温阳益心汤治疗气虚血瘀型冠心病合并负性情绪患者临床研究

Clinical Study on Wenyang Yixin Decoction(温阳益心汤) in the Treatment of Patients with Qi Deficiency and Blood Stasis Type Coronary Heart Disease with Negative Emotion

目的观察温阳益心汤治疗气虚血瘀型冠心病合并负性情绪患者的临床疗效。方法将2019年4月—2021年5月于该院收治的气虚血瘀型冠心病合并负性情绪患者84例随机分为两组,每组42例。对照组给予抗抑郁药物(盐酸氟西汀)治疗;研究组在其基础上加用温阳益心汤(炙甘草汤合柴胡疏肝散)治疗,两组疗程均为12周。比较两组患者治疗前后中医证候积分、负性情绪改善情况[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分]、生活质量评分(WHOQOL-BREF生活质量量表)、炎症指标[白细胞介素6(IL-6)、白细胞介素1β(IL-1β)、肿瘤坏死因子-α(TNF-α)]变化,并评估两组临床疗效及治疗期间不良反应发生情况。结果与治疗前比较,治疗后两组患者WHOQOL-BREF评分显著升高(均P<0.05);中医证候积分、HAMA评分、HAMD评分、IL-6、IL-1β、TNF-α水平均显著降低,差异具有统计学意义(P<0.05)。且研究组患者上述指标改善情况均显著优于对照组,差异具有统计学意义(P<0.05)。治疗后,研究组总有效率为90.5%(38/42),对照组为73.8%(31/42),差异具有统计学意义(P<0.05)。结论温阳益心汤可显著改善气虚血瘀型冠心病合并负性情绪患者临床症状,改善患者焦虑、抑郁负面情绪,有效抑制炎症反应,值得临床推广应用。

Objective To observe the clinical study of Wenyang Yixin Decoction(温阳益心汤)in the treatment of patients with coronary heart disease of Qi deficiency and blood stasis combined with negative emotions.Methods A total of 84 patients with coronary heart disease of Qi deficiency and blood stasis type combined with negative emotion who were admitted to our hospital from April 2019 to May 2021 were randomly divided into two groups with 42 cases in each group.The control group was treated with antidepressant drugs(fluoxetine hydrochloride);the study group was treated with Wenyang Yixin Decoction[Zhigancao Decoction(炙甘草汤)and Chaihu Shugan Powder(柴胡疏肝散)]on the basis of this treatment.The treatment course of the two groups was 12 weeks.Compare the scores of TCM syndromes,the improvement of negative emotions[Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD)score],quality of life score(WHOQOL-BREF quality of life scale),and inflammation indicators before and after treatment between the two groups of patients[interleukin 6(IL-6),interleukin 1β(IL-1β),tumor necrosis factor(TNF-α)]changes,and evaluate the clinical efficacy of the two groups and the occurrence of adverse reactions during treatment.Results Compared with before treatment,after treatment the WHOQOL-BREF score of the two groups of patients was significantly increased(P<0.05);TCM syndrome score,HAMA score,HAMD score,IL-6,IL-1β,and TNF-αlevels were significantly reduced,the difference was statistically significant(P<0.05).Moreover,the improvement of the above indicators in the study group was significantly better than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the total effective rate was 90.5%(38/42)in the study group and 73.8%(31/42)in the control group,the difference was statistically significant(P<0.05).Conclusion Wenyang Yixin Decoction can significantly improve the clinical symptoms of patients with coronary heart disease of Qi deficiency and blood stasis combined with negative emotions,improve patients'anxiety and depression and negative emotions,and effectively inhibit inflammation.It is worthy of clinical application.