通脉益气活血汤联合西药治疗气滞血瘀型冠心病心绞痛患者的效果

Effects of Tongmai Yiqi Huoxue decoction combined with Western medicine on coronary heart disease angina pectoris of qi stagnation and blood stasis type

目的:观察通脉益气活血汤联合西药治疗气滞血瘀型冠状动脉粥样硬化性心脏病(冠心病)心绞痛患者的效果。方法:选取2019年7月至2021年11月该院收治的80例气滞血瘀型冠心病心绞痛患者进行前瞻性研究,按照随机数字表法分为观察组与对照组各40例。对照组采用常规西药治疗,观察组在对照组基础上加用通脉益气活血汤治疗,比较两组临床疗效、治疗前后心绞痛发作情况、血液流变学指标水平、血清炎性因子[肿瘤坏死因子-α(TNF-α)和C反应蛋白(CRP)]水平,以及不良反应发生率。结果:观察组治疗总有效率为95.00%,明显高于对照组的80.00%,差异有统计学意义(P<0.05);治疗后,观察组心绞痛发作频率低于对照组,心绞痛每次发作时间短于对照组,差异有统计学意义(P<0.05);治疗后,两组全血黏度(高切、低切)、血浆黏度、纤维蛋白原水平以及血清CRP、TNF-α水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗期间,两组均未发生明显不良反应。结论:通脉益气活血汤联合西药治疗气滞血瘀型冠心病心绞痛患者可提高治疗总有效率,缩短心绞痛每次发作时间,降低心绞痛发作频率、血液流变学指标水平和血清炎性因子水平,效果优于单纯常规西药治疗。

Objective: To observe effects of Tongmai Yiqi Huoxue decoction combined with Western medicine on coronary heart disease angina pectoris of qi stagnation and blood stasis type. Methods: A prospective study was conducted on 80 patients with coronary heart disease angina pectoris of qi stagnation and blood stasis type admitted to the hospital from July 2019 to November 2021. They were divided into observation group and control group according to the random number table method, 40 cases in each. The control group was treated with conventional Western medicine,while the observation group was treated with Tongmai Yiqi Huoxue decoction on the basis of that of the control group. The clinical efficacy, the angina pectoris attack conditions, the hemorheology index level, the serum inflammatory factor levels [tumor necrosis factor-α(TNF-α) and C-reactive protein(CRP)], and the incidence of adverse reactions were compared between the two groups. Results: The total effective rate of treatment in the observation group was 95.00%, which was significantly higher than 80.00% in the control group, and the difference was statistically significant(P<0.05). After the treatment, the frequency of angina pectoris attack in the observation group was lower than that in the control group, the time of each angina pectoris attack was shorter than that in the control group, and the differences were statistically significant(P<0.05). After the treatment,the levels of whole blood viscosity(high shear, low shear) and plasma viscosity, the fibrinogen level, and the serum CRP and TNF-α levels in the two groups were lower than those before the treatment, those in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). However, no obvious adverse reactions occurred in the two groups during the treatment. Conclusions: Tongmai Yiqi Huoxue decoction combined with Western medicine in the treatment of coronary heart disease angina pectoris of qi stagnation and blood stasis type can improve the total effective rate of treatment, shorten the time of each angina pectoris attack, and reduce the frequency of angina pectoris attack, the hemorheology index levels and the serum inflammatory factor levels. Moreover, it is superior to single conventional Western medicine treatment.