海南医科大学学报

目的:观察瓜蒌薤白半夏汤合丹参饮治疗不稳定型心绞痛(UA)痰瘀互结证的临床疗效及安全性。方法:研究纳入80例低、中危的UA属痰瘀互结证的患者,随机分成试验组与对照组各40例。对照组给予西医常规治疗,试验组给予西医常规加中药颗粒瓜蒌薤白半夏汤合丹参饮治疗,干预4周,观察记录干预前后两组患者心绞痛的发作情况、中医证候积分、硝酸甘油使用量、生活质量评分、血脂、凝血指标以及临床总疗效。结果:治疗4周后,两组心绞痛的发作情况(发作次数、持续时间)均较前改善,且试验组比对照组效果更佳,差异具有统计学意义(P<0.05);试验组硝酸甘油停减率优于对照组,差异具有统计学意义(P<0.05);两组的临床总有效率比较,差异具有统计学意义(P<0.05);试验组的中医证候积分明显低于对照组,差异具有统计意义(P<0.05);试验组的血脂指标低密度脂蛋白(LDL-C)、总胆固醇(TC)及凝血指标凝血酶原时间(PT),改善程度均优于对照组,差异具有统计学意义(P<0.05)。研究期间,两组均未发生明显的不良反应。结论:瓜蒌薤白半夏汤合丹参饮能有效缓解UA痰瘀互结证患者心绞痛的发作,减少硝酸甘油的使用量,调节患者的血脂水平及血流状态,有效改善患者的临床症状,提高生活质量,药物的安全性较好。

Objective:To observe the clinical efficacy and safety of Gualou Xiebai Banxia decoction combined with Danshen decoction on unstable angina(UA)with phlegm and blood stasis syndrome.Method:Eighty patients with UA were divided into the treatment group(40 cases)and the control group(40 cases)by random number table method. The control group was given conventional western medicine treatment,and the experimental group was given Gualou Xiebai Banxia decoction and Danshen decoction on the basis of the western medicine treatment. Both groups were treated for 4 weeks. Before and after treatment,the angina attacks,dosage of nitroglycerin,traditional Chinese medicine syndrome score,quality of life score,blood lipid,coagulation index and clinical total efficacy were observed and recorded. Results:After 4 weeks of treatment,both of the attack times and duration of angina in the two groups decreased compared with those before treatment. And the treatment group showed more reductions than the control group,the difference was statistically significant(P<0.05);the consumption of nitroglycerin of the treatment group was 90.0%,which was better than that of the control group(67.5%)with statistically significant difference(P<0.05);the total effective rate of the treatment group was 90%,which was better than that of the control group(65%)with statistically significant difference(P< 0.05);the traditional Chinese medicine(TCM)syndrome score of the experimental group was lower than that of the control group with statistically significant difference(P<0.05). The improvement of low density lipoprotein(LDL-C),total cholesterol(TC)and prothrombin time(PT)in the experimental group was better than that in the control group(P<0.05). During the study,there were no obvious adverse reactions in both groups.Conclusion:Gualou Xiebai Banxia decoction combined with Danshen decoction can effectively relieve the attack of angina and the consumption of nitroglycerin,improve clinical symptoms. regulate blood lipid and blood flow state,and improve the quality of life of patients with UA,with good clinical efficacy and safety.