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调心方改善冠心病稳定型心绞痛气滞痰瘀证伴焦虑状态患者的疗效研究
作者姓名:沈虹  韦婧  章怡祎  毛美娇  刘萍
作者单位:上海中医药大学附属龙华医院,上海 200032
基金项目:上海市科学技术委员会科研计划项目(18401900200);浦东新区卫生和计划生育委员会卫生计生科研项目(PW2018D-11)。
摘    要:目的探讨调心方对冠心病稳定型心绞痛气滞痰瘀证伴焦虑状态患者的治疗作用,客观评价该方缓解焦虑的有效性,为临床应用和推广提供依据。方法共纳入66例冠心病稳定型心绞痛气滞痰瘀证伴焦虑状态的患者,随机分为试验组33例、对照组33例。两组均行冠心病心绞痛常规治疗,试验组在常规治疗基础上加用调心方,对照组在常规治疗基础上加用氟哌噻吨美利曲辛片,疗程均为8周。比较两组患者治疗前后广泛性焦虑障碍量表(generalized anxiety disorder-7, GAD-7)、中医证候积分、心绞痛量表、睡眠状况自评量表(self-rating scale of sleep, SRSS)的变化。结果治疗后,试验组GAD-7有效率为78.8%,对照组为90.9%,两组比较差异无统计学意义(P>0.05);试验组中医证候积分有效率为93.9%,对照组为60.6%,试验组疗效及有效率均明显优于对照组(P<0.05);治疗后,试验组心绞痛量表有效率为57.5%,对照组为27.3%,试验组疗效及有效率均优于对照组(P<0.05);治疗后,两组SRSS总分较治疗前均明显降低(P<0.01)。结论中药复方调心方能有效缓解冠心病稳定型心绞痛气滞痰瘀证伴焦虑状态患者的焦虑症状,并改善相关中医证候、提高生活质量、改善睡眠质量,可以同时从躯体和精神心理两方面发挥治疗作用,具有"双心同治"的特点。

关 键 词:冠心病  稳定型心绞痛  气滞痰瘀证  焦虑状态  调心方

Study on the Effect of Tiaoxin Formula on Patients with Stable Angina Pectoris of Coronary Heart Disease with Syndrome of Qi Stagnation and Phlegm Stasis Accompanied by Anxiety
Authors:SHEN Hong  WEI Jing  ZHANG Yiyi  MAO Meijiao  LIU Ping
Institution:(Longhua Hospital Affiliated to Shanghai University of Chinese Medicine,Shanghai 200032,China)
Abstract:Objective To discuss the therapeutic effect of Tiaoxin Formula on patients with stable angina pectoris of coronary heart disease(CHD)with syndrome of qi stagnation and phlegm stasis accompanied by anxiety,and to objectively evaluate the effectiveness of Tiaoxin Formula in alleviating anxiety,so as to provide basis for clinical application and promotion.Methods 66 patients with stable angina pectoris of CHD with syndrome of qi stagnation and phlegm stasis accompanied by anxiety were randomly divided into experimental group(33 cases)and control group(33 cases).Both groups received routine treatment of CHD angina pectoris,the experimental group was additionally treated with Tiaoxin Formula,and the control group was additionally treated with flupentixol meritracine tablets,for a course of 8 weeks.The changes of generalized anxiety disorder-7(GAD-7),TCM syndrome score,angina pectoris scale,self-rating scale of sleep(SRSS)were compared before and after treatment in 2 groups.Results After treatment,the effective rate of GAD-7 was 78.8%in the experimental group and 90.9%in the control group,and there was no significant difference between the two groups(P>0.05).The effective rate of TCM syndrome score in experimental group was 93.9%,and that in control group was 60.6%.The efficacy and effective rate in experimental group were significantly better than that in control group(P<0.05).After treatment,the effective rate of angina pectoris scale in experimental group was 57.5%,and that in control group was 27.3%.The efficacy and effective rate in experimental group were better than those in control group(P<0.05).After treatment,the total score of the SRSS in both groups was significantly lower than that before treatment(P<0.01).Conclusion TCM Tiaoxin Formula can effectively relieve anxiety symptom and the relevant TCM syndromes,improve the quality of life and sleep of patients with stable angina pectoris of CHD with syndrome of qi stagnation and phlegm stasis accompanied by anxiety,and can play a therapeutic role from both physical and mental aspects at the same time,has the characteristic of"double heart treatment".
Keywords:coronary heart disease  stable angina pectoris  qi stagnation and phlegm stasis syndrome  state of anxiety  Tiaoxin Formula
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