从痰论治冠心病并发抑郁状态临床研究

目的:观察从痰论治对冠心病抑郁状态患者的症状及HAMD评分的改善情况。方法:将本院60例冠心病并发抑郁状态患者随机分为对照组和治疗组各30例,对照组采用冠心病常规药物口服,加用黛力新(丹麦灵北制药,每片含二盐酸氟哌噻吨0.5 mg和盐酸美利曲辛10 mg),早晨1片口服。治疗组在对照组治疗的基础上辨证论治,痰气郁结证采用半夏厚朴汤合柴胡疏肝散加减治疗;痰浊蒙心证采用瓜蒌薤白半夏汤合涤痰汤加减治疗;痰瘀互结证采用血府逐瘀汤合二陈汤加减治疗;气虚痰生证采用香砂六君子汤加减治疗。两组疗程均为6周。结果:对照组有效率为70.00%,治疗组有效率为86.68%,两组有效率比较,差异有统计学意义(P0.05);两组患者治疗后HAMD评分较治疗前均明显降低(P0.05),组间比较有统计学意义(P0.05);两组治疗后心电图ST段下移及T波低平或倒置例数均明显减少,组间比较有统计学意义(P0.05);心肌标志物CTnl及CK-MB均较治疗前明显降低(P0.05);组间比较有统计学意义(P0.05)。结论:从痰论治可以改善冠心病并发抑郁状态患者的症状,降低HAMD评分。

Clinical Research on Coronary Heart Disease Complicated with Depression Treated from the Phlegm

Objective:To observe the improvement of symptoms and HAMD scores in the treatment of CHD and depression from the aspect of phlegm.Methods:Totally 60 patients with coronary heart disease complicated with depression were randomlv divided into control group and treatment group,30 cases in each group.Control group were given conventional oral administration for coronary heart disease,added with Deanxit,1 tablet for oral administration in the morning.Treatment group were added with syndrome differentiation and treatment.Syndrome of phlegm stagnation was treated with Pinellia and Officinal Magnolia Bark Decoction combined with Modifed Bupleurum Liver-Soothing Powder;syndrome of phlegm turbidity confusing the heart can be treated with Trichosanthes,Chinese Chive and Pinellia Decoction combined with Modified Two Matured Substances Decoction;syndrome of qi deficiency and phlegm generation can be treated with Modified Costusroot and Amomum Six Gentlemen Decoction,six weeks for a treatment course for both groups.Results:The effective rate was 70.00％ in control group and 86.68％ in treatment group;the difference had statistical significance (P ＜ 0.05).The scores of HAMD in both groups declined obviously (P ＜0.05);there was statistical significance (P ＜ 0.05);The ST segment moving down and flat cases or inverted cases of T wave on the ECG decreased obviously,with statistical significance (P ＜ 0.05).The CTnl and CK-MB declined apparently after treatment,with statistical significance (P ＜ 0.05).Cnnclusion:The treatment from the phlegm can improve the coronary heart disease and depression of the patients and reduce the score of HAMD.