从肝论治气滞血瘀型心肌桥的临床观察

Clinical Observation on Treatment of Qi Stagnation and Blood Stasis Type Myocardial Bridge from Liver

目的探讨疏肝活血方柴胡疏肝散加减治疗心肌桥的有效性和安全性。方法选取2014年10月—2016年2月收治住院的患者,经冠状动脉造影术检查诊断为心肌桥,并符合中医气滞血瘀型症候的研究对象,共60例。随机分为对照组和治疗组,对照组30例采取常规用药美托洛尔缓释片23. 75~47. 5 mg每日1次(有β-受体阻滞剂禁忌症者改用维拉帕米缓释片0. 24 g每日1次)。治疗组30例予柴胡疏肝散加减。治疗观察6周后比较2组治疗效果及药物不良反应。结果治疗组的中医证候积分、心电图疗效、心绞痛临床症状改善均优于对照组常规西药治疗,并且观察过程中未见不良反应。结论柴胡疏肝散加减治疗气滞血瘀型心肌桥临床效果明显,能够有效改善患者症状,安全性可靠。

Objective To investigate the efficacy and safety of Shugan Huoxue decoction and Shugan powder in the treatment of myocardial bridge.Methods Patients who were hospitalized from October 2014 to February 2016 were enrolled.The 60 patients with qi stagnation and blood stasis syndrome were diagnosed as myocardial bridge.According to the random number table,they were divided into the control group and the treatment group.In the control group,30 cases were treated with conventional metoprolol sustained-release tablets 23.75~47.5 mg qd(the contraindications withβ-blockers were changed to Verapaimi sustained release tablets 0.24 g qd).30 patients in the treatment group were treated with Chaihu Shugan powder.After 6 weeks of treatment observation,the therapeutic effects and adverse drug reactions were compared between the two groups.Results The clinical symptom improvement rate,ECG efficacy and TCM syndrome scores of angina pectoris in the treatment group were better than those in the control group,and no adverse reactions were observed during the observation.Conclusion Chaihu Shugan powder has a significant clinical effect in the treatment of qi stagnation and blood stasis type myocardial bridge,which can effectively improve the patient’s symptoms,and is safe and reliable.