舒心汤治疗冠心病心绞痛合并焦虑症临床疗效观察

Clinical Effect of Shuxin Decoction(舒心汤)on Angina Pectoris Complicated with Anxiety

目的观察舒心汤干预冠心病心绞痛合并焦虑症(心胆气虚、痰火扰心证)的临床疗效。方法将符合纳入标准的冠心病合并焦虑症(心胆气虚、痰火扰心证)患者80例按入选前后顺序用抽签法随机分为对照组和治疗组,每组40例。对照组在冠心病心绞痛常规治疗基础上加用地西泮片2.5 mg,日1次口服;治疗组在冠心病心绞痛常规治疗基础上加用中药复方舒心汤100 mL,日2次口服。比较治疗前后两组在中医症状评分、汉密顿焦虑量表(HAMA)、心绞痛量表SAQ评分改善上的差异,以及安全性指标。结果 (1)治疗组总有效率87.5%,对照组总有效率75%,治疗组在中医证候改善方面有效率显著高于对照组(P<0.05)。(2)治疗后两组患者的中医证候评分均下降,且治疗组显著低于对照组(P<0.05)。(3)治疗后两组患者HAMA评分均下降,且治疗组显著低于对照组(P<0.05)。(4)治疗后治疗组SAQ心绞痛评分总分显著高于对照组(P<0.05),其中治疗组在心绞痛发作情况和心绞痛稳定状态两维度方面得分显著高于对照组(P<0.05)。结论舒心汤治疗冠心病心绞痛合并焦虑症心胆气虚、痰火扰心证疗效优于西药地西泮片,尤其在改善其临床症状、减轻焦虑程度、减少心绞痛发作次数、避免不稳定型心绞痛发生方面疗效显著,提示具有疏肝理气、清热化痰、养心安神之功效的中药复方舒心汤在治疗"双心病"方面疗效确切,值得进一步临床推广。

Objective To observe the clinical effect of Shuxin Decoction(舒心汤)on angina pectoris complicated with anxiety(syndrome of deficiency of heart and gallbladder Qi,phlegm and fire disturbing the heart). Methods 80 patients with angina pectoris complicated with anxiety(heart gallbladder Qi deficiency,phlegm fire disturbing the heart syndrome)were randomly divided into control group and treatment group by drawing lots before and after the inclusion,40 cases in each group. In the control group,2.5 mg diazepam tablets were added to the conventional treatment of coronary heart disease and angina pectoris,orally once a day. The treatment group was given 100 mL of Chinese medicine compound Shuxin Decoction on the basis of the conventional treatment of coronary heart disease and angina pectoris,orally twice a day. After treatment,the curative effect of TCM syndrome of the two groups was observed,and the improvement of TCM symptom score,HAMA score and SAQ score of angina pectoris scale between the two groups before and after treatment,as well as the safety indicators. Results(1)The total effective rate of the treatment group was 87.5%,and the total effective rate of the control group was 75%. The effective rate of the treatment group in improving TCM syndromes was significantly higher than that of the control group(P<0.05).(2)After treatment,the TCM symptom scores of the two groups of patients decreased,and the treatment group was significantly lower than the control group(P<0.05).(3)The HAMA scores of the two groups of patients decreased after treatment,and the treatment group was significantly lower than the control group(P<0.05).(4)After treatment,the total score of SAQ angina pectoris in the treatment group was significantly higher than that in the control group(P<0.05),and the scores in the two dimensions of angina pectoris and angina pectoris in the treatment group were significantly higher than those in the control group(P<0.05). Conclusion Shuxin Decoction is better than Western medicine diazepam tablets in the treatment of angina pectoris complicated with anxiety(syndrome of deficiency of heart and gallbladder Qi,phlegm and fire disturbing the heart),especially in improving its clinical symptoms,reducing anxiety,reducing the number of angina pectoris,and avoiding unstable types. The curative effect of angina pectoris is remarkable,suggesting that the traditional Chinese medicine compound Shuxin Decoction,which has the effects of soothing the liver,regulating Qi,clearing heat and resolving phlegm,and nourishing the heart and calming the nerves,has a definite effect in the treatment of"biheart disease"and is worth further clinical promotion.