加味温胆汤对痰热瘀血证冠心病合并焦虑抑郁患者的临床疗效及血hsCRP的影响

目的观察加味温胆汤治疗痰热瘀血证冠心病合并焦虑抑郁的临床疗效及对血hsCRP的影响。方法选取2017年3月-2018年6月在山东省千佛山医院中医科门诊及病房住院的痰热瘀血证冠心病合并焦虑抑郁患者70例,随机分为对照组和治疗组各35例,对照组在冠心病常规用药基础上加用黛力新,每次1片,每日2次。治疗组在对照组基础上加服加味温胆汤,方药组成:半夏9g,黄连6g,丹参10g,郁金10g,竹茹6g,枳实9g,陈皮10 g,茯苓10 g,甘草6 g,生姜3片,大枣3个。2组疗程均为4周。结果生活质量评价中治疗组在躯体活动受限程度、心绞痛稳定状态、心绞痛发作频率、治疗满意程度、疾病的认识5个维度方面评分均高于对照组(P<0.05)。治疗组血hsCRP水平较对照组显著下降(P<0.05)。治疗组汉密尔顿焦虑量表(HAMA)及汉密尔顿抑郁量表(HAMD)评分显著低于对照组(P<0.05)。治疗组中医临床疗效总有效率91.4%,对照组总有效率71.4%(P<0.05)。结论痰热瘀血证冠心病合并焦虑抑郁患者在西医常规治疗同时加用加味温胆汤,可减轻患者血清炎症反应,可有效改善冠心病及焦虑抑郁病情。

Clinical Effect of Wendan Decoction on the Coronary Artery Disease of Phlegm Heat and Blood Stasis Syndrome Accompanied with Anxiety and Depression and Influence of Blood hsCRP

Objective To observe effect of Wendan decoction on coronary artery disease of phlegm heat and blood stasis syndrome accompanied with depression and anxiety and influence of blood hsCRP.Methods Included from outpatients and inpatients in traditional Chinese medicine department of Shandong provincial Qianfoshan hospital during March 2017 and June 2018,70 patients with coronary artery disease of phlegm heat and blood stasis syndrome accompanied with depression and anxiety,were randomly divided into control group and observation group with35 cases in each group.The control group was treated with conventional western medicine and Flupentixol and Melitracen Tablets,1 tablet one time,2 times a day.On the basis of the control group,the observation group was treated with modified Wendan decoction,which was composed of pinelliae rhizoma 9 g,coptidis rhizoma 6 g,salviae miltiorrhizae radix et rhizomalO g,curcumae radix 10 g,bambusae caulis in taenias 6 g,aurantii fructus immaturus 9 g,citri reticulatae pericarpium 10 g,poria 10 g,glycyrrhizae radix et rhizoma 6 g,zingiberis rhizoma recens 3 pieces and6 jujubae fructus.Both groups were treated for 4 weeks.Results There was statistical significance in the observation group in the degree of confinement of physical activity,state of angina pectoris,angina attack frequency,treatment satisfaction,quality of life evaluation and hsCRP(P<0.05).HAMA and HAMD score of the observation group was significantly lower than that of the control group(P<0.05).The observation group with the total efficiency 91.4%was better than the control group with the total efficiency 71.4%in angina pectoris(P<0.05).Conclusion In combination with routine western medicine,Wendan decoction can reduce inflammatory reaction,and is effective to relieve coronary artery disease of phlegm heat and blood stasis syndrome accompanied with anxiety and depression.