大柴胡汤加味对冠心病稳定型心绞痛(气滞血瘀证)的治疗效果分析

Analysis of Therapeutic Effect of Dachaihu Decoction on Stable Angina Pectoris(Qi Stagnation and Blood Stasis Syndrome) of Coronary Heart Disease

目的 分析大柴胡汤加味在冠状动脉粥样硬化性心脏病(简称冠心病)稳定型心绞痛(气滞血瘀证)中的作用。方法 选取2021年1月—2023年1月徐州新沂市中医医院心血管二科收治的80例冠心病稳定型心绞痛(气滞血瘀证)患者为研究对象,采用随机数表法分为两组,对照组40例,接受西医常规治疗方案,观察组40例,联合使用大柴胡汤加味方案,对比两组中医证候积分、血液流变学、血清相关粘附因子和冠状动脉微循环状态。结果 用药前,两组中医证候积分、全血高切黏度、全血低切黏度、红细胞聚集指数比较,差异无统计学意义(P>0.05)。用药后观察组中医证候积分为(6.70±1.30)分,全血高切黏度为(4.32±0.36)mPa·s,全血低切黏度为(9.24±1.06)mPa·s,红细胞聚集指数为(7.36±0.78)%,血小板聚集率为(30.27±6.54)%,均低于对照组,差异有统计学意义(t=8.053、7.120、5.086、4.195、6.176,P<0.05)。观察组用药后可溶性细胞间粘附分子1、可溶性血管细胞间粘附分子1水平、循环抵抗指数均低于对照组,冠状动脉血流储备明显高于对照组,差异有统计学意义(P<0.05)。结论予以冠心病稳定型心绞痛(气滞血瘀证)患者大柴胡汤加味方案,可降低中医证候积分,改善血液高凝状态,抗血管粘附作用明显,对冠状动脉微循环状态同样有改善作用。

Objective To analyze the effect of modified Dachaihu Decoction on stable angina pectoris(qi stagnation and blood stasis syndrome) of coronary heart disease.Methods 80 patients with stable angina pectoris(Qi stagnation and blood stasis syndrome) of coronary heart disease admitted to the Cardiovascular Department of Xinyi Traditional Chinese Medicine Hospital in Xuzhou from January 2021 to January 2023 were selected as the research subjects.They were randomly divided into a control group of 40 patients who received conventional Western medicine treatment plans,an observation group of 40 patients who received the modified Dachaihu Decoction plan.The TCM symptom scores,blood rheology,and serum related adhesion factors and coronary microcirculation status.Results Before medication,there was no statistically significant difference in the scores of traditional Chinese medicine symptoms,whole blood high shear viscosity,whole blood low shear viscosity,and red blood cell aggregation index between the two groups(P>0.05).After medication,the TCM syndrome score of the observation group was(6.70±1.30) points,the whole blood high shear viscosity was(4.32±0.36) mPa·s,the whole blood low shear viscosity was(9.24±1.06) mPa·s,the red blood cell aggregation index was(7.36±0.78)%,and the platelet aggregation rate was(30.27±6.54)%,all lower than the control group,the difference was statistically significant(t=8.053,7.120,5.086,4.195,6.176,P<0.05).After medication,the levels of soluble intercellular adhesion molecule-1,soluble vascular intercellular adhesion molecule-1,and circulating resistance index in the observation group were lower than those in the control group,and the coronary artery blood flow reserve was significantly higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion The modified Dachaihu decoction regimen for patients with stable angina pectoris(qi stagnation and blood stasis syndrome) with coronary heart disease can reduce the syndrome score of traditional Chinese medicine,improve blood hypercoagulability,have a significant anti-vascular adhesion effect,and also improve coronary microcirculation.