黄丽娟治疗冠心病介入术后再狭窄用药规律的研究

Study on Huang Lijuan's Medication Rules on the Treatment of Restenosis after Percutaneous Coronary Intervention

建立"黄丽娟治疗冠心病介入术后再狭窄病例观察表"。通过跟师抄方,完整记录患者的病史、症状、体征、舌脉、辨证分型、处方用药,进行中医药辨证治疗,应用临床观察性研究方法,跟踪观察患者治疗过程中的临床症状、体征、舌脉、处方用药等,观察黄丽娟治疗冠心病介入术后再狭窄的用药规律。结果表明,107例冠心病介入术后再狭窄患者的常见中医证候以气阴两虚、心血瘀阻证最多见;其次为脾虚失运、痰瘀互结证,肾阳虚损、寒饮夹瘀证,肝失疏泄、气滞血瘀证;再次为心肺气虚、心血瘀阻证,热毒血瘀证。常用药物主要包括益气、养阴、温阳、行气、活血、安神、化湿、清热、通腑、化痰等药物。用药共113味,排在前15位的为:生黄芪、茯苓、太子参、白术、麦冬、五味子、百合、白芍、枳壳、佛手、丹参、郁金、元胡、鸡血藤、酸枣仁。

An observation schedule was established about Huang Lijuan’s treatment on the therapy of restenosis after percutaneous coronary intervention cases. Doctor Huang Lijuan’ s medication rules on the treatment of restenosis after percutaneous coronary intervention was observed by following Doctor Huang Lijuan about clinical experiences and recording the patient’ s medical history,symptoms,signs,tongue and pulse,syndrome differentiation and prescription drugs completely. By observing the 107 patients,it was found that the most common TCM syndromes of restenosis after percutaneous coronary intervention were the syndrome of deficiency of both qi and yin and obstruction of blood in heart; then syndrome of dysfunction of spleen in transport,syndrome of phlegm and blood stasis,syndrome of deficiency of kidney- yang,syndrome of cold fluid and stasis,syndrome of impeded flow of liver- qi and syndrome of qi stagnation and blood stasis followed. The third group were syndrome of deficiency of qi both of heart and lung,syndrome of heart blood stasis and epidemic heat and blood stasis syndrome. The common drugs used mainly included supplementing qi,nourishing yin,warming yang,promoting qi,activating blood,tranquilization,dissipating dampness,clearing away heat,Fu- unblocking and phlegm- resolving drugs,etc. There were 113 kinds of drugs used in total and the top 15 were Astragalus,Poria,Radix pseudostell,Atractylodes,Liriope,Schisandra,Lily,Peony root,Citrus aurtantium,Bergamot,Salvia,Curcuma,Rhizoma corydalis,Milettia reticulate and Spine date seed.