解郁通痹汤治疗气滞血瘀型冠心病心绞痛
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摘要
目的观察解郁通痹汤治疗气滞血瘀型冠心病心绞痛的临床疗效及安全性。方法选择2016年1月-2018年6月我院收治的120例气滞血瘀型冠心病心绞痛患者作为研究对象,按随机表法分为治疗组与对照组,各60例。对照组采用西医常规治疗,治疗组在对照组基础上加用解郁通痹汤进行治疗。观察2组的临床治疗效果、中医证候疗效,并统计比较2组心绞痛发作次数改善情况、硝酸甘油停减率及不良反应发生情况。结果治疗4周后,治疗组的总有效率为96.7%,优于对照组的73.3%(P <0.05);治疗组心绞痛发作次数少于对照组,差异存在统计学意义(P <0.05);治疗组硝酸甘油减停率90.0%,优于对照组的55.0%(P <0.01);治疗组中医症状总有效率98.3%,优于对照组的78.3%(P <0.01);治疗组和对照组治疗期间的不良反应发生率分别为6.67%、8.33%,2组间差异无统计学意义(P> 0.05)。结论加用解郁通痹汤治疗可明显改善气滞血瘀型冠心病心绞痛患者的临床症状,提高临床疗效,缩短心绞痛发作次数,且不会增加不良反应。
Objective To observe the clinical efficacy and safety of Jieyu Tongbi Decoction in treating angina pectoris of coronary heart disease with qi stagnation and blood stasis. Methods From January 2016 to June 2018,120 patients with angina pectoris of coronary heart disease with qi stagnation and blood stasis were enrolled in our hospital. The patients were divided into treatment group and control group according to the order of admission, with60 cases in each group. The control group was treated with conventional western medicine, while the treatment group was given Jieyu Tongbi Decoction based on the control group. The ef fect of clinical treatment and TCM syndrome were observed and analyzed, and the times of angina pectoris, the reduction rate of nitroglycerin and the adverse reaction were counted in the two groups. Results After 4 weeks, the total ef fective rate of the treatment group was96.7%, which was better than 73.3% of the control group, the dif ference was statistically significant(P < 0.05). The number of angina attacks in the treatment group was less than that of the control group, the dif ference was statistically significant(P < 0.05). The reduction rate of nitroglycerin was 90.0% in the treatment group, which was significant higher than 55.0% in the control group(P < 0.01). The total ef fective rate of TCM symptoms in the treatment group was 98.3%, which was significant higher than 78.3% in the control group(P < 0.01). The incidence of adverse reactions was 6.67% in the treatment group versus 8.33% in control group, and there was no significant dif ference between the two groups(P > 0.05). Conclusion The addition of Jieyu Tongbi Decoction can obviously improve the clinical symptoms of patients with angina pectoris of coronary heart disease with qi stagnation and blood stasis,improve the clinical curative effect, shorten the frequency of angina pectoris attack, and not increase the obvious adverse reaction.
Objective To observe the clinical efficacy and safety of Jieyu Tongbi Decoction in treating angina pectoris of coronary heart disease with qi stagnation and blood stasis. Methods From January 2016 to June 2018,120 patients with angina pectoris of coronary heart disease with qi stagnation and blood stasis were enrolled in our hospital. The patients were divided into treatment group and control group according to the order of admission, with60 cases in each group. The control group was treated with conventional western medicine, while the treatment group was given Jieyu Tongbi Decoction based on the control group. The ef fect of clinical treatment and TCM syndrome were observed and analyzed, and the times of angina pectoris, the reduction rate of nitroglycerin and the adverse reaction were counted in the two groups. Results After 4 weeks, the total ef fective rate of the treatment group was96.7%, which was better than 73.3% of the control group, the dif ference was statistically significant(P < 0.05). The number of angina attacks in the treatment group was less than that of the control group, the dif ference was statistically significant(P < 0.05). The reduction rate of nitroglycerin was 90.0% in the treatment group, which was significant higher than 55.0% in the control group(P < 0.01). The total ef fective rate of TCM symptoms in the treatment group was 98.3%, which was significant higher than 78.3% in the control group(P < 0.01). The incidence of adverse reactions was 6.67% in the treatment group versus 8.33% in control group, and there was no significant dif ference between the two groups(P > 0.05). Conclusion The addition of Jieyu Tongbi Decoction can obviously improve the clinical symptoms of patients with angina pectoris of coronary heart disease with qi stagnation and blood stasis,improve the clinical curative effect, shorten the frequency of angina pectoris attack, and not increase the obvious adverse reaction.
引文
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[16]王颖.姜黄、黄丝郁金活血化瘀作用与药性寒温的初步研究[D].成都:成都中医药大学, 2008.
[17]王朝霞.七厘散加减治疗带状疱疹后遗神经痛32例[J].陕西中医, 2009, 30(10):1337.
[18]张海波,傅警龙.腰痹宁胶囊配合中药外敷治疗腰椎间盘突出症68例[J].长春中医药大学学报, 2013, 29(6):1068-1069.
[19]黄微微.健康教育和心理护理对冠心病心绞痛患者生活质量的影响[J].现代医药卫生, 2017, 33(4):600-601.
[20]冯超.赤芍与白芍的药动学研究与化学成分的液质联用分析[D].石家庄:河北医科大学, 2010.
[21]陈碧莲,解勤之,李清.急性冠脉综合征患者氯吡格雷抵抗与近期疗效的临床观察[J].中国临床药理学与治疗学,2009, 14(3):328-332.
[22]李益萍,阮小芬,王肖龙.盾叶冠心宁治疗冠心病心绞痛临床疗效的Meta分析[J].中西医结合心脑血管病杂志,2017, 15(19):2376-2380.
[23]辛国,赵昕彤,李文,等.不同时间煎煮柴胡对五柴胡饮中柴胡皂苷含量及药效学的影响[J].长春中医药大学学报, 2018, 34(4):641-644.
[24]齐锋,宋柏奇.解郁通脉颗粒干预冠心病介入术后焦虑症的临床研究[J].中医临床研究, 2017, 9(8):76-78.
[25]茆翔.柴胡皂苷a对颅脑创伤后大鼠认知功能的保护作用及其机制的研究[D].合肥:安徽医科大学, 2014.
[26]刘丹.柴胡皂苷d诱导前列腺癌LNCap细胞凋亡及自噬的研究[D].沈阳:中国医科大学, 2018.
[27]薛小青,郑西魁,徐刚锋.自拟活血通脉汤联合西药治疗冠心病心绞痛的临床研究[J].中西医结合心血管病电子杂志, 2018, 14(3):141-142.
[2]李伟,贾树培.贾树培教授应用痰瘀同治法治疗冠心病心绞痛经验[J].中医临床研究, 2017, 9(27):1-2.
[3]周婷,安冬青.冠心病心绞痛中医药治法研究进展[J].中西医结合心脑血管病杂志, 2017, 15(9):1055-1056.
[4]辛国,赵昕彤,黄晓巍.柴胡化学成分及药理作用研究进展[J].吉林中医药, 2018, 38(10):1196-1198.
[5]王东升,刘东亮.中西医结合治疗冠心病心绞痛的临床疗效观察[J].保健医学研究与实践, 2017, 14(3):67-68, 105.
[6]吕映华,何迎春,杨娟,等.冠心病心绞痛(气虚血瘀证)症状疗效评分量表的研究[J].中国临床药理学与治疗学,2008, 13(7):786-791.
[7]杨琛,彭奇,黄安宇.自拟化瘀通痹汤熏蒸治疗气滞血瘀型腰椎间盘突出症临床观察[J].浙江中西医结合杂志,2019, 29(1):54-57.
[8]中华人民共和国卫生部.中药新药治疗冠心病心绞痛的临床研究指导原则[M].北京:中国中医药出版社, 2002:68-69.
[9]隋玉玲.丹参多酚酸盐的药理作用与临床应用研究进展[J].临床合理用药杂志, 2017, 10(23):178-180..
[10]李诗畅,张慧,于莹,等.丹参饮药理研究及临床应用研究进展[J].中医药信息, 2017, 34(5):117-120..
[11]柯彤.芪参通痹汤治疗冠心病心绞痛疗效观察[J].陕西中医, 2017, 38(6):694-696.
[12]苗瑞锋.丹桂通痹汤治疗冠心病不稳定型心绞痛的临床研究[J].中医临床研究, 2018, 10(19):54-56.
[13]刘健.宣痹通阳汤治疗冠心病心绞痛室性期前收缩临床研究[J].中医学报, 2017, 32(9):1728-1732.
[14]刘元花,王福文.益气活血通痹法辅助治疗冠心病心绞痛的临床研究[J].泰山医学院学报, 2017, 38(8):862-864.
[15]胡晨霞,梁幼雅,吴庆光.姜黄用于痹证治疗探讨[J].新中医, 2008, 40(5):106-107.
[16]王颖.姜黄、黄丝郁金活血化瘀作用与药性寒温的初步研究[D].成都:成都中医药大学, 2008.
[17]王朝霞.七厘散加减治疗带状疱疹后遗神经痛32例[J].陕西中医, 2009, 30(10):1337.
[18]张海波,傅警龙.腰痹宁胶囊配合中药外敷治疗腰椎间盘突出症68例[J].长春中医药大学学报, 2013, 29(6):1068-1069.
[19]黄微微.健康教育和心理护理对冠心病心绞痛患者生活质量的影响[J].现代医药卫生, 2017, 33(4):600-601.
[20]冯超.赤芍与白芍的药动学研究与化学成分的液质联用分析[D].石家庄:河北医科大学, 2010.
[21]陈碧莲,解勤之,李清.急性冠脉综合征患者氯吡格雷抵抗与近期疗效的临床观察[J].中国临床药理学与治疗学,2009, 14(3):328-332.
[22]李益萍,阮小芬,王肖龙.盾叶冠心宁治疗冠心病心绞痛临床疗效的Meta分析[J].中西医结合心脑血管病杂志,2017, 15(19):2376-2380.
[23]辛国,赵昕彤,李文,等.不同时间煎煮柴胡对五柴胡饮中柴胡皂苷含量及药效学的影响[J].长春中医药大学学报, 2018, 34(4):641-644.
[24]齐锋,宋柏奇.解郁通脉颗粒干预冠心病介入术后焦虑症的临床研究[J].中医临床研究, 2017, 9(8):76-78.
[25]茆翔.柴胡皂苷a对颅脑创伤后大鼠认知功能的保护作用及其机制的研究[D].合肥:安徽医科大学, 2014.
[26]刘丹.柴胡皂苷d诱导前列腺癌LNCap细胞凋亡及自噬的研究[D].沈阳:中国医科大学, 2018.
[27]薛小青,郑西魁,徐刚锋.自拟活血通脉汤联合西药治疗冠心病心绞痛的临床研究[J].中西医结合心血管病电子杂志, 2018, 14(3):141-142.