温阳通脉汤联合西药治疗冠心病心绞痛临床研究

Clinical Study on Wenyang Tongmai Decoction(温阳通脉汤)Combined with Western Medicine in Treating Angina Pectoris of Coronary Heart Disease

目的:探讨温阳通脉汤联合单硝酸异山梨酯、尼可地尔治疗冠心病心绞痛的临床疗效。方法:选取160例冠心病心绞痛患者,按照随机数字表法分为对照组和观察组各80例,对照组采用单硝酸异山梨酯、尼可地尔进行治疗,观察组在对照组基础上联合温阳通脉汤治疗。连续治疗2个月,比较两组患者心绞痛发作情况及中医证候积分,比较两组患者血脂[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)]、炎症因子[超敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、可溶性细胞间黏附分子-1(sICAM-1)]水平。结果:治疗后,两组患者的心绞痛发作频率、持续时间均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);西雅图心绞痛量表(SAQ)评分较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。治疗后,两组患者的TC、TG、LDL-C水平均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);HDL-C均较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。治疗后,两组患者hs-CRP、IL-6、sICAM-1水平均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。治疗后,两组患者心悸、胸痛、气短评分均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。治疗后,对照组不良反应发生率为12.50%,观察组为3.75%,观察组不良反应发生情况优于对照组(P<0.05)。结论:温阳通脉汤联合单硝酸异山梨酯、尼可地尔治疗冠心病心绞痛疗效确切,可有效改善患者的血脂指标,降低炎症水平,改善不良反应发生情况。

Objective:To investigate the clinical effect of Wenyang Tongmai Decoction(温阳通脉汤)combined with isosorbide mononitrate and nicodil on angina pectoris of coronary heart disease.Methods:A total of 160 patients with angina pectoris of coronary heart disease were selected and divided into the control group and the observation group according to random number table method,with 80 cases in each group.The control group was treated with isosorbide mononitrate and nicodil,and the observation group was combined with Wenyang Tongmai Decoction on the basis of the treatment of the control group.After a continuous treatment of 2 months,angina pectoris attack and traditional Chinese medicine(TCM)syndrome score,blood lipids[total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C)],inflammatory factors[hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),soluble intercellular adhesion molecule-1(sICAM-1)]were compared between the two groups.Results:After treatment,the frequency and duration of angina pectoris in both groups were lower than those before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).The score of Seattle Angina Questionnaive(SAQ)in both groups was higher than that before treatment(P<0.05),and the observation group was higher than the control group(P<0.05).After treatment,the levels of TC,TG and LDL-C in both groups were lower than those before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).HDL-C in both groups was higher than that before treatment(P<0.05),and the observation group was higher than the control group(P<0.05).After treatment,the levels of hs-CRP,IL-6 and sICAM-1 in both groups were lower than those before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).After treatment,the scores of palpitation,chest pain and shortness of breath in both groups were lower than those before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).After treatment,the incidence of adverse reactions was 12.50%in the control group and 3.75%in the observation group,and the incidence of adverse reactions in the observation group was better than that in the control group(P<0.05).Conclusions:Wenyang Tongmai Decoction combined with isosorbide mononitrate and nicordil is effective in the treatment of angina pectoris of coronary heart disease,which can effectively improve the blood lipid index,reduce the level of inflammation and improve the occurrence of adverse reactions.