加味升陷汤治疗痰瘀毒互结型冠心病心绞痛的临床疗效

安桐志 邢晋 张桂敏 李立 张馨

[摘要] 目的 觀察加味升陷汤联合常规药物对“痰瘀毒互结型”冠心病心绞痛的疗效，并探讨其作用机制。 方法 将2018年7月至2019年11月就诊于我院的72例“痰瘀毒互结型”冠心病心绞痛患者随机分成两组，每组各36例。对照组予常规冠心病心绞痛用药，治疗组在对照组的基础上予加味升陷汤加减治疗，疗程4周，观察两组患者治疗前后心绞痛发作次数、持续时间、硝酸甘油含服量、血脂水平、血液流变学指标，统计临床疗效。 结果 治疗组治疗前后的心绞痛发作次数、持续时间、硝酸甘油含服量、TG、HDL-C、LDL-C、TC、FIB、全血比黏度、血浆黏度比较，差异均有统计学意义（P<0.05）。对照组治疗前后的HDL-C、全血比黏度比较，差异无统计学意义（P>0.05）。治疗后两组心绞痛发作次数、持续时间、硝酸甘油含服量、TG、HDL-C、LDL-C、TC、FIB、血浆黏度比较，差异均有统计学意义（P<0.05）;两组全血比黏度比较，差异无统计学意义（P>0.05）。治疗组总有效率为77.78%，明显高于对照组的58.33%，差异有统计学意义（P<0.05）。 结论 加味升陷汤治疗冠心病心绞痛疗效显著，可有效改善患者临床症状，减少心绞痛发作次数，改善血脂指标。

[关键词] 加味升陷汤;冠心病;心绞痛;痰瘀毒互结型

[中图分类号] R286.23          [文献标识码] B          [文章编号] 1673-9701（2021）08-0119-04

Clinical effect of Jiawei Shengxian Decoction on angina pectoris of coronary heart disease with syndrome of phlegm， blood stasis and poison

AN Tongzhi   XING Jin   ZHANG Guimin   LI Li   ZHANG Xin

Department of Cardiology，Fushun Hospital of Traditional Chinese Medicine in Liaoning Province，Fushun  113000，China

[Abstract] Objective To observe the curative effect of Jiawei Shengxian Decoction combined with conventional drugs on angina pectoris of coronary heart disease with syndrome of phlegm， blood stasis and poison， and to explore its mechanism of action. Methods Seventy-two patients with coronary heart disease and angina pectoris with syndrome of phlegm， blood stasis and poison who were admitted to our hospital from July 2018 to November 2019 were randomly divided into two groups，with 36 cases in each group. The control group was treated with conventional drugs for coronary angina pectoris， and the treatment group was treated with Jiawei Shengxian Decoction on the basis of treatment in the control group. The course of treatment was 4 weeks. The times of angina pectoris onset， duration， nitroglycerin dosage， blood lipid level， and hemorheology of the two groups before and after treatment were observed. The statistical clinical efficacy was calculated. Results There was significant difference in the times and duration of angina pectoris， nitroglycerin dosage， TG， HDL-C， LDL-C， TC， FIB， whole blood viscosity， and plasma viscosity in the treatment group before and after treatment（P<0.05）. There was no statistically significant difference in HDL-C and whole blood viscosity in the control group before and after treatment（P>0.05）. After treatment， the differences in the times of angina pectoris episodes，duration， nitroglycerin dosage， TG， HDL-C， LDL-C， TC， FIB， and plasma viscosity between the two groups were statistically significant（P<0.05）. There was no significant difference in whole blood viscosity between the two groups（P>0.05）. The total effective rate in the treatment group was 77.78%，which was higher than that of 58.33% in the control group， with significant difference（P<0.05）. Conclusion Jiawei Shengxian Decoction is effective in treating coronary heart disease angina pectoris. It can effectively improve the clinical symptoms of patients， reduce the number of angina pectoris， and improve blood lipids.

[Key words] Jiawei Shengxian Decoction; Coronary heart disease; Angina pectoris; Phlegm， blood stasis and poison

冠心病心绞痛是以胸口疼痛、头晕目眩、心慌、恶心呕吐为主要症状，甚至可危及生命的威胁人类健康的“第一号杀手”，且冠心病是导致心血管病患者死亡的重要原因[1-2]。所以临床要提高警惕，早发现早治疗。冠心病是在冠状动脉粥样硬化基础上，由血管栓塞、痉挛、畸形及结缔组织病等原因导致[3]。冠心病患者在发病时最常表现为稳定性心绞痛[4]。研究表明，中医药针对心肌梗死的二级预防及缓解心绞痛方面具有值得肯定的临床优势[5]。本研究基于"痰瘀毒互结型"冠心病心绞痛的基本病因病机，以益气升阳，化痰祛瘀为基本治疗原则，应用加味升陷汤加减联合常规药物治疗对冠心病心绞痛进行治疗，获得满意疗效，现报道如下。……