中西医结合治疗精神压力引起心肌缺血的效果研究

目的 探讨中西医结合治疗对精神压力引起的心肌缺血的效果.方法 将24例稳定型冠心病患者完全随机分为中西医结合组和常规治疗组,每组12例.所选患者均于入组前行精神压力测试和心电图检查.测试证实心肌缺血后常规治疗组应用阿司匹林0.1g,1次/d,倍他乐克25 mg,2次/d,阿托伐他汀10 mg每晚口服治疗.中西医结合组在常规治疗基础上加用振源胶囊0.25 g,3次/d口服治疗.比较2组患者治疗8周后血压、心率和抑郁自评表（PHQ-9）及焦虑筛查量表（GAD-7）评分情况.结果 24例行标准精神压力测试后,患者ST-T段较测试前改变（0.051 ±0.018）mm,差异有统计学意义（P＜0.05）,证实精神压力引起入选患者心肌缺血.治疗8周后中西医结合组舒张压、PHQ-9评分、GAD-7评分均较治疗前降低,差异均有统计学意义分别为（76 ±5）mmHg（1 mmHg =0.133 kPa）比（92±6）mmHg,（69±4）次/min比（83 ±6）次/min,4.5±1.2比7.8±3.4,2.3 ± 1.4比5.8±3.8]（均P＜0.05）.治疗8周后常规治疗组舒张压、PHQ-9评分及GAD-7评分与治疗前比较,差异均无统计学意义分别为（76±5）mmHg比（90±8）mmHg,（67±6）次/min比（84±7）次/min,5.8±2.8比7.6±3.9,5.2±3.7比5.9±3.3]（均P＞0.05）.中西医结合组治疗后PHQ-9评分、GAD-7评分与常规治疗组比较,差异均有统计学意义（均P＜0.05）.结论 中西医结合治疗具有改善精神压力引起的心肌缺血的作用.

Study on effect of combined treatment of traditional Chinese medicine and western medicine on myocardial ischemia induced by mental stress

Objective To investigate the effect of combination of traditional Chinese medicine and western medicine on myocardial ischemia induced by mental stress.Methods Totally 12 cases with coronary heart disease were put into combined treatment of traditional Chinese medicine and western medicine（group Ⅰ）.According to the sex,age,blood pressure（BP） and heart rate（HR）,other 12 cases with stable coronary heart disease were chosen as the conventional treatment group （group Ⅱ）.Group Ⅰ was given aspirin 0.1 g once daily,metoprolol 25 mg two times per day and atorvastatin 10 mg qn.Group Ⅱ had also Zhenyuan capsule 0.25 g three times per day.We compared the blood pressure,heart rate before and after the standard stress testing.After 8 weeks,the two groups were compared regarding the changes of blood pressure,heart rate,PHQ-9 score and GAD-7 score.Results After standard stress test,ST-T elevated with （0.051 ± 0.0 1 8）mm （P 〈 0.05）.After eight weeks of combining traditional Chinese and western medicine treatment,diastolic blood pressure,PHQ-9 scores and GAD-7 score in Chinese and western medicine treatment group were reduced ; the differences were statistically significant （76 ± 5） mmHg vs （92 ± 6） mmHg,（69 ± 4） times per min vs （83 ± 6） times per min,4.5 ± 1.2 vs 7.8 ± 3.4,2.3 ± 1.4 vs 5.8 ± 3.8,respectively] （all P 〈0.05）.Diastolic blood pressure,PHQ-9 scores and GAD-7 score in conventional treatment group had no obvious changes compared with before treatment and there were no statistically significant differences （76 ± 5） mmHg vs （90 ± 8） mmHg,（67 ± 6） times per min vs （84 ± 7） times per min,5.8 ± 2.8 vs 7.6 ± 3.9,5.2 ± 3.7 vs 5.9 ± 3.3] （all P 〉 0.05）.PHQ-9 score and GAD-7 score in traditional Chinese and western medicine group were reduced after treatment compared with the conventional treatment group; the difference was statistically significant （all P 〈 0.05）.Conclusion Combined treatment with traditional Chinese medicine and western medicine can improve the state of myocardial ischemia induced by mental stress.