桂附地黄丸加减对冠心病PCI术后患者生活质量的影响及用药安全性评价

目的:探讨桂附地黄丸加减(温肾活血方)对冠心病患者经皮冠状动脉介入治疗(PCI)术后生活质量的影响及该方的用药安全性。方法:选取2017年6月至2018年5月重庆市中医院心内科门诊及住院部PCI术后患者147例,采取随机单双号的方法分为治疗组和对照组,对照组采取基础治疗(西医药物),治疗组在对照组的基础上加用桂附地黄丸加减,疗程均为4周。记录比较两组患者治疗前后的明尼苏达心力衰竭生活质量调查表总评分,6 min步行距离,西雅图心绞痛量表得分,中医证候评分,心功能评价,并观察不良反应,评价PCI术后患者的生活质量及其用药安全性。结果:与本组治疗前和对照组治疗后比较,治疗组患者明尼苏达心功能质量表评分显著降低(P0.01),6 min步行距离显著增长(P0.01),西雅图心绞痛量表评分显著提高(P0.01),中医证候评分显著降低(P0.01),左心室射血分数(LVEF)和舒张早期/舒张晚期最大血流速度(E/A)明显提高(P0.05)。结论:在常规西医药物治疗的基础上,服用温肾活血方能有效改善PCI术后患者体力、情绪、中医症状、减轻心绞痛程度,增强心功能且无不良反应,可以达到改善术后患者生活质量的目的,值得推广。

Effect of Modified Guifu Dihuang Wan on Quality of Life of Patients with Coronary Heart Disease After PCI and Evaluation on Medication Safety

Objective: To explore effect of modified Guifu Dihuang Wan (Wenshen Huoxue Fang) on life quality in patients with coronary hear disease (CHD) after percutaneous coronary intervention (PCI) and evaluate the safety of its clinical use. Method: The 147 postoperative patients with PCI in Chongqing Traditional Chinese Medicine Hospital cardiology outpatient and the inpatient departments between June 2017 to May 2018 were selected and randomly divided into the treatment group and control group by random even and odd number. The patients in control group took the basic treatment (western medicine), and the patients in the treatment group additionally received modified Guifu Dihuang Wan based on the treatment in control group, with a course of 4 weeks in both groups. Minnesota Living with Heart Failure Questionnaire (MLHFQ) total score, 6 minutes walk test (6 mWT), Seattle Angina Scale (SAQ) score, and traditional Chinese medicine(TCM) syndrome score were recorded and compared between two groups before and after treatment; their cardiac function was evaluated and adverse reactions were observed to assess the drug safety and quality of life after PCI. Result: The MLHFQ scores in treatment group after treatment were significantly lower than those before treatment and those in control groups after treatment (P<0.01); 6 mWT walking distance was significantly increased (P<0.01); SAQ scores were improved significantly (P<0.01); TCM syndrome score was reduced significantly (P<0.01); left ventricular ejective fraction (LVEF) and late diastolic/late diastolic maximal blood flow velocity (E/A) in treatment group were also improved after treatment (P<0.05). Conclusion: On the basis of conventional western medicine therapy, the modified Guifu Dihuang Wan can effectively improve the physical strength, mood, TCM symptoms, relieve angina pectoris, and enhance cardiac function with no adverse reactions in PCI postoperative patients. It can achieve the purpose of improving quality of life in postoperative patients, worthy of promotion.