PCI术后心绞痛患者血府逐瘀汤治疗前后心功能和血脂水平变化研究

Changes of cardiac function and blood lipid in patients with angina pectoris after PCI before and after a treatment with Xuefu Zhuyu decoction

目的探讨经皮冠状动脉介入治疗(PCI)术后心绞痛患者血府逐瘀汤治疗前后心功能和血脂水平变化。方法采用随机数字表法将120例2019年6月-2022年6月山西省长治市中医研究所附属医院心病科门诊和住院收治的PCI术后心绞痛患者分为对照组(60例)和观察组(60例)。2组均给予常规治疗,对照组在此基础上给予盐酸曲美他嗪片进行治疗,观察组在对照组基础上给予血府逐瘀汤进行治疗,2组均治疗3个月。比较2组治疗3个月后的疗效,治疗前、治疗3个月后的心绞痛发生情况、西雅图心绞痛量表(SAQ)评分、中医证候积分、心功能及血脂。结果治疗3个月后,观察组总有效率为90.00%,高于对照组的75.00%(P<0.05)。与治疗前比较,治疗3个月后,2组每次心绞痛持续时间均缩短,且观察组短于对照组(P<0.05);2组每周心绞痛发生次数均减少,且观察组少于对照组(P<0.05);2组SAQ评分及左室射血分数(LVEF)、每搏量(SV)均升高,且观察组高于对照组(P<0.05);2组左室收缩末期内径(LVESD)、胸闷、胸痛、心悸气短、面色紫黯、倦怠乏力评分、左室舒张末期内径(LVEDD)及血清B型钠尿肽(BNP)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、总胆固醇(TC)水平均降低,且观察组低于对照组(P<0.05)。结论PCI术后心绞痛患者经血府逐瘀汤治疗后中医证候得到明显改善,血脂水平得以降低,心绞痛症状及心功能得到明显缓解,生活质量及疗效得以提高。

Objective To investigate the changes of cardiac function and blood lipid in patients with angina pectoris after percutaneous coronary intervention(PCI)before and after a treatment with Xuefu Zhuyu decoction.Methods A total of 120 patients with angina pectoris after PCI admitted to the Cardiology Department of the Affiliated Hospital of Changzhi Institute of Traditional Chinese Medicine from June 2019 to June 2022 were selected as the research subjects,and they were divided into a control group(60 cases)and an observation group(60 cases)by the random number table method.Both groups were given a routine treatment,and the control group was given trimetazidine hydrochloride tablets on that basis,while on the basis of the control group,the observation group was treated with Xuefu Zhuyu decoction.Both groups were treated for 3 months.The efficacy after 3 months of treatment,the incidence of angina pectoris,the scores of the Seattle Angina Questionnaire(SAQ),the traditional Chinese medicine syndromes,the levels of cardiac function and blood lipid were compared between the two groups before and after treatment.Results After 3 months of treatment,the total effective rate of the observation group was 90.00%,higher than 75.00%in the control group(P<0.05).Compared with before treatment,after 3 months of treatment,the duration of angina pectoris was shortened in both groups,and the duration in the observation group was shorter than that in the control group(P<0.05);the frequency of angina pectoris per week decreased in both groups,and the number of angina pectoris in the observation group was less than that in the control group(P<0.05);the scores of SAQ,left ventricular ejection fraction(LVEF)and stroke volume(SV)increased in the two groups,and the scores in the observation group were higher than those in the control group(P<0.05);the left ventricular end systolic diameter(LVESD),scores of chest tightness,chest pain,palpitations,shortness of breath,dark complexion,tiredness and fatigue,left ventricular end diastolic diameter(LVEDD),and the serum levels of B-type natriuretic peptide(BNP),low density lipoprotein cholesterol(LDL-C),triglycerides(TG),total cholesterol(TC)decreased in the two groups,and those in the observation group were lower than those in the control group(P<0.05).Conclusion In patients with angina pectoris after PCI,Xuefu Zhuyu decoction significantly improves their traditional Chinese medicine syndromes,lowers their levels of blood lipid,significantly relieves their angina symptoms and cardiac function,and improves their quality of life and curative effect.