柴胡桂枝汤加减治疗冠心病气滞心胸证临床疗效观察

Clinical Observation of Chaihu Guizhi Decoction in the Treatment of Coronary Heart Disease with Heart and Chest Syndrome of Qi Stagnation

目的分析柴胡桂枝汤治疗冠心病气滞心胸证的临床疗效及安全性。方法将符合纳入标准的冠心病稳定型心绞痛患者78例随机分为治疗组和对照组,各39例。治疗组在常规西药治疗基础上予柴胡桂枝汤,对照组予单纯常规西药治疗,治疗8周后比较2组中医证候疗效、心绞痛疗效、心电图疗效、西雅图心绞痛量表积分及安全性相关指标。结果中医证候疗效总有效率治疗组(89.19%,33/37)优于对照组(68.42%,26/38)(P<0.05)。心绞痛疗效治疗组总有效率(86.48%,32/37)优于对照组(65.79%,25/38)(P<0.05)。静息心电图疗效治疗组总有效率(67.57%,25/37)优于对照组(44.74%,17/38)(P<0.05)。2组西雅图心绞痛量表各维度积分治疗前后差值比较,治疗组优于对照组(P<0.01或P<0.05)。2组治疗前后血常规、肝肾功能各项检测指标未发现明显异常变化,临床未见明显不良反应。结论柴胡桂枝汤能有效改善冠心病稳定型心绞痛患者的临床症状,提高患者生活质量,改善心肌缺血情况。

Objective To compare and analyze the clinical efficacy and safety of Chaihu Guizhi decoction in the treatment of coronary heart disease with syndrome of qi stagnation in heart and chest.Methods 78 patients who met the diagnostic criteria were randomly divided into treatment group (n=39) and control group (n=39).The treatment group was treated with Chaihu Guizhi decoction and routine western medicine,and the control group was treated with routine western medicine.After 8 weeks of treatment,the efficacy of TCM syndrome,angina pectoris,ECG,Seattle angina pectoris scale score and safety related indexes were compared between the two groups.Results In terms of the curative effect of TCM syndrome,the total effective rate of TCM syndrome in the treatment group was 89.19%,while that in the control group was 68.42%.Compared between the two groups,the treatment group was better than the control group (P<0.05).In terms of angina pectoris,the total effective rate of angina pectoris was 86.48% in the treatment group and 65.79% in the control group.There was significant difference between the two groups (P<0.05).In the comparison of the curative effect of resting ECG between the two groups,the total effective rate of resting ECG in the treatment group was 67.57%,while that in the control group was only 44.74%.There was significant difference between the two groups (P<0.05).4.4.The difference of the scores of all dimensions of the Seattle angina pectoris scale before and after treatment,There was difference between the two groups (P<0.01 or P<0.05).There were no obvious abnormal changes in blood routine,liver and kidney function before and after treatment,and no obvious adverse reactions were found in the two groups before and after treatment.Conclusion Chaihu Guizhi decoction in the treatment of stable angina pectoris of coronary heart disease can significantly reduce angina pectoris,improve myocardial ischemia and improve the quality of life of patients with coronary heart disease,which is worthy of clinical promotion.