枣仁安神方联合艾司西酞普兰治疗冠心病伴焦虑症患者的疗效观察及与神经递质相关的机制探讨

Effect of Zaoren Anshen Priscription combined with escitalopram in treatment of coronary heart disease with anxiety disorder and its mechanism on neurotransmitters

目的观察自拟枣仁安神方联合艾司西酞普兰治疗冠心病(CHD)伴焦虑症患者的效果,以及对血清相关神经递质的影响,探讨自拟枣仁安神方的作用机制。方法选取驻马店市中心医院2016年4月—2018年3月期间收治的120例CHD伴焦虑症患者,随机分为对照组和治疗组,每组各60例。两组均给予CHD常规治疗方案,包括阿司匹林肠溶片、琥珀酸美托洛尔片、单硝酸异山梨酯、阿托伐他汀。对照组同时给予艾司西酞普兰,治疗组在对照组的基础上联合自拟枣仁安神方治疗,4周为1个疗程,连续3个疗程。在治疗前后对患者进行汉密尔顿焦虑量表(HAMA)评分、中医证候评分和心绞痛评分,评价CHD和焦虑症疗效,并检测血清5-羟色胺(5-HT)、髓过氧化物酶(MPO)、去甲肾上腺素(NE)和血浆神经肽(NPY)水平。结果治疗后,治疗组CHD和焦虑症有效率分别为91.67%、93.33%,高于对照组的78.33%、80.00%,差异显著(P<0.05);治疗组HAMA评分、中医证候评分和心绞痛评分均低于对照组(P<0.05);治疗组患者血清5-HT、NE、NPY水平高于对照组,MPO水平低于对照组(P<0.05)。结论自拟枣仁安神方联合艾司西酞普兰治疗CHD伴焦虑症,能够改善患者CHD和焦虑症症状,提高疗效,通过调节5-HT、NE、NPY和MPO水平来发挥治疗作用。

Objective To study the effect of self-made Zaoren Anshen Priscription combind with escitalopram in treatment of coronary heart disease with anxiety disorder and its effect on neurotransmitters,and discussion on the mechanism of drug prescription.Methods A total of 120 cases of CHD with anxiety disorder in Zhumadian Central Hospital from April 2016 to March 2018 were randomly divided into the control group and the experimental group for 60 cases in each group.The two groups were given conventional treatment for coronary heart disease,including Aspirin Enteric-coated Tablets,Metoprolol Succinate Tablets,isosorbide mononitrate,and atorvastatin.The control group was given escitalopram,while the experimental group was treated with Zaoren Anshen Priscription on the basis of the control group.Four weeks as a one course of treatment,three courses in a row.Before and after treatment,the HAMA score,TCM syndrome score,and angina pectoris score were evaluated,and evaluated the effect of coronary heart disease and anxiety,and the serum levels of 5-HT,MPO,NE,NPY were measured.Results After treatment,the effective rate of coronary heart disease and anxiety in the experimental group was 91.67%,93.33%,higher than 78.33%and 80%in the control group(P<0.05);The HAMA score,TCM syndrome score,and angina score in the experimental group were lower than those in the control group(P<0.05);The5-HT,NE and NPY in the test group were higher,while MPO was lower than that in the control group(P<0.05).Conclusion The treatment of coronary heart disease and anxiety can improve the symptoms of coronary heart disease and anxiety,and improve the curative effect,and was adjusting the level of 5-HT,NE,NPY,and MPO to play the therapeutic effect.