瓜蒌薤白半夏汤联合运动处方在冠心病稳定型心绞痛经皮冠状动脉介入术后患者Ⅱ期康复中的应用研究

Study on Application of Gualou Xiebai Banxia Decoction Combined with Exercise Prescription in Patients in Stage Ⅱ Rehabilitation After Percutaneous Coronary Intervention for Stable Angina Pectoris of Coronary Heart Disease

目的:观察瓜蒌薤白半夏汤联合运动处方对冠心病稳定型心绞痛(SAP)经皮冠状动脉介入(PCI)术后患者的Ⅱ期康复效果。方法:选取SAP行PCI术后患者66例,随机分为对照组和治疗组各33例。2组均给予阿司匹林、氯吡格雷、他汀类降脂药物、β-受体阻滞剂、血管紧张素转化酶抑制剂(ACEI)/血管紧张素受体阻滞剂(ARB)以及降糖药等治疗;对照组联合运动处方干预;治疗组在对照组的基础上加用瓜蒌薤白半夏汤内服。2组疗程均为6个月。比较2组临床疗效、治疗前后心功能指标[心率无氧阈值(AT)、每公斤耗氧量运动峰值(VO_(2max))、代谢当量(METS)、射血分数(EF)]、再狭窄发生率。结果:治疗组临床总有效率为96.97%,对照组为75.76%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组心功能指标AT、VO_(2max)、METS、EF水平比较,差异无统计学意义(P>0.05);治疗后,2组AT值明显较治疗前降低(P<0.05),2组VO_(2max)、METS、EF较治疗前明显升高(P<0.05),且治疗组以上指标改善均明显优于对照组(P<0.05)。术后6个月,治疗组冠动脉再狭窄发生率为3.03%,显著低于对照组24.24%,差异有统计学意义(P<0.05)。结论:瓜蒌薤白半夏汤联合运动处方干预SAP经PCI术后患者疗效显著,可改善Ⅱ期康复患者的心功能,减少冠状动脉再狭窄的发生。

Objective:To observe the curative effect of Gualou Xiebai Banxia Decoction combined with exercise prescription for patients in stage Ⅱ rehabilitation after Percutaneous Coronary Intervention(PCI)for Stable Angina Pectoris of Coronary Heart Disease.Methods:A total of 66 cases of patients with SAP after PCI were randomly divided into the control group and the treatment group,with 33 cases in each group.Both groups were routinely treated with Aspirin,Clopidogrel,statin lipid-lowering drugs,β-blockers,angiotensin converting enzyme inhibitor(ACEI)/angiotensin receptor blockers(ARB)and antidiabetic drugs;the control group was additionally intervened with exercise prescription,and the treatment group was additionally given the oral administration of Gualou Xiebai Banxia Decoction.Both groups were treated for6 months.Before and after treatment,heart function indexes including anaerobic threshold(AT)of heart rate,maximum oxygen consumption per kilogram during exercise(VO_(2max)),metabolic equivalents(METS)and ejection fraction(EF)as well as the incidence of restenosis were compared between the two groups.Results:Before treatment,there was no significant difference being found in the comparison of the levels of heart function indexes including AT,VO_(2max),METS and EF between the two groups(P>0.05);after treatment,the AT values in the two groups were significantly decreased when compared with those before treatment(P<0.05),and the levels of VO_(2max),METS and EF in the two groups were significantly increased when compared with those before treatment(P<0.05);the improvement of above indexes in the treatment group was significantly better than that in the control group(P<0.05).In 6 months after surgery,the incidence of restenosis in coronary artery was 3.03% in the treatment group,significantly lower than that of 24.24% in the control group,the difference being significant(P<0.05).Conclusion:The therapy of Gualou Xiebai Banxia Decoction combined with exercise prescription for patients with SAP after PCI can improve their heart function in stage II rehabilitation,and reduce the incidence of restenosis in coronary artery.