通脉养心丸和复方丹参片治疗气虚血瘀证慢性稳定性心绞痛54例临床观察

目的: 探讨通脉养心丸和复方丹参片治疗慢性稳定性心绞痛(气虚血瘀证)的临床疗效及对生活质量的影响。 方法: 将108例患者随机按诊疗顺序分为对照组和观察组各54例。对照组服用阿司匹林片,100 mg/次,1次/d;美托洛尔片,100 mg/次,2次/d;辛伐他汀片,20 mg/次,1次/d。观察组在对照组治疗的基础上加用通脉养心丸,40粒/次,2次/d;复方丹参片,4片/次,2次/d。两组必要时服用硝酸甘油片,半片或1片/次,舌下含服,5 min可重复1次。两组疗程均为12周。记录研究期间心绞痛发作情况;进行治疗前后气虚血瘀证评分;检测治疗前后心电图;记录硝酸甘油片停减情况;采用西雅图心绞痛量表(SAQ)评价生活质量。 结果: 经Ridit分析,观察组心电图疗效优于对照组(P<0.05);经Ridit分析,观察组心绞痛疗效优于对照组(P<0.05);治疗后8,12周观察组气虚血瘀证评分低于对照组(P<0.01),治疗后观察组气虚血瘀证评分下降幅度多于对照组(P<0.01);治疗后观察组硝酸甘油片停减率为90.74%,高于对照组的74.07%(P<0.05);治疗后观察组躯体活动受限程度、心绞痛稳定状态、心绞痛发作情况、治疗满意程度评分高于对照组(P<0.05,P<0.01)。 结论: 在西医常规治疗的基础上,加服通脉养心丸和复方丹参片能减少慢性稳定性心绞痛(气虚血瘀证)患者心绞痛的发作,减少硝酸甘油片的使用,改善气虚血瘀证和心电图,提高患者的生活质量。

Clinical Observation of Tongmai Yangxin Pills and Compound Danshen Tablets in Treating 54 Cases with Chronic Stable Angina Qi-deficency and Blood-stasis Syndromes

Objective: To discuss the clinical efficacy of Tongmai Yangxin pills and compound Danshen tablets in treating chronic stable angina(Qi-deficency and blood-stasis syndromes) and improving the quality of life. Method: Totally 108 patients were randomly divided into the control group (54 cases) and the observation group (54 cases). The control group took aspirin tablets (100 mg/time, qd), Metoprolol tablets (100 mg/time, bid) and Simvastatin tablets (20 mg/time, qd). Based on the therapies of the control group, the observation group were additionally given Tongmai Yangxin pills (40 pills/time, bid) and compound Danshen tablets (4 pills/time, 2 qd). When necessary, both groups can sublingually take Nitroglycerin tablets (0.5 or 1 tablet/time at the interval of 5 min). Both groups were treated for 12 weeks. During the study, efforts were made to record Angina frequency, score Qi-deficency and blood-stasis syndromes before and after the treatment, detect electrocardiogram before and after the treatment, record nitroglycerin stop and reduction and adopt seattle angina questionnaire (SAQ) to evaluate the quality of life. Result: According to Ridit analysis, the Electrocardiogram efficacy in the observation group was higher than that in the control group (P<0.05). angina efficacy in the observation group was better than that in the control group (P<0.05). The Qi-deficency and blood-stasis syndromes score in the observation group was less than that in the control group at the eighth and twelfth weeks after the treatment (P<0.01), with a higher decline decrease degree than the control group (P<0.01). After the treatment, the nitroglycerin stop and reduction rate in the observation group was 90.74% and higher than 74.07% in the control group (P<0.05). After the treatment, the limited physical activity level, angina stabilization state, angina frequency, treatment satisfaction in the observation group were higher than that in the control group (P<0.05, P<0.01). Conclusion: On the basis of conventional western medicine therapies, Tongmai Yangxin pills and compound Danshen tablets can reduce the angina frequency of patients with chronic stable angina (Qi-deficency and blood-stasis syndromes) and the use of nitroglycerin, relieve Qi-deficency and blood-stasis syndromes and electrocardiogram and enhance the patient's quality of life.