摘要
目的观察分析气虚血瘀型稳定型心绞痛合并H型高血压病患者应用保元汤合血府逐瘀汤治疗的临床效果。方法选取2018年1月—2019年6月大连市中医医院收治的84例稳定型心绞痛合并H型高血压病患者作为研究对象,随机分成两组,每组42例,对照组根据病情需要应用抗心绞痛及降压药物治疗,治疗组在其基础上应用保元汤合血府逐瘀汤,经过4周的临床治疗,比较两组治疗前后中医临床证候积分、血压、同型半胱氨酸(Hcy)水平、心功能指标、血清细胞因子水平及西雅图量表(SAQ)评分,同时评价治疗后中医证候疗效。结果两组中医证候疗效比较,治疗组总有效率(90.5%)明显优于对照组(66.7%)。两组第21、28天中医证候积分较治疗前明显降低(P<0.05);治疗组第28天较第7天降低明显(P<0.05);治疗组第21、28天中医证候积分较对照组降低明显(P<0.05)。两组患者收缩压与舒张压在治疗第14、21、28天较治疗前均显著下降(P<0.05),第14、21天与第7天比较差异无统计学意义(P>0.05);治疗组收缩压及舒张压在第14、21、28天较对照组降低显著(P<0.05)。治疗后两组血Hcy水平均较治疗前下降(P<0.05),且治疗组优于对照组(P<0.05)。治疗后两组患者左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、舒张期室间隔厚度(LVST)水平均改善,且治疗组优于对照组(P<0.05)。治疗后,两组患者C反应蛋白(CRP)、一氧化氮(NO)、内皮素(ET)、超氧化物歧化酶(SOD)水平均改善,且治疗组明显优于对照组(P<0.05)。治疗后,两组患者SAQ评分均改善,且治疗组优于对照组(P<0.05)。结论保元汤合血府逐瘀汤能明显改善气虚血瘀型稳定型心绞痛合并H型高血压病患者的临床症状、血压水平及血清细胞因子水平,降低血Hcy水平,提高患者的心功能及生命质量。
Objective To observe and analyze the clinical effect of Baoyuan Decoction(保元汤)combined with Xuefu Zhuyu Decoction(血府逐瘀汤)in the treatment of stable angina pectoris of Qi deficiency and blood stasis type combined with H-type hypertension.Methods Selected January 2018 and June 2019,Dalian hospital of traditional Chinese medicine 84 cases of stable angina merger H-type hypertensive patients as the research object,randomly divided into two groups:42 cases in each group,control group according to the illness needs to use of angina pectoris and antihypertensive drug treatment,the treatment group on the basis of the application using Baoyuan Decoction combined with Xuefu Zhuyu Decoction,after 4 weeks of treatment,TCM clinical syndrome score,blood pressure,homocysteine(Hcy)level,cardiac function index,serum cytokine level and SAQ score were compared between the two groups before and after treatment,and the efficacy of TCM syndromes after treatment were evaluated.Results The total effective rate of the treatment group(90.5%)was significantly better than that of the control group(66.7%).The TCM syndrome scores of the two groups on 21 st and 28 th day were significantly lower than those before treatment(P<0.05);The treatment group on 28 th day was significantly lower than that on 7 th day(P<0.05);The TCM syndrome scores in the treatment group were significantly lower than those in the control group on 21 st and 28 th day(P<0.05).The systolic blood pressure and diastolic blood pressure in two groups were significantly decreased on the 14 th,21 st and 28 th day compared with before treatment(P<0.05),and there was no statistical significance on the 14 th,21 st and 7 th day(P>0.05).The systolic and diastolic blood pressure in the treatment group were significantly lower than those in the control group on 14 th,21 st and 28 th day(P<0.05).After treatment,blood Hcy in both groups decreased compared with before(P<0.05),and the treatment group was better than the control group(P<0.05).After treatment,the levels of LVESD,LVEDD,LVEF and LVST in both groups were improved,and the treatment group was better than the control group(P<0.05).After treatment,the levels of CRP,NO,ET and SOD in 2 groups were improved,and the treatment group was significantly better than the control group(P<0.05).After treatment,SAQ scores improved in both groups,and the treatment group was better than the control group(P<0.05).Conclusion Baoyuan Decoction combined with Xuefu Zhuyu Decoction can significantly improve the clinical symptoms,blood pressure levels and serum cytokine levels in patients with stable angina pectoris of Qi-deficiency and blood-stasis type complicated with H-type hypertension,reduce the blood Hcy level,and improve the cardiac function and quality of life of patients.
作者
孙晓波
黄健
刘浩
牛永军
石岩
白长川
SUN Xiaobo;HUANG Jian;LIU Hao;NIU Yongjun;SHI Yan;BAI Changchuan(Dalian Hospital of Traditional Chinese Medicine,Dalian 116013,Liaoning,China;Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China)
出处
《辽宁中医药大学学报》
CAS
2022年第1期112-116,共5页
Journal of Liaoning University of Traditional Chinese Medicine
基金
国家重点基础研究发展计划(973计划)(2013CB532004)
辽宁省科学技术计划项目(2019-ZD-0889)
国家中医药管理局全国名中医传承工作室建设项目(国中医药办人教[2018]119号)。
关键词
保元汤
血府逐瘀汤
气虚血瘀
稳定型心绞痛
H型高血压病
Baoyuan Decoction(保元汤)
Xuefu Zhuyu Decoction(血府逐瘀汤)
Qi deficiency and blood stasis
stable angina pectoris
H-type hypertension
