益气活血法早期干预对冠心病陈旧心梗或支架术后患者心功能及神经内分泌影响的研究

夏惠英　王居新　王金秀　李婷　魏明　张玥

【摘要】 目的 观察益气活血中药早期干预对冠心病陈旧心肌梗死（心梗）或支架术后患者心功能及神经内分泌指标的影响。方法 60例冠心病陈旧心梗或支架术后、中医辨证属气虚血瘀型患者， 随机分为治疗组与对照组， 各30例。对照组采用西药常规治疗， 治疗组在西药常规治疗基础上加益气活血中药治疗， 连续应用8周。于治疗前后观察两组中医症候积分、生活质量评分、血浆肾素、血管紧张素Ⅱ、醛固酮变化情况。结果 治疗组治疗后各指标较治疗前均明显改善（P<0.05）。治疗后两组中医症候积分、生活质量评分及血浆肾素、醛固酮比较， 差异有统计学意义（P<0.05）；治疗后血管紧张素Ⅱ治疗组为（82.1±34.17）ng/（ml·h）与对照组的（93.53±39.40）ng/（ml·h）比较差异无统计学意义（P>0.05）。结论 益气活血法早期干预对陈旧心梗或支架术后患者改善症状及改善神经内分泌调节具有确切疗效。

【关键词】 心力衰竭；冠心病；中西医结合疗法；益气活血

DOI：10.14163/j.cnki.11-5547/r.2016.26.004

【Abstract】 Objective To observe influence by tonifying Qi and activating blood early intervention on cardiac function and neuroendocrine in patients with coronary heart disease old myocardial infarction or after stenting. Methods A total of 60 patients with coronary heart disease old myocardial infarction or after stenting with Qi deficiency and blood stasis type as syndrome differentiation were randomly divided into treatment group and control group， with 30 cases in each group. The control group received conventional Western medicine for treatment， and the treatment group received additional tonifying Qi and activating blood traditional Chinese medication therapy. Treatment lasted for 8 weeks. Observation was made on changes of traditional Chinese medicine syndrome scores， quality of life scores， plasma rennin， angiotensin Ⅱ， and aldosterone before and after treatment in both groups. Results The treatment group had all better indexes after treatment than those before treatment （P<0.05）. After treatment， the difference of traditional Chinese medicine syndrome scores， quality of life scores， plasma rennin， and aldosterone between the two groups had statistical significance （P<0.05）. There was no statistically significant difference of angiotensin Ⅱ between the treatment group as （82.1±34.17） ng/（ml·h） and the control group as （93.53±39.40） ng/（ml·h） （P>0.05）. Conclusion Tonifying Qi and activating blood early intervention contains precisely curative effect in improving symptom and neuroendocrine regulation in patients with coronary heart disease old myocardial infarction or after stenting.

【Key words】 Heart failure； Coronary heart disease； Combined therapy of Chinese and Western medicines； Tonifying Qi and activating blood

心力衰竭（心衰）是各种心脏疾病的最终表现。随着社会老龄化的进展， 心衰的患病率高、社会负担重， 已成为家庭和社会的沉重负担。目前中西医对心衰防治方面的不足：在心衰C、D期研究较多， 而在早期及预防心衰的研究较少。C期以前阶段患者临床症状不明显， 患者错过治疗节点， 致使心力衰竭向不可逆转的方向发展。为此， 作者采用随机对照研究方法， 用益气活血法早期（B期）干预， 结合常规西药治疗陈旧心梗或支架术后患者， 现报告如下。

1 资料与方法

1. 1 一般资料 选取2013年11月～2015年10月本院门诊及住院60例患者， 均有陈旧心梗或支架术病史， 心功能（NYHA标准）Ⅰ级， 阶段为B期， 按随机数字表法分为治疗组与对照组， 各30例。……