Effect of Gualou Xiebai Banxia decoction combined with Danshen Decoction on clinical efficacy of unstable angina with phlegm and blood stasis syndrome

Objective:To observe the clinical efficacy and safety of Gualou Xiebai Banxia decoction combined with Danshen decoction on unstable angina(UA)with phlegm and blood stasis syndrome.Method:Eighty patients with UA were randomly divided into treatment group(40 cases)and control group(40 cases)by random number table.The control group was given conventional western medicine treatment,and the experimental group was given Gualou Xiebai Banxia decoction and Danshen decoction on the basis of the control group.Both groups were treated for 4 weeks.Before and after treatment,the angina attacks,dosage of nitroglycerin,traditional Chinese medicine syndrome score,quality of life score,blood lipid,coagulation index and clinical total efficacy were observed and recorded.Results:After 4 weeks of treatment,the attack times and duration of angina in the two groups were both decreased compared with those before treatment.And the treatment group was more significantly reduced than the control group,the difference was statistically significant(p<0.05);the consumption of nitroglycerin of the treatment group was 90.0%,which was better than 67.5%of the control group,the difference was statistically significant(p<0.05);the total effective rate of the treatment group was 90%,which was better than 65%of the control group,the difference was statistically significant(p<0.05);the traditional Chinese medicine(TCM)syndrome score of the experimental group was lower than that of the control group,the differences was significant(p<0.05).The improvement of low density lipoprotein(LDL-C),total cholesterol(TC)and prothrombin time(PT)in the experimental group was better than that in the control group(p<0.05).During the study,there were no obvious adverse reactions in both groups.Conclusion:Gualou Xiebai Banxia decoction combined with Danshen decoction can effectively relieve the attack of angina and the consumption of nitroglycerin,improve clinical symptoms,regulate blood lipid and blood flow state,and improve the quality of life of patients with UA,with good clinical efficacy and safety.

Efficacy of Danlou Tablet in the Treatment of Coronary Heart Disease with Phlegm and Blood Stasis Syndrome and Its Effects on Serum Inflammatory Factors

[Objectives] To explore the efficacy of Danlou Tablet( DLT) in the treatment of coronary heart disease( CHD) with phlegm and blood stasis syndrome and its effects on serum inflammatory factors. [Methods]One hundred and ninety-seven patients with CHD and phlegm and blood stasis syndrome in our hospital from January 2016 to January 2018 were selected and randomly divided into two groups: control group( n =98) treated with aspirin plus atorvastatin,and research group( n =99) treated with DLT and aspirin plus atorvastatin for one month. The clinical efficacy and incidence of adverse reactions were observed. Serum secretory phospholipase A2( s PLA2),lipoprotein-associated phospholipase A2( LP-PLA2),oxidized low-density lipoprotein( ox-LDL),monocyte chemoattractant protein-1( MCP-1) and World Health Organization Quality of Life( WHOQOL-100) scores were compared before and after one month of treatment. [Results] The total effective rate was93. 94% in the research group,which was higher than that in the control group( 79. 59%,P < 0. 05);the levels of serum s PLA2,LP-PLA2,ox-LDL and MCP-1 in the research group were lower than those in the control group after one month of treatment( P < 0. 05). There was no statistical significance of the difference in the total incidence of adverse reactions between the research group and the control group( P > 0. 05).After one month of treatment,WHOQOL-100 scores were higher in two groups,which were higher in the research group than that in the control group( P < 0. 05). [Conclusions]DLT can significantly reduce the level of serum inflammatory factors,improve the quality of life in patients with CHD and phlegm and blood stasis syndrome.

Professor Jun Li Treating Vascular Dementia from Mutual Conclusion of Phlegm and Blood Stasis

Professor Jun Li believes that the main etiology and pathogenesis of vascular dementia is the combination of phlegm and blood stasis.The symptoms include feeling faint and declined senses in organs of the head,caused by mystery reason.To cure phlegm and blood stasis simultaneously,the therapy promotes the notion of“resolving phlegm and stimulating the circulation of blood,liberate brain orifices,”and treatments with the addition and removal of“Naotaitong Decoction,”which has an amazing clinical curative effect.This paper examines Professor Jun Li’s theoretical foundations and ideas from the syndrome differentiation and treatment of phlegm and blood stasis,systematically examines the curative effect and mechanism of Naotaitong Decoction in the treatment of vascular dementia,and examines the prescription and medication of typical cases for readers,in the hopes of providing guidance to clinical diagnosis and treatment of this disease.

Discussion on the Prevention and Treatment of COVID-19 Causing Lung Disease and Heart Damage Based on Lei Zhongyi's Theory of Intermingled Phlegm,Blood Stasis and Toxin

Novel coronavirus infection not only damages lung function,but also causes myocardial injury,elevated myocardial enzymes and heart failure,especially for patients with basic heart diseases who develop COVID-19,the first consideration should be the protection of cardiac function.Based on the theory of intermingled phlegm,blood stasis and toxin of heart disease put forward by Master Lei Zhongyi,the dialectical treatment thinking of COVID-19 patients from the concept of damage of phlegm,blood stasis and toxin to the heart were discussed.During the diagnosis,critical stage and recovery period of COVID-19,expectorant and blood-activating agents,heat and detoxification agents can be added to promote lung and asthma,free Bizheng and remove blood stasis,calm the heart and calm the mind,and promote the recovery of cardiopulmonary functions.

On the Treatment of Kidney Fibrosis from the Theory of Internal Deficiency of Qi and the Coexistence of Phlegm and Blood Stasis

Traditional Chinese medicine believes that the etiology and pathogenesis of renal fibrosis are characterized by deficiency of the lung,spleen and kidney,and phlegm,blood stasis,dampness and poison.The positive and the evil can influence each other and cause and effect each other,forming the pathological characteristics of the deficiency,the deficiency,the deficiency and the reality.Chinese medicine treatment of the disease has its unique advantages,external and internal injury equal emphasis,correction and dispelling evil and regulation.From the point of view of"deficiency of qi and coexistence of phlegm and blood stasis",the treatment of renal fibrosis can provide theoretical basis for the treatment of the disease.

Comparing the mechanism of four classic Gualou-Xiebai prescriptions for cardiovascular diseases with phlegm and blood stasis syndrome based on molecular network modeling

Background:Four classical Traditional Chinese Medicine prescriptions,namely Gualou Xiebai Baijiu decoction,Gualou Xiebai Banxia decoction(GLXBBX),Zhishi Xiebai Guizhi decoction(ZSXBGZ)and Danlou prescription(DL),have been frequently used for treatment of phlegm and blood stasis syndrome(PBSS)-related cardiovascular diseases.However,its therapeutic mechanism has not been clearly elucidated.This study aimed to explore PBSS and its molecular mechanism,clarify and compare the mechanisms of four prescriptions in treating PBSS-related diseases.Method:In this study,we collected four prescriptions’compounds,predicted therapeutic targets,and enriched pathways which were based on network pharmacology.Then,we analysed the commen and different mechanisms by combing the network of components,targets and pathways.Finally,molecular docking was engaged to assess the binding potential of key compounds and hub targets.Results:We showed that four prescriptions’intersection genes(VEGFA,SRC,EGFR,etc.)were commonly enriched in PI3K-AKT signaling pathway,HIF-1 signaling pathway,etc.In addition,platelet activation and cAMP signaling pathway were singly enriched from the GLXBBX through unique compounds 12,13-epoxy-9-hydroxynonadeca-7,10-dienoic acid and Cyclo(L-tyrosyl-L-phenylalanyl).These bioactive compounds may exert GLXBBX’s unique pharmacological pathways via involving in mediating PPARA,PTGER3,etc.Sphingolipid signaling pathway was singly enriched from the ZSXBGZ through unique compounds tetramethoxyluteolin,ergosterol peroxide,etc.These bioactive compounds could mediate ADORA1,ADORA3 and TNFRSF1A to regulate ZSXBGZ’s unique pharmacological pathways.AMPK signaling pathway was singly enriched from the DL through unique compounds kaempferol,evofolinb,ethyl acid and aureusidin.These bioactive compounds were involved in mediating the main targets of AMPK signaling pathway,such as TNF,TNFRSF1A,etc.Conclusions:Our research demonstrated that GLXB-prescriptions involved in almost all pathological stages of PBSS-related cardiovascular diseases by modulating high-frequency shared pathways and targets mainly through key compounds(quercetin,mandenol,sitosteryl acetate and luteolin,etc.),for example,participate in the process of atherosclerosis,lipid metabolism,inflammation,immune response,thrombosis,inhibit inflammatory factors and platelet aggregation,regulate immune function,vascular function,oxidative stress.In addition to common pharmacological efficacies,there could also be specificities among GLXB prescriptions due to different compounds.For example,GLXBBX tends to regulate the function of vascular and endothelial barrier,prevent thrombosis.ZSXBGZ tends to regulate lipid metabolism and protect the heart from lipid accumulation.DL tends to maintain energy homeostasis and improve inflammation.

Clinical study on Chuanxiong Hualiu Mixture in the treatment of blood stasis and phlegm stagnation type of ovarian cyst

Objective:To observe the clinical efficacy of Chuanxiong Hualiu Mixture in the treatment of blood stasis and phlegm stagnation type of ovarian cyst and the effects on physical and chemical indicators.Methods: A total of 80 patients with blood stasis and phlegm stagnation type of ovarian cyst were randomly divided into two groups, research group (n=40) took Chuanxiong Hualiu Mixture, control group (n=40) took Guizhi Fuling Capsule, 3 months was a course of treatment, and the curative effect was compared between two groups.Results:(1) The overall response rate of Chuanxiong Hualiu mixture group after 3 months of treatment was 82.5%, that of Guizhi Fuling Capsule group was 62.5%, the overall response rate of Chuanxiong Hualiu mixture group was higher than that of control group, and the difference was statistically significant;(2) before and after treatment, sex hormone and hemorheology index E2 of both groups decreased significantly, whole blood viscosity, whole blood reduced viscosity and plasma viscosity decreased significantly, the results were statistically significant, but there was no difference between two groups;(3) rank sum test of TCM symptom efficacy between two groups before and after treatment showed that the overall response rate of Chuanxiong Hualiu mixture group was 95%, the overall response rate of Guizhi Fuling Capsule group was 85%, the overall response rate of research group was better than that of control group, and the difference was statistically significant.Conclusion:Chuanxiong Hualiu mixture has good curative effect for the treatment of ovarian cyst, it can effectively improve the patients' blood stasis and phlegm stagnation constitution, and its mechanism of action is associated with lowering estrogen levels and improving hemorrheology.

Research progress of traditional Chinese medicine in the treatment of breast cancer based on “Binding of Phlegm and Stasis”

Breast cancer is a common malignancy in female,which seriously endangers women’s health.Chinese medicine believed that the incidence of breast cancer is related to“Stagnation of Liver-Qi”and“Phlegm,Disharmony of Thoroughfare and Conception Vessels”,“Stagnation of Qi and Blood Stasis”,constitution and other characteristics.Modern research believed that phlegm is related to abnormal energy metabolism of tumor cells,and stasis is the pathological change of tumor angiogenesis.How to combine tumor angiogenesis and energy replacement abnormality with the theory of“Binding of Phlegm and Stasis”has become a new direction of traditional Chinese medicine anti-tumor research.The drugs of“Activating Blood Circulation”and“Removing Blood Stasis”,“Resolving Phlegm”and“Dispersing Constipation”have a wide range of pharmacological effects and definite curative effect.They have the functions of anti-inflammatory,anti-tumor,anti-pathogenic microorganism and improving the immune ability of the body.In this paper,the effects and mechanisms of phlegm-reducing and stasis dispersing active ingredients and compound preparations in regulating angiogenesis and energy metabolism of breast cancer were reviewed,and the differences in efficacy,targets and pathways of Phlegm-Reducing and Stasis Dispersing drugs were summarized,so as to provide some reference for the research and development of traditional Chinese medicine for breast cancer.

齐元富基于“解毒”治疗观辨治肺癌经验

齐元富教授重视毒邪在肺癌发生、发展中的重要作用,“解毒”是其治疗肺癌的经验特色之一。齐教授将导致肺癌的毒邪分为热毒、郁毒、痰毒、瘀毒四种类型,热毒者主以清热解毒治之,郁毒者主以理气消癥治之,痰毒者主以化痰除湿治之,瘀毒者主以活血散结治之,临床常获佳效。附验案1则。

基于“坚者削之,结者散之”治疗消化道息肉理论探析

消化道息肉主要是指胃肠道息肉,目前本病临床上最常用的治疗方法为内镜下治疗,虽见效快,但并发症较多,且治疗后仍有较高的复发率。中医药对于预防本病复发有一定的优势,本课题组通过总结古今相关文献以及结合临床实践研究,认为消化道息肉的核心病机多以脾虚气滞为本,而脾胃气机壅滞进一步产生湿、痰、瘀等病理因素为标,故紧扣病机,根据“坚者削之,结者散之”理论,提出“消散法”辨治消化道息肉,临证时需灵活变通,随症加减,以期为中医药治疗消化道息肉提供新的见解。

毛德西教授加味大补心汤治疗胸痹心痛验案

胸痹心痛的发病与心脏功能失调密切相关,《黄帝内经》中“心为阳中之太阳”高度概括了心的发病特点。毛德西教授基于《黄帝内经》“心为阳中之太阳”理论自拟加味大补心汤治疗胸痹心痛(痰浊血瘀证),现总结毛德西教授治疗本病的临床经验。

高尿酸血症对痰瘀互结型急性冠脉综合征患者PCI预后的影响

[目的]基于真实临床诊疗数据,通过倾向性评分匹配法(PSM)探讨无症状高尿酸血症(HUA)对痰瘀互结型急性冠脉综合征(ACS)患者经皮冠状动脉介入(PCI)预后的影响,以便准确评估HUA患者心血管风险,为进一步探索中西医结合治疗方案提供理论基础。[方法]通过医院信息系统,获得2019年1月至2023年6月所有在天津中医药大学第二附属医院诊断为痰瘀互结型ACS并行PCI治疗的45岁及以上患者住院资料,随访至PCI后12月,主要终点为主要不良心脑血管事件(MACCE),次要终点为心源性死亡、非致死性心肌梗死、卒中、新发或加重心力衰竭(HF)。根据血清尿酸(SUA)浓度将患者分为HUA组和非HUA组,通过1∶2 PSM平衡协变量,采用多因素Cox回归分析HUA对终点事件的影响。[结果]共纳入484例患者,平均年龄(63.72±10.18)岁,74.59%为男性,25.41%为女性,与非HUA组相比,HUA组男性患者比例更高,诊断为ST段抬高型心肌梗死患者更多。PSM后HUA组68例(33.66%),非HUA组134例(66.34%),两组间各协变量分布均衡。PSM后多因素Cox回归表明,与非HUA组相比,HUA组PCI后12月内MACCE发生风险增加139%[HR=2.39,95%CI(1.13,5.07),P<0.05]、新发或加重HF发生风险增加272%[HR=3.72,95%CI(1.11,12.48),P<0.05],并且SUA浓度每升高1μmol/L,MACCE发生风险增加0.6%[HR=1.006,95%CI(1.002,1.010),P<0.05],新发或加重HF发生风险增加0.6%[HR=1.006,95%CI(1.000,1.012),P<0.05],但两组心源性死亡、非致死性心肌梗死、卒中的发生风险差异无统计学意义(P>0.05)。亚组分析进一步表明仅在年龄≥65岁、高血压、糖尿病、非ST段抬高型ACS、多支病变患者中,两组新发或加HF发生风险差异有统计学意义。[结论]入院时合并无症状HUA与45岁及以上的痰瘀互结型ACS患者PCI预后不良相关,对新发或加重HF具有潜在预测价值。

益心通络汤联合运动康复训练对急性心肌梗死患者经皮冠脉介入术后的影响研究

目的:观察益心通络汤联合个性化运动康复训练对急性心肌梗死经皮冠脉介入术(PCI)后气虚痰瘀证患者心功能及身体素质的影响。方法:选择急性心肌梗死PCI术后气虚痰瘀证患者180例,按照随机数字表法分为对照组和治疗组各90例,对照组患者接受西医常规治疗和个性化运动康复训练,治疗组患者在对照组治疗方案的基础上服用益心通络汤,两组均连续治疗4周。比较两组患者的身体素质、六分钟步行试验(6MWT)距离、中国心血管病患者生活质量评定问卷(CQQC)评分、左室射血分数(LVEF)、血浆脑利尿钠肽(BNP)水平、中医四诊信息计分,评价中医证候疗效,并记录两组治疗期间的不良反应情况。结果:治疗后,两组患者的6MWT距离、CQQC评分、血浆BNP水平、中医四诊信息计分均优于治疗前(P<0.05),且治疗组患者的身体素质水平、CQQC评分、血浆BNP水平、中医四诊信息计分、中医证候疗效均优于对照组(P<0.05)。两组患者治疗期间均未出现严重不良反应。结论:益心通络汤联合个性化运动康复训练可显著改善急性心肌梗死PCI术后气虚痰瘀证患者的身体素质水平、心脏泵功能、临床症状及运动耐力等,可降低患者血浆BNP水平,安全性高。

从虚、痰、瘀、毒论治肺部磨玻璃结节

随着体检中胸部CT的普及,肺部磨玻璃结节(ground-glass nodule,GGN)的检出率越来越高,其具有一定比例的恶性概率,容易引起患者的恐慌,值得临床重视。目前对于无手术适应症的肺部GGN西医只是随访观察,而中医学对肺部GGN的研究尚不足,并且未形成统一的认识。通过查阅文献以及临床上四诊合参发现磨玻璃结节的病机特点多以虚痰瘀毒夹杂为主,基于虚、痰、瘀、毒讨论肺部GGN的病机特点及治疗方法,希冀为肺部磨玻璃结节的诊疗提供一定的思路。

基于“阳化气、阴成形”理论探讨线粒体与非酒精性脂肪性肝病的关系

非酒精性脂肪性肝病是本虚标实之证,基本病机为“阳化气不足、阴成形太过”,以脾肾阳虚为本,痰浊、水湿、瘀血等阴邪停聚体内为标。其病理因素可归于湿、痰、瘀等具有阴性特点的物质。线粒体功能障碍导致的活性氧产生过多、线粒体自噬异常、脂肪酸氧化异常等会引起脂质代谢异常,进一步导致肝细胞受损和炎症发展。由此可见,阳化气不足是线粒体失衡的基础条件,阴成形太过为线粒体失衡的重要表现。临证运用补气健脾、化痰祛瘀、调和阴阳等治法,使气行不滞,气有所化,调整阴阳代谢,有效减轻线粒体损伤,增加线粒体自噬能力,促进线粒体稳态恢复,稳定细胞内环境,促进疾病向愈,从而达到阴平阳秘的平衡状态。

祛瘀化痰中药复方对心房颤动大鼠线粒体自噬PINK1/Parkin通路作用机制研究

目的 观察祛瘀化痰中药复方对心房颤动大鼠心肌自噬影响及可能的作用机制。方法 将90只健康雄性大鼠随机分成正常组、模型组、胺碘酮组及中药低、中、高剂量组;除正常组外,各组大鼠进行尾静脉注射Ach-CaCl_(2)混合液制备心房颤动模型。电生理记录仪测量大鼠Ⅱ导联房颤持续时间,HE染色观察房颤大鼠心肌组织变化,Western blotting检测各组大鼠心肌组织PINK1、Parkin、LC3B、P62、Atg5和Beclin1蛋白表达情况。RT-PCR检测各组大鼠心肌组织PINK1、Parkin、LC3B和P62 mRNA表达情况。结果 与正常组相比,其余各组大鼠心电图均出现典型AF改变(P<0.01);模型组大鼠PINK1、Parkin、LC3B、Atg5、Beclin1蛋白及mRNA表达降低(P<0.01),P62蛋白及mRNA表达升高(P<0.01)。与模型组相比,中药低、中、高剂量组及胺碘酮组大鼠AF持续时间均缩短(P<0.05);PINK1、Parkin、LC3B、Atg5、Beclin1蛋白及m RNA表达升高(P<0.05),P62蛋白及mRNA表达降低(P<0.05)。结论 祛瘀化痰中药复方可以上调PINK1/Parkin通路,进一步激活线粒体自噬,减轻心肌的损伤,从而保护心肌组织,缓解房颤的发生并对房颤产生治疗作用。

Wellens综合征左前降支狭窄程度及预后与中医证型的相关性研究

【目的】探讨Wellens综合征(WS)冠状动脉(简称冠脉)左前降支狭窄程度及预后与中医不同证型之间的关系。【方法】采用回顾性分析方法,收集2021年9月至2023年9月于广州中医药大学第一附属医院心内科住院治疗,符合Wellens综合征诊断且完善冠脉造影检查的70例患者作为研究对象,整理资料,建立数据库,将所有患者分为气虚血瘀证、气阴两虚证、热毒血瘀证、痰浊血瘀证4种证型,分析所有患者的基本资料、中医证型分布特点、左前降支狭窄程度(Gensini评分)、风险预后的评分(TIMI危险评分),探讨Wellens综合征左前降支狭窄程度及预后与中医证型的关系。【结果】(1)中医证型分布方面,在70例Wellens综合征患者中,热毒血瘀证占比最多,为37.14%(26/70),气虚血瘀证占比最少,为12.86%(9/70),中医证型分布占比从高到低依次为热毒血瘀证>痰浊血瘀证>气阴两虚证>气虚血瘀证。(2)性别、年龄方面,不同中医证型间的性别、年龄分布比较,差异均无统计学意义(P>0.05)。(3)中医证型分布与Gensini评分、TIMI危险评分方面,不同中医证型组间的Gensini评分比较,差异有统计学意义(P<0.01),热毒血瘀证和痰浊血瘀证的Gensini评分较高,其中以痰浊血瘀证的Gensini评分最高,事后两两比较发现,热毒血瘀证组和痰浊血瘀证组的Gensini评分均明显高于气虚血瘀证组(P<0.05)。不同中医证型组间的TIMI危险评分比较,差异有统计学意义(P<0.05),事后两两比较发现,热毒血瘀证组的TIMI危险评分高于气虚血瘀证组(P<0.05),其余各组间两两比较,差异均无统计学意义(P>0.05)。(4)心电图分型与Gensini评分、TIMI危险评分方面,WS-Ⅱ型患者的Gensini评分、TIMI危险评分均高于WS-Ⅰ型患者(P<0.05)。(5)对TIMI危险评分及Gensini评分进行相关性分析,发现TIMI危险评分与Gensini评分之间存在相关关系(R_(S)=0.258,P<0.05)。【结论】在Wellens综合征患者中,热毒血瘀证和痰浊血瘀证的Gensini评分较高,提示左前降支狭窄程度更严重,且Gensini评分与TIMI危险评分存在一定的相关关系。

活血通窍法治疗儿童过敏性鼻炎临床观察

目的:观察活血通窍方治疗儿童痰瘀互结型过敏性鼻炎的临床疗效。方法:将60例符合纳入标准的过敏性鼻炎患儿随机分为两组各30例。对照组予口服盐酸西替利嗪片及糠酸莫米松喷鼻,治疗组在对照组基础上予活血通窍方,疗程均为28天。观察两组治疗前后中医各证候积分、鼻腔检查评分、PLT、EOS水平。结果:治疗组、对照组总有效率分别为96.67%、76.67%,两组比较差异无统计学意义(P﹥0.05),治疗组愈显率为70.00%高于对照组的40.00%(P﹤0.05);治疗后,两组患儿各主症、鼻腔检查积分、EOS水平均较治疗前明显下降(P﹤0.01),治疗组各次症积分、PLT水平较治疗前明显下降(P﹤0.01),对照组面色口唇、睡眠质量积分较治疗前下降(P﹤0.05)。治疗组主症、次症、鼻腔检查积分、PLT、EOS水平明显低于对照组(P﹤0.01,P﹤0.05)。结论:活血通窍方联合盐酸西替利嗪片、糠酸莫米松喷雾剂能有效改善过敏性鼻炎患儿的临床症状,同时可降低PLT、EOS水平。

化痰通络汤加味方治疗冠心病PCI术后心绞痛痰瘀互结型的临床研究

【目的】探讨化痰通络汤加味方(由半夏、橘红、茯苓、枳实、丹参、川芎、红花、石菖蒲、远志等组成)对冠心病经皮冠状动脉介入(PCI)术后心绞痛痰瘀互结型患者的临床疗效及生活质量的影响。【方法】将广州中医药大学附属阳江市中医医院2023年1月至2024年1月期间收治的80例冠心病PCI术后心绞痛痰瘀互结型患者按随机数字表法随机分为对照组和治疗组,每组各40例。对照组给予常规西药治疗,治疗组在对照组的基础上联合化痰通络汤加味方治疗,疗程为1个月。观察2组患者治疗前后中医证候积分、生活质量西雅图心绞痛量表(SAQ)评分的变化情况,并评价2组患者的中医证候疗效和心电图疗效。【结果】(1)SAQ评分方面,治疗后,2组患者的躯体活动受限程度、心绞痛稳定状态、心绞痛发作情况、治疗满意程度、疾病认知程度等各项SAQ评分均较治疗前升高(P<0.05),且治疗组的升高幅度均明显优于对照组(P<0.05)。(2)中医证候积分方面,治疗后,2组患者的中医证候积分均较治疗前降低(P<0.05),且治疗组的降低幅度明显优于对照组,差异有统计学意义(P<0.05)。(3)中医证候疗效方面,治疗1个月后,治疗组的总有效率为90.00%(36/40),对照组为82.50%(33/40);组间比较,治疗组的总体疗效(秩和检验)明显优于对照组,差异有统计学意义(P<0.05);总有效率(χ^(2)检验)有优于对照组趋势,但差异无统计学意义(P>0.05)。(4)心电图疗效方面,治疗1个月后,2组患者的心电图均呈现出明显的改善趋势,治疗组的总有效率为87.50%(35/40),对照组为70.00%(28/40);组间比较,治疗组的总体疗效(秩和检验)和总有效率(χ^(2)检验)均明显优于对照组(P<0.05)。【结论】针对冠心病PCI术后心绞痛痰瘀互结型患者,在常规西药治疗基础上联合化痰通络汤加味方治疗,对提高患者临床疗效、改善患者生活质量有积极影响。

基于经方化裁的消瘀散结方治疗痰瘀互结型中危肺结节的临床研究

【目的】观察基于经方柴胡桂枝干姜汤和活络效灵丹化裁的消瘀散结方治疗痰瘀互结型中危型肺结节的临床疗效。【方法】将104例符合纳入标准的痰瘀互结型中危型肺结节患者按随机数字表法随机分为试验组和对照组,每组各52例,因疫情等原因,最终共完成97例,其中试验组48例,对照组49例。在健康宣教基础上,对照组仅给予定期随访,试验组给予消瘀散结方汤药治疗,疗程为3个月。观察2组患者治疗前后中医证候积分及最大肺结节面积的变化情况,并评估2组患者整体上和不同结节类型的中医证候疗效和西医疗效。【结果】(1)中医证候积分方面,治疗后,试验组的中医证候积分分布情况较治疗前明显改善(P <0.01),而对照组较治疗前无明显改善(P> 0.05);治疗后组间比较,试验组对中医证候积分分布情况的改善作用明显优于对照组(P <0.01)。(2)中医证候疗效方面,从整体上来看,试验组的总有效率为81.25%(39/48),对照组为20.41%(10/49),组间比较(秩和检验),试验组的整体中医证候疗效明显优于对照组(P <0.01)。从结节类型来看,试验组对多发性结节、混合实性结节、纯磨玻璃结节、实性结节的中医证候疗效均优于对照组,其中以多发性结节和混合实性结节的疗效更为显著,差异均有统计学意义(P <0.05或P <0.01)。(3)最大肺结节面积方面,治疗后,试验组的最大肺部结节面积较治疗前明显缩小(P <0.01),而对照组较治疗前无明显缩小(P> 0.05);组间治疗后及治疗前后差值比较,差异均有统计学意义(P <0.05或P <0.01),提示试验组对最大肺结节面积的缩小作用明显优于对照组。(4)西医疗效方面,从整体上来看,试验组的总有效率为45.83%(22/48),对照组为6.12%(3/49),组间比较(秩和检验),试验组的整体西医疗效明显优于对照组(P <0.01)。从结节类型来看,试验组在治疗多发性结节方面的西医疗效优于对照组(P <0.01),而2组在治疗混合实性结节、实性结节及纯磨玻璃结节方面的西医疗效差异均无统计学意义(P> 0.05)。【结论】消瘀散结方能够显著改善痰瘀互结型中危型肺结节患者的临床症状,能有效稳定、缩小甚至消除部分肺结节,其组方思想具有进一步研究推广价值。