针刺联合温胆汤治疗痰瘀互结型稳定型心绞痛的疗效观察

目的观察针刺联合温胆汤加减治疗痰瘀互结型稳定型心绞痛的临床疗效。方法将符合纳入标准的60例痰瘀互结型稳定型心绞痛患者按照随机数字表法分为对照组和治疗组,每组30例。对照组给予西医常规治疗,治疗组在对照组治疗基础上加以针刺和温胆汤加减治疗。治疗4周后,比较两组安全性指标(血肝/肾功能指标)、中医证候评分、中医证候疗效、血脂指标和相关临床指标(心绞痛发作频次、发作持续时间和硝酸甘油用量)。结果两组治疗后安全性指标(血肝/肾功能指标)与治疗前比较差异无统计学意义(P>0.05),治疗后组间比较差异无统计学意义(P>0.05)。两组治疗后中医证候评分均较治疗前显著降低(P<0.05),治疗组治疗后中医证候评分明显低于对照组(P<0.05)。治疗后,治疗组和对照组中医证候疗效总有效率分别为90.0%和70.0%,两组比较差异有统计学意义(P<0.05)。治疗组治疗后的血脂指标均优于对照组,差异均有统计学意义(P<0.05)。治疗后,治疗组心绞痛发作频次、发作持续时间及硝酸甘油用量均优于对照组,组间差异均具有统计学意义(P<0.05)。结论在西药治疗基础上予针刺联合温胆汤加减治疗可改善痰瘀互结型稳定型心绞痛的中医证候,提高中医证候疗效,改善血脂,减少心绞痛发作频次、发作持续时间和硝酸甘油用量,且无肝肾损伤,安全性高。

Observations on the Efficacy of Acupuncture plus Wen Dan Decoction for Stable Angina Pectoris of Phlegm and Blood Stasis Type

Objective To observe the clinical efficacy of acupuncture plus modified Wen Dan decoction for stable angina pectoris of phlegm and blood stasis type.Method Sixty patients with stable angina pectoris of phlegm and blood stasis type meeting the diagnostic criteria were allocated,using a random number table,to control and treatment groups,with 30 cases in each group.The control group received conventional Western medical treatment and the treatment group,acupuncture plus modified Wen Dan decoction in addition.Safety indicators(blood liver/kidney function indicators),TCM syndrome scores,therapeutic effects on TCM syndrome,blood lipid indicators and related clinical indicators(angina attack frequency,attack duration and nitroglycerin dosage)were compared between the two groups after four weeks of treatment.Result There were no statistically significant pre-/post-treatment differences in safety indicators(blood liver/kidney function indicators)in the two groups(P>0.05)and no post-treatment differences between the two groups(P>0.05).After treatment,the TCM syndrome scores decreased significantly in the two groups compared with before(P<0.05)and was significantly lower in the treatment group than in the control group(P<0.05).After treatment,the total efficacy rate for TCM syndrome was 90.0%in the treatment group,versus 70.0%in the control group,with a statistically significant difference between the two groups(P<0.05).After treatment,blood lipid indicators were better in the treatment group than in the control group with statistically significant differences between the two groups(P<0.05).After treatment,angina attack frequency,attack duration and nitroglycerin dosage were better in the treatment group than in the control group,with statistically significant differences between the two groups(P<0.05).Conclusion Acupuncture plus modified Wen Dan decoction on the basis of Western medical treatment can improve the TCM syndromes,increase the total efficacy rate for TCM syndrome,improve blood lipids and reduce angina attack frequency,attack duration and nitroglycerin dosage without liver and kidney injuries and with safety in stable angina pectoris of phlegm and blood stasis type.