益气活血法在合并颈动脉粥样硬化斑块冠心病心绞痛患者中的效果

Effffect of Yiqi Huoxue therapy on coronary heart disease angina pectoris patients with carotid atherosclerotic plaque

目的探讨益气活血法对合并颈动脉粥样硬化斑块的冠心病心绞痛患者中医症状体征及心电图缺血性改变的影响。方法将2021年11月-2023年3月郑州市中医院收治的合并颈动脉粥样硬化斑块的冠心病心绞痛患者80例随机分为对照组和观察组,各40例。对照组给予西医常规治疗,观察组在对照组基础上采用益气活血法进行治疗,2组均持续治疗8周。比较2组治疗8周后的心电图疗效、中医证候疗效,治疗前、治疗8周后的中医症状体征积分、颈动脉彩超结果、心电图缺血性改变情况及血脂水平。结果观察组治疗8周后心电图总有效率(95.00%,38/40)高于对照组(77.50%,31/40)(P<0.05);观察组治疗8周后中医证候总有效率(95.00%,38/40)高于对照组(75.00%,30/40)(P<0.05)。与治疗前比较,治疗8周后,2组神疲、乏力、气短、脉络瘀血、疼痛评分、颈动脉内膜-中层厚度(IMT)、阻力指数(RI)、博动指数(PI)、收缩期峰值流速(SPV)、T波倒置导联数、T波低平导联数、ST段下移导联数、血清三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平降低,观察组低于对照组(P<0.05);2组血清高密度脂蛋白胆固醇(HDL-C)水平升高,观察组高于对照组(P<0.05)。结论益气活血法可明显改善合并颈动脉粥样硬化斑块的冠心病心绞痛患者中医症状体征、颈动脉血流动力学、心肌供血及血脂水平,有利于提高心电图及中医证候疗效。

Objective To investigate the effect of Yiqi Huoxue therapy on the TCM symptoms and signs and the electrocardiogram ischemic changes of coronary heart disease angina pectoris patients with carotid atherosclerosis plaque.Methods From November 2021 to March 2023,80 patients with coronary heart disease angina pectoris and carotid atherosclerosis plaque admitted to Zhengzhou Traditional Chinese Medicine Hospital were grouped into the control group(40 cases)and the observation group(40 cases)with the random number table method.The control group received a routine western medicine treatment,while the observation group received a treatment with the Yiqi Huoxue therapy on the basis of the control group,both for 8 weeks continuously.The ECG efficacy and TCM symptoms efficacy after 8 weeks of treatment,as well as the scores of TCM symptoms and signs,carotid artery ultrasound results,ischemic changes in ECG,and levels of blood lipid before and after 8 weeks of treatment were compared between the two groups.Results After 8 weeks of treatment,the total effective rate of ECG in the observation group(95.00%,38/40)was higher than that in the control group(77.50%,31/40)(P<0.05),and the total effective rate of TCM syndromes in the observation group(95.00%,38/40)was also higher than that in the control group(75.00%,30/40)(P<0.05).Compared with before treatment,after 8 weeks of treatment,the two groups showed a decrease in scores of spiritlessness,fatigue,shortness of breath,choroidal congestion,pain,carotid intimamedia thickness(IMT),resistance index(RI),pulsatility index(PI),peak systolicflow velocity(SPV),number of T wave inverted leads,number of T wave lowflat leads,number of ST segment downshift leads,serum levels of triglyceride(TG),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL-C),and the observation group was lower than the control group(P<0.05),while the serum levels of high-density lipoprotein cholesterol(HDL-C)increased in both groups,and the observation group was higher than the control group(P<0.05).Conclusion The Yiqi Huoxue therapy can significantly improve the TCM symptoms and signs,carotid artery hemodynamics,myocardial blood supply and blood lipid level in the coronary heart disease angina pectoris patients complicated with carotid atherosclerosis plaque,and is conducive to improving the ECG and TCM syndrome efficacy.