穴位贴敷联合补阳还五汤加味治疗气虚血瘀型冠心病稳定型心绞痛的临床观察

Clinical Observation on Acupoint Application Combined with Buyang Huanwu Decoction in Treating Stable Angina of Coronary Heart Disease with Qi Deficiency and Blood Stasis

目的:探讨穴位贴敷联合补阳还五汤加味治疗气虚血瘀型冠心病稳定型心绞痛的临床疗效。方法:选取符合纳入标准的60例稳定型心绞痛患者,随机分为对照组与治疗组,各30例。对照组应用中药汤剂补阳还五汤加味联合常规西药治疗;治疗组在对照组的基础上联合应用心俞、内关、膻中、关元、血海穴位贴敷。两组疗程均为4周。观察患者总有效率、中医证候疗效、中医证候总积分、心绞痛疗效及血脂的变化情况。结果:治疗组与对照组总有效率分别为93.33%(28/30)、76.67%(23/30)(P<0.05);治疗后治疗组与对照组相比,中医证候疗效明显改善(P<0.05),中医证候总积分下降(P<0.05),心绞痛发作频率降低、持续时间降低、硝酸甘油用量减少(P<0.05),但血脂无明显变化(P>0.05)。结论:穴位贴敷联合补阳还五汤加味在提高临床总有效率、改善中医证候、减少心绞痛发作频率、缩短持续时间、减少硝酸甘油用量等方面优于单纯的中药汤剂,能更有效地改善患者的临床症状。

Objective:To explore the clinical efficacy of acupoint application combined with Buyang Huanwu Decoction in treating stable angina of coronary heart disease with qi deficiency and blood stasis.Methods:60 patients with stable angina pectoris of coronary heart disease were randomly divided into the control group(n=30)and the study group(n=30).The control group was treated with Buyang Huanwu Decoction combined with conventional western medication;on which basis,the study group was also treated with acupoint application on Xinshu(BL15),Neiguan(PC6),Danzhong(RN17),Guanyuan(RN4)and Xuehai(SP10).After four weeks of the treatment,the total effective rate,the efficacy of TCM syndromes,TCM syndrome integral,the efficacy of improving angina pectoris and the change of blood lipids were observed in the two groups.Results:The total effective rate was 93.33%(28/30)in the study group,which was significantly higher than 76.67%(23/30)in the control group(P<0.05).Compared to those in the control group,the efficacy of TCM syndromes was higher(P<0.05),TCM syndrome integral was significantly decreased(P<0.05),the onset frequency and duration of angina pectoris were reduced,the use of nitroglycerin was decreased in the study group after the treatment(P<0.05).There was no statistical difference in blood lipids between the two groups after the treatment(P>0.05).Conclusion:Acupoint application combined with Buyang Huanwu Decoction can increase the total clinical efficiency,improve TCM syndrome,and reduce the frequency and duration of the onset and the dosage of nitroglycerin,with its remarkable clinical efficacy.