补阳还五汤合瓜蒌薤白半夏汤治疗冠状动脉粥样硬化性心脏病心绞痛

目的:观察补阳还五汤合瓜蒌薤白半夏汤治疗冠状动脉粥样硬化性心脏病(简称冠心病)心绞痛的临床疗效。方法:选取2016年6月至2019年3月广东省第二中医院黄埔医院收治的冠心病心绞痛患者114例,按照随机数字表法随机分为对照组和研究组,每组57例。对照组给予冠心病二级预防治疗,研究组在对照组治疗的基础上加用补阳还五汤合瓜蒌薤白半夏汤治疗。比较两组的临床疗效、中医证候积分、西雅图心绞痛调查量表(SAQ)、心绞痛发作次数和持续时间、血脂总胆固醇(total cholesterol,TC)、三酰甘油(three acyl glycerin,TG)、高密度脂蛋白(high density lipoprotein,HDL)、低密度脂蛋白(low density lipoprotein,LDL)]、内皮功能一氧化氮(nitric oxide,NO)、内皮素-1(endothelin-1,ET-1)]、氧化应激超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malonaldehyde,MDA)]等。结果:研究组有效率为82.46%,对照组有效率为70.18%,研究组有效率高于对照组,差异具有统计学意义(P<0.05);研究组治疗后中医证候评分低于对照组,差异具有统计学意义(P<0.05);研究组治疗后SAQ评分高于对照组,差异具有统计学意义(P<0.05);研究组治疗后心绞痛发作次数和持续时间均低于对照组,差异具有统计学意义(P<0.05);研究组治疗后TC、TG、LDL、ET-1、MDA均低于对照组,研究组NO、SOD均高于对照组,差异具有统计学意义(P<0.05)。结论:补阳还五汤合瓜蒌薤白半夏汤治疗冠心病心绞痛可提高临床疗效,改善患者生存质量,改善内皮功能和氧化应激反应。

Therapeutic Effect of Yang-Supplementing and Five-Returning Decoction Combined with Trichosanthes and Chinese Chive and Pinellia Decoction on Angina Pectoris of Coronary Heart Disease

Objective:To observe the clinical curative effect of Yang-Supplementing and Five-Returning Decoction combined with Trichosanthes and Chinese Chive and Pinellia Decoction on angina pectoris of coronary heart disease.Methods:A total of 114 patients with angina pectoris of coronary heart disease admitted to Huangpu Hospital of the Second Hospital of TCM of Guangdong Province from June 2016 to March 2019 were selected and randomly divided into the control group and the study group according to the random number table method,with 57 cases in each group.The control group was given secondary prevention and treatment of coronary heart disease,while the study group was treated with Yang-Supplementing and Five-Returning Decoction combined with Trichosanthes and Chinese Chive and Pinellia Decoction on the basis of the control group.The clinical efficacies,TCM syndrome scores,Seattle Angina Questionnaire(SAQ),the number and duration of angina pectoris,blood lipids including total cholesterol(TC),three acyl glycerin(TG),high density lipoprotein(HDL),and low density lipoprotein(LDL),endothelial function including nitric oxide(NO)and endothelin-1(ET-1),oxidative stress including superoxide dismutase(SOD)and malonaldehyde(MDA),etc.were compared between the two groups.Results:The effective rate was 82.46%in the study group and70.18%in the control group.The difference was statistically significant(P<0.05).After the treatment,the TCM syndrome score of the study group was lower than that of the control group,and the difference was statistically significant(P<0.05).The SAQ score of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).The number and duration of angina attack of the study group were lower than that of the control group,and all the differences were statistically significant(P<0.05).After the treatment,TC,TG,LDL,ET-1 and MDA in the study group were lower than those in the control group,while NO and SOD in the study group were higher than those in the control group,and all the differences were statistically significant(P<0.05).Conclusion:In terms of treating angina pectoris of coronary atherosclerotic heart disease,YangSupplementing and Five-Returning Decoction combined with Trichosanthes and Chinese Chive and Pinellia Decoction can improve the clinical effect,the quality of life,endothelial function and oxidative stress response.