58 cases in each group.The control group was treated with conventional Western medication,while the treatment group was given additional warming-unblocking needling intervention.The clinical efficacy was evaluated through comparing the flare-up times and duration of angina,the reduction degrees of four traditional Chinese medicine(TCM)symptoms scores including chest tightness,chest pain,palpitation and aversion to cold,and Visual Analogue Scale(VAS)score of pain between the two groups.Result After treatment,the flare-up times and duration dropped more significantly in the treatment group than in the control group(P<0.05);the scores of four TCM symptoms including chest tightness,chest pain,palpitation and aversion to cold were lower in the treatment group than in the control group(P<0.05);the VAS score decreased after treatment in both groups(P<0.05),and was lower in the treatment group than in the control group(P<0.05).The total effective rate in the treatment group(87.9%)was higher than that in the control group(70.7%)(P<0.05).Conclusion In addition to conventional Western medication,warming-unblocking needling method can improve the clinical symptoms and body signs in patients with SAP of yang-deficiency and blood-stagnation pattern and effectively prevent acute coronary events.It can be taken as an assistant approach for SAP.