生脉陷胸汤治疗冠心病不稳定型心绞痛临床研究

Clinical Study on the Treatment of Coronary Heart Disease Unstable Angina with Pulse-Engendering Raising the Sinking Decoction

目的:观察生脉陷胸汤治疗冠状动脉粥样硬化性心脏病(简称冠心病)不稳定型心绞痛的临床疗效。方法:将60例冠心病不稳定型心绞痛患者按照随机数字表法分为对照组和试验组,每组各30例。对照组给予常规治疗,试验组在对照组治疗的基础上联合生脉陷胸汤治疗。比较两组患者治疗前后中医证候积分、血清指标[P选择素、缺血修饰性蛋白(ischemia modified albumin, IMA)、正五聚蛋白3(pentraxin 3,PTX3)、可溶性CD40配体(soluble CD40L,sCD40L)]及生活质量评分变化情况;采用24 h动态心电图观察两组患者治疗前后心肌缺血发作次数、心肌缺血持续时间及心肌缺血总负荷。结果:两组患者治疗后中医证候积分低于本组治疗前,且治疗后试验组低于对照组(P<0.05)。两组患者治疗后IMA、P选择素、PTX3、sSCD40L低于本组治疗前,且治疗后试验组低于对照组(P<0.05)。两组患者治疗后心肌缺血发作次数、心肌缺血持续时间、心肌缺血总负荷低于本组治疗前,且治疗后试验组低于对照组(P<0.05)。两组患者治疗后主观感受、躯体功能、生理功能、西雅图心绞痛量表总分高于本组治疗前,且治疗后试验组高于对照组(P<0.05)。结论:生脉陷胸汤治疗冠心病不稳定型心绞痛,可缓解患者的临床症状,减少心肌缺血发作次数,缩短心肌缺血持续时间,改善心肌功能状况,从而提高生活质量。

Objective:To observe the clinical efficacy of Pulse-Engendering Raising the Sinking Decoction on coronary heart disease un-stable angina.Methods:A total of 60 patients with coronary heart disease unstable angina were divided into thecontrol group and the ex-perimental group according to the random number table method,with 30 cases in each group.The control group was given conventional treatment,while the experimental group was treated with Pulse-Engendering Raising the Sinking Decoction on the basis of the control group.The changes in TCM syndrome scores,serum indexes[including P-Selectin,ischemia modified albumin(IMA),pentaxin 3(PTX-3),soluble CD40 ligand(sCD40L)] and quality of life scores before and after treatment were compared between the two groups.The number of myocardial ischemic attack,duration of myocardial ischemia and total load of myocardial ischemia before and after treat-ment were observed by 24h dynamic electrocardiogram.Results:After treatment,the TCM syndrome scores in the two groups were lower than those before treatment,and the experimental group's scores were lower than those of the control group(P<0.05);The IMA,Ps,PTX-3 and sSCD40L in the two groups were lower than those before treatment,and the experimental group'a above indexes were lower than those of the control group(P<0.05);The number of myocardial ischemic attack,duration of myocardial ischemia and total load of myocardial ischemia in the two groups were lower than those before treatment,and the experimental group's above indexes were lower than those of the control group(P<0.05).The subjective feelings,physical function,physiological function and total score of SAQ after treatment in the two groups were significantly higher than those before treatment,and the experimental group's above indexes were high-er than those of the control group(P<0.05).Conclusion:Pulse-Engendering Raising the Sinking Decoction for unstable angina pecto-ris of coronary heart disease can relieve the clinical symptoms of patients,reduce the number of myocardial ischemic attack,shorten the duration of myocardial ischemia,improve myocardial function,and enhance the quality of life.