瓜薤香丹方配合八段锦治疗稳定型心绞痛临床疗效及对患者生活质量的影响

Guaxie Xiangdan Prescription Combined with Baduanjin in the Treatment of Stable Angina Pectoris:Clinical Efficacy and Influence on the Quality of Life of Patients

目的探讨瓜薤香丹方配合八段锦在稳定型心绞痛(Stable angina pectoris,SAP)中应用价值。方法前瞻性选取2018年10月—2020年10月期间就诊于海南省安宁医院的107例SAP患者,按随机数字表法分为对照组53例和治疗组54例。对照组采取常规西药治疗,治疗组基于对照组采取瓜薤香丹方配合八段锦,两组患者均治疗8周。观察比较两组患者疗效、不良反应及治疗前后中医证候积分(胸闷、胸痛、咳嗽咳痰)、心脏指标[左心室射血分数(Left ventricular ejection fraction,LVEF)、左室收缩末期容积(Left ventricular end-systolic volume,LVESV)、二尖瓣下舒张早期血流峰值/舒张晚期血流峰值(Peak transmitral valve flow velocity in early diastole/Peak transmitral valve flow velocity in late diastole,E/A)]、血清指标[同型半胱氨酸(Homocysteine,Hcy)、C反应蛋白(C-reactive protein,CRP)、可溶性细胞间黏附分子-1(Soluble intercellular adhesion molecule-1,sICAM-1)]、生活质量[西雅图心绞痛量表(Seattle anginaquestionnaiire,SAQ)]评分情况。结果治疗8周后治疗组治疗总有效率为88.89%(48/54)明显高于对照组69.81%(37/53),差异有统计学意义(P<0.05)。治疗8周后两组患者中医证候积分及血清Hcy、sICAM-1、CRP水平低于治疗前,差异有统计学意义(P<0.05);且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗8周后两组患者LVEF、E/A均高于治疗前,LVESV低于治疗前,差异有统计学意义(P<0.05);且治疗组LVEF、E/A高于对照组,LVESV低于对照组,差异有统计学意义(P<0.05)。治疗8周后两组患者SAQ评分高于治疗前,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论瓜薤香丹方配合八段锦治疗SAP效果显著,有利于缓解临床症状,改善心功能,提高生活质量,且安全性高。

Objective To explore the application value of Guaxie Xiangdan Prescription combined with Baduanjin in patients with stable angina pectoris(SAP).Methods A total of 107 SAP patients treated in Hainan Provincial Anning Hospital from October 2018 to October 2020 were prospectively selected and randomly assigned into a control group(n=53)and a study group(n=54).The control group was treated with conventional western medicine,and the study group with Guaxie Xiangdan Prescription combined with Baduanjin.The treatments in both groups lasted for eight weeks,and the clinical efficacy was compared between the two groups.The adverse reactions,TCM syndrome scores,cardiac indexes[left ventricular ejection fraction(LVEF),left ventricular end-systolic volume(LVESV),and peak early-to-late diastolic mitral flow velocity(E/A ratio)],serum indexes[homocysteine(Hcy),C-reactive protein(CRP),and soluble intercellular adhesion molecule-1(sICAM-1)],and quality of life[Seattle angina questionnaire(SAQ)]score were compared betweenbefore and after treatment and between the two groups.Results The study group had higher total effective rate[88.89%(48/54)vs.69.81%(37/53),P<0.05]than the control group.After eight weeks of treatment,the TCM syndrome scores and serum Hcy,sICAM-1,and CRP levels in the two groups declined compared with those before treatment and were lower in the study group than in the control group(P<0.05).The treatments in both groups increased the LVEF and E/A ratio and decreased the LVESV(P<0.05).Moreover,the study group had higher LVEF and E/A ratio and lower LVESV than the control group(P<0.05).After eight weeks of treatment,the SAQ scores of the two groups elevated compared with those before treatment(P<0.05).The incidence of adverse reactions showed no significant difference between the two groups(P>0.05).Conclusion Guaxie Xiangdan Prescription combined with Baduanjin has significant effect in the treatment of SAP,which is conducive to relieving clinical symptoms and improving heart function and quality of life and has high safety.