血府逐瘀汤联合西药治疗心血瘀阻型胸痹随机平行对照研究

目的]观察血府逐瘀汤联合西药治疗心血瘀阻型胸痹疗效。方法]使用随机平行对照方法,将60例住院患者按就诊顺序编号随机分为两组。对照组30例单硝酸异山梨酯20mg/次,2次/d;阿司匹林100mg/次,1次/d;心绞痛发作时舌下含服心痛定5mg。治疗组30例血府逐瘀汤(桃仁12g,红花、当归、生地黄各9g,川芎5g,赤芍6g,牛膝9g,桔梗5g,柴胡3g,枳壳6g,甘草3g。瘀血痹阻重,胸痛剧烈,加乳香、没药各12g、郁金9g,丹参12g。血瘀气滞并重,胸闷痛,加沉香、檀香各9g。寒凝血瘀或阳虚血瘀,伴畏寒肢冷,脉沉细者,加桂枝9g、细辛、薤白各5g。气虚血瘀,伴气短乏力、自汗,加人参4g,黄芪6g),1剂/d,水煎300mL,分早午晚3次温服;西药治疗同对照组。连续治疗14d为1疗程。观测临床症状、心电图、不良反应。连续治疗2疗程,判定疗效。结果]治疗组临床症状显效19例,有效10例,无效1例,总有效率96.67%;心电图显效7例,有效15例,无效8例,总有效率73.33%。对照组临床症状显效10例,有效14例,无效6例,总有效率80.00%;心电图显效3例,有效13例,无效14例,总有效率53.33%。治疗组疗效优于对照组(P0.05)。结论]血府逐瘀汤联合西药治疗心血瘀阻型胸痹,疗效满意,无副作用,值得推广。

Xuefu Zhuyu Decoction Combined with Western Medicine in Treating Blood Stasis Type Chest Randomized Parallel Controlled Study

Objective ] To study the effect of modified Xuefu Zhuyu Decoction Combined with western medicine on treating chest pain with blood stasis syndrome. Method ] Using randomized controlledmethods, 60 patients were randomly divided into two groups, 30cases in the control group of Isosorbide mononitrate tablets 20mg/ times, 2 times/d orally.Aspirinenteric-coated tablets of 100rag/ times, 1 times/d orally. Sublingual nifedipine 5mg when heart attacks.Treatment of 30 cases of application of Xuefu Zhuyu decoction （ Peach kernell2g, Safflower, Chinese angelica root, Rehmannia 9g, Chuanxiong 5g, Radix paeoniae Rnbra 6g, Achyranthes 9g, Radix platycodi 5g, Bupleururn 3g, Frnctus aurantii 6g, Radix glycyrrhiza uralensis 3g. Among Blockage of severe bleeding, severe chest pain, plus frankincense, myrrh 12g, Turmeric 9g, Salvia 12g.Both of qi stagnation and blood stasis, chest pain worse, plus Aloes wood, Sandalwood each 9g. Blood stasis due to cold or yang deficiency and blood stasis, with chills, thin pulse, Guizhi 9g, Asarnm, Allium5g.Qi-deficiency and blood-stasis syndrome, accompanied by shortness of breath fatigue, plus Ginseng 4g, Astragalus 6g ）, 1 agent / d, Water frying 300ml, take the decoction 3 times a day, western medicine treatments are the same as control group.One course oftreatment was 2 weeks, observe the changes of clinical symptoms and ECG, clinical effects were observed after two course of treatment. Results ] The treatment group symptoms improved markedly 19 cases, effective 10 cases, invalid 1 cases, the total efficiency of 96.67%. Electrocardiogram in 7 cases, effective 15 cases, invalid 8 cases, the total efficiency of 73.33%. The control group symptoms improved markedly 10 cases, effective 14 cases, invalid 6 cases, the total efficiency of 80.00%. 3 cases of electrocardiogram, effective 13 cases, invalid 14 cases, the total efficiency of 53.33%. Effect of treatment of Group better than the controlg roup （ P〈0.05 ） . Conclusion ] Xuefu Zhuyu decoction combined with western medicine cu