从脾论治气虚血瘀证不稳定型心绞痛的临床研究

目的:观察从脾论治气虚血瘀证不稳定型心绞痛(UA)的临床疗效及安全性。方法:本研究采用历史性对照研究,选取2012年8月至2014年8月在福建中医药大学附属人民医院心血管内科收住入院的经冠脉造影确诊的气虚血瘀证不稳定型心绞痛病例120例,所有病例冠状动脉狭窄50%~70%,未行介入治疗,按随机数字表法分为观察组和对照组,每组60例。观察组给予四君子汤合血府逐瘀汤联合西药常规治疗,对照组只给予西药常规治疗,疗程4周。观察2组患者治疗前后心绞痛疗效、气虚血瘀证候评分、心电图、高敏C-反应蛋白(hs-CRP)、血同型半胱氨酸(HCY)的变化;比较2组4周后不良事件的发生率。结果:2组基线临床资料比较,差异无统计学意义。治疗后观察组在总有效率(84.21%vs73.33%)及心电图改善(77.19%vs 66.67%)方面优于对照组,差异均有统计学意义(P0.05);与治疗前比较,观察组治疗后,患者气虚血瘀证候评分、hs-CRP、HCY降低,差异有统计学意义(P0.01);与对照组比较,观察组治疗后气虚血瘀证候评分、hs-CRP、HCY明显降低,差异有统计学意义(P0.01);2组不良反应发生率比较差异无统计学意义(P0.05)。结论:从脾论治气虚血瘀证UA有效且安全,可提高患者的心绞痛疗效,改善临床症状,抑制炎性反应。

Clinical Study on Treating Unstable Angina of Qi Deficiency and Blood Stasis Pattern from Spleen

To observe the clinical effects and safety of treating unstable angina of qi deficiency and blood stasis pattern from spleen.Methods:Historical control was conducted as study design.A total of 120 patients with unstable angina of qi deficiency and blood stasis pattern via coronary angiography who were hospitalized in People''s Hospital of Fujian University of Traditional Chinese Medicine from August 2012 to August 2014 were enrolled in this study.Coronary artery stenosis occurred in 50%-70% of all the subjects,without any interventional therapy.The subjects were divided into treatment group and control group according to the random digit table,with 60 cases in each group.Patients in treatment group were treated with Sijunzi decoction and Xuefu Zhuyu decoction on the basis of conventional therapy of western medicine,while the patients in control group were treated with conventional therapy of western medicine only.The treatment course was 4 weeks in both groups.The therapeutic effect on angina pectoris,qi deficiency and blood stasis pattern scores,electrocardiogram (ECG),levels of high sensitive C reactive protein (hs-CRP),homocysteine (HCY) before and after treatment were observed in the two groups.The incidence of adverse events within 4 weeks in two groups was compared.Results:There was no statistically significant difference in baseline clinical information between two groups.Total effective rate was 84.21% and 73.33% in treatment group and control group respectively after 4 weeks of treatment (P<0.05).The effects on ECG were observed in the treatment group,showing significant statistical difference in improving ECG to the control group (P<0.05).Qi deficiency and blood stasis pattern scores,levels of hs-CRP and HCY were significantly reduced in treatment group (P<0.01),with significant difference as compared with control group (P<0.01).There was no difference in the incidence of adverse events between the two groups.Conclusion:Treating unstable angina of qi deficiency and blood stasis pattern from spleen was effective and safe.It could improve the effects on angina pectoris,improve clinical symptoms and inhibit the inflammation reaction.