麝香保心丸联合体外反搏治疗气虚血瘀型稳定型心绞痛的疗效观察

Clinical observation on Shexiang Baoxin Pills combined with external counterpulsation in treatment of Qi deficiency and blood stasis type stable angina pectoris

目的分析麝香保心丸联合体外反搏治疗气虚血瘀型稳定型心绞痛的临床疗效。方法选取2018年2月—2019年12月衡水市中医医院收治的80例气虚血瘀型稳定型心绞痛患者,按照随机数字表法将所有患者分为对照组和治疗组,每组40例。对照组患者给予常规化学药治疗及体外反搏。治疗组患者在对照组基础上口服麝香保心丸,2丸/次,3次/d。两组患者的治疗时间均为4周。比较两组患者的临床疗效、心绞痛评分、心电图心肌缺血情况、心脏耐受性和心功能分级。结果治疗后,治疗组总有效率是97.50%,显著高于对照组的85.00%(P<0.05)。治疗后,两组患者认知水平评分、身体受限评分、发作程度评分、稳定水平评分、满意度评分均较治疗前显著升高(P<0.05);且治疗后,治疗组心绞痛评分均显著高于对照组(P<0.05)。治疗后,两组ST段压低最大程度较治疗前显著降低,而运动持续时间、6 min步行试验(6MWT)显著增加(P<0.05);治疗后,治疗组心电图心肌缺血和心脏耐受性改善优于对照组(P<0.05)。治疗后,两组NYHA心功能III级均较本组治疗前降低(P<0.05),且治疗组低于对照组(P<0.05)。结论麝香保心丸联合体外反搏治疗气虚血瘀型稳定型心绞痛患者具有较好的临床疗效,能够更大程度改善心绞痛SAQ评分、心电图心肌缺血情况及心功能NYHA分级,提高心脏耐受性,值得推广应用。

Objective To analyze the clinical therapeutic effect of Shexiang Baoxin Pills combined with external counterpulsation in treatment of Qi deficiency and blood stasis type stable angina pectoris.Methods A total of 80 patients with Qi deficiency and blood stasis type stable angina pectoris admitted to Hengshui Hospital of Traditional Chinese Medicine from February 2018 to December 2019 were selected and divided into control group and treatment group according to random number table method,with 40 cases in each group.Patients in the control group were treated with conventional western medicine and in vitro counterpulsation.Patients in the treatment group were po administered with Shexiang Baoxin Pills on the basis of the control group,2 pills/time,three times daily.Both groups were treated for 4 weeks.The clinical efficacy,angina scores,ECG myocardial ischemia,cardiac tolerance and cardiac function grades of the two groups were compared.Results After treatment,the total effective rate of the treatment group was 97.50%,which was significantly higher than that of the control group(85.00%)(P<0.05).After treatment,the scores of cognitive level,physical limitation,attack degree,stability level and satisfaction were significantly increased in two groups compared with before treatment(P<0.05).After treatment,angina scores in the treatment group were significantly higher than those in the control group(P<0.05).After treatment,the maximum degree of ST-segment depression was significantly decreased in both groups compared with before treatment,while the exercise duration and 6-min walking test(6MWT)were significantly increased(P<0.05).After treatment,the improvement of ECG myocardial ischemia and cardiac tolerance in the treatment group was better than that in the control group(P<0.05).After treatment,NYHA grade III cardiac function in both groups was lower than that before treatment(P<0.05),and the treatment group was lower than the control group(P<0.05).Conclusion Shexiang Baoxin Pills combined with external counterpulsation has good clinical effect in treatment of Qi deficiency and blood stasis type stable angina pectoris,and can significantly improve the SAQ score of angina pectoris,myocardial ischemia in electrocardiogram and NYHA grade of cardiac function,and improve cardiac tolerance,which is worth popularizing and applying.