辛伐他汀联合生脉散合血府逐瘀汤治疗冠心病的疗效分析

目的 分析辛伐他汀联合生脉散合血府逐瘀汤治疗冠心病（coronary heart disease，CHD）的疗效。方法 选择2017年2月-2018年2月在黔西南州中医院就诊的气阴两虚血瘀证CHD患者108例，采用随机数字表法分为2组，对照组（54例）给予辛伐他汀治疗，观察组（54例）在对照组基础上联合生脉散合血府逐瘀汤治疗。分析2组的疗效及其治疗前后相关指标变化情况。结果 观察组心功能改善的总有效率（90.73%）明显高于对照组的75.93%（P<0.05）；观察组患者中医症候疗效为92.58%，高于对照组的77.78%（P<0.05）。治疗前，2组患者心功能、心脏超声参数、血脂、炎性因子以及血液流变学指标水平比较均无统计学意义；治疗后，观察组的心脏超声参数舒张末期左心室内径（LVEDD）、血脂水平总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、hs-CRP、IL-6、TNF-α以及血液流变学指标水平明显低于对照组（P<0.05），左室射血分数（LVEF）、E/A、左室短轴缩短率（△FS）以及高密度脂蛋白胆固醇（HDL-C）水平明显高于对照组（P<0.05）。2组患者的不良反应发生率比较无统计学意义，治疗前后谷草转氨酶、谷丙转氨酶及肌酸激酶水平无明显变化。结论 辛伐他汀联合生脉散合血府逐瘀汤可以明显改善CHD患者的心功能，降低TC、TG、LDL-C、血液流变学指标及炎性因子水平，提高HDL-C水平。

Therapeutic Effect of Simvastatin Combined with Shengmai Powder and Xuefu Zhuyu Decoction on Coronary Heart Disease

OBJECTIVE To analyze the efficacy of simvastatin combined with Shengmai powder and Xuefu Zhuyu decoction in the treatment of coronary heart disease(CHD). METHODS One hundred and eight patients with CHD of qi-yin deficiency and blood stasis syndrome who were admitted to Qianxi Traditional Chinese Medicine Hospital from February 2017 to February 2018 were selected and divided into two groups by random number table method. The control group(54 cases) was treated with simvastatin, and the observation group(54 cases) was treated with Shengmai powder and Xuefu Zhuyu decoction on the basis of the control group. The curative effect of the two groups and the changes of relevant indexes before and after treatment were analyzed. RESULTS The total effective rate of cardiac function improvement in the observation group was 90.73%, which was significantly higher than 75.93% in the control group(P<0.05). The therapeutic effect of traditional Chinese medicine syndrome in the observation group was 92.58%, which was higher than 77.78% in the control group(P<0.05). Before the treatment, the levels of cardiac function, cardiac ultrasound parameters, blood lipids, inflammatory factors and hemorheology indexes in the two groups were not statistically significant. After treatment, the observation group of echocardiographic parameters of left ventricular end-diastolic diameter(LVEDD), blood lipid levels of total cholesterol(TC), three acyl glycerin(TG), low density lipoprotein cholesterol(LDL-C), the hs-CRP, IL-6 and TNF-α and hemorheology index levels significantly lower than the control group(P<0.05), left ventricular ejection fraction(LVEF), E/A, left ventricular short axis shortening rate(ΔFS) and high density lipoprotein cholesterol(HDL-C) level was significantly higher than that of control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups, and there was no significant change in aspartate aminotransferase, alanine aminotransferase and creatine kinase levels before and after treatment. CONCLUSION Simvastatin combined with Shengmai powder and Xuefu Zhuyu decoction can significantly improve the cardiac function of CHD patients, reduce TC, TG, LDL-C, hemorheology and inflammatory factors, and increase the level of HDL-C.