益心方治疗气虚血瘀型不稳定型心绞痛的临床效果及对患者血液流变学参数的影响

Clinical effects of Yixinfang on unstable angina pectoris of qi deficiency and blood stasis type and its influence on hemorheology parameters

目的观察益心方治疗气虚血瘀型不稳定型心绞痛(UAP)的临床效果及对患者血液流变学参数的影响。方法选取2017年1月至2019年9月首都医科大学附属北京中医医院收治的116例气虚血瘀型UAP患者,按随机数字表法分为对照组和观察组,各58例。对照组予常规治疗,观察组在对照组基础上加用中药益心方,2组均治疗3个月。比较2组心肌缺血参数、临床症状改善情况及疗效、血液流变学参数、不良反应。结果治疗后,观察组缺血持续时间短于对照组、缺血总负荷均低于对照组,胸闷、胸痛、心悸、气短、神疲、乏力积分均低于对照组,差异均有统计学意义(均P<0.05)。观察组总有效率明显高于对照组[89.5%(51/57)比71.4%(40/56)],差异有统计学意义(χ^(2)=5.867,P=0.015)。观察组全血黏度、血浆黏度、血细胞比容均低于对照组,差异均有统计学意义(均P<0.05)。观察组与对照组不良反应发生率比较差异无统计学意义[15.8%(9/57)比19.6%(11/56)](χ^(2)=0.288,P=0.592)。结论益心方治疗气虚血瘀型UAP安全有效,且可降低血黏度。

Objective To observe the clinical effects of Yixinfang on unstable angina pectoris(UAP)of qi deficiency and blood stasis type and its influence on hemorheology parameters.Methods Totally 116 patients with UAP of qi deficiency and blood stasis type admitted to Beijing Hospital of Traditional Chinese Medicine,Capital Medical University from January 2017 to September 2019 were selected.They were randomly divided into control group and observation group,with 58 cases in each group.The control group was treated with routine treatment,and the observation group was treated with Yixinfang on the basis of the control group.Both groups were treated for 3 months.Myocardial ischemia parameters,improvement of clinical symptoms,curative efficacy,hemorheology parameters and adverse reactions were compared between the two groups.Results After treatment,the duration of ischemia in the observation group was shorter than that in the control group,the total ischemic load was lower than that in control group,and the scores of chest tightness,chest pain,palpitation,shortness of breath,mental fatigue and fatigue in the observation group were lower than those in the control group(all P<0.05).The total effective rate of the observation group was significantly higher than that of the control group[89.5%(51/57)vs71.4%(40/56)](χ^(2)=5.867,P=0.015).The whole blood viscosity,plasma viscosity and hematocrit of the observation group were lower than those of the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group[15.8%(9/57)vs 19.6%(11/56)](χ^(2)=0.288,P=0.592).Conclusions Yixinfang is safe and effective in treating UAP of qi deficiency and blood stasis type,and can reduce blood viscosity.