五神安位方治疗冠心病血运重建后心境障碍的临床研究

Clinical study on the treatment of mood disorder after coronary artery disease revascularization with Wushen Anwei Formula

目的:观察五神安位方干预冠心病血运重建后心境障碍的临床疗效。方法:纳入150例冠心病血运重建后心境障碍患者,分为治疗组和对照组,治疗组在西药常规治疗基础上加用五神安位方,比较两组患者治疗前后心绞痛、中医证候、生活质量、心境状态以及血清促肾上腺皮质激素(ACTH)、皮质醇(CORT)、去甲肾上腺素(NE)的变化情况,进行统计学分析。结果:①两组患者心绞痛、中医证候评分较治疗前均显著下降(P<0.05),生活质量评分较治疗前均显著升高(P<0.05);仅治疗组在治疗后心境状态评分显著下降(P<0.05)。②治疗组在改善心绞痛、中医次症、社会功能、健康变化、心境状态评分方面优于对照组(P<0.05)。③治疗组血清CORT水平较治疗前显著下降(P<0.05)。结论:五神安位方对冠心病血运重建后心境障碍患者躯体症状和心境状态均有改善,具有“双心同调”作用,其机制可能与抑制下丘脑-垂体-肾上腺皮质(HPA)轴过度活化有关。

Objective:To observe the clinical effect of Wushen Anwei Formula on mood disorder(MD)after revascularization of coronary heart disease(CHD).Methods:A total of 150 patients with MD after revascularization of CHD were divided into treatment group and control group.After the treatment,the treatment group was added with Wushen Anwei Formula on the basis of conventional western medicine treatment.The changes of angina pectoris,TCM syndrome,quality of life,mood state and the serum ACTH,CORT and NE before and after treatment were compared between the two groups for statistical analysis.Results:The scores of angina pectoris and TCM syndrome in the two groups were significantly lower than those before treatment(P<0.05),the scores of quality of life were significantly higher than those before treatment(P<0.05),and the scores of mood state were significantly lower after treatment only in the treatment group(P<0.05).②The treatment was superior to the control group in improving angina pectoris,secondary symptoms of TCM,social function,health changes and mood state score(P<0.05).③The serum CORT level in the treatment group was significantly lower than that before treatment(P<0.05).Conclusion:Wushen Anwei Formula can improve the somatic symptoms and mood state of patients with MD after revascularization of CHD,and has the effect of‘double heart and same tune’.The mechanism may be related to the inhibition of hypothalamic-pituitary-adrenocortical(HPA)axis overactivation.