加味丹葛止痛方对冠心病PCI术后心绞痛的临床疗效评价

发布时间：2018-05-20 23:19

本文选题：加味丹葛止痛方 + 冠状动脉支架植入术后心绞痛　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:观察有益气活血功效的加味丹葛止痛方对冠心病经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后气虚血瘀证心绞痛患者的临床疗效。方法:选取2015年1月至2017年1月在我院心内科就诊的冠心病PCI术后气虚血瘀证心绞痛患者67名,随机分为观察组和对照组,观察组34例,对照组33例。观察组在西医常规治疗组的基础上加用加味丹葛止痛方进行临床治疗;对照组直接进行西药常规治疗。治疗疗程4周,随访3个月。主要从心绞痛发作次数和持续时间、西雅图心绞痛量表评分、中医症候评分、硝酸甘油减停率和血脂等多项评价标准来对加味丹葛止痛方进行临床疗效评价。结果:治疗前,两组患者的年龄、性别、病程、BMI、既往史、过敏史、呼吸、脉搏、血压、心绞痛发作次数和持续时间、西雅图心绞痛量表、中医症候评分和血脂等指标在组间分布差异均无统计学意义(P0.05),具有可比性。经4周治疗后,观察组对PCI术后气虚血瘀证患者的胸痛、胸闷、心悸、气短、神疲乏力等症状改善更加显著;通过中医症候评分和西雅图心绞痛量表评分比较,观察组的改善优于对照组,差异有统计学意义(P0.05);与对照组相比,观察组的心绞痛发作的次数和持续时间和硝酸甘油减停率更有改善,差异有统计学意义(P0.05)。治疗后,与对照组比较,观察组的血脂中TC和LDL-C明显降低,HDL-C明显升高标改善更明显,差异有统计学意义(P0.05)。但治疗后观察组TG与对照组相比,差异无统计学意义(P0.05)。结论:加味丹葛止痛方联合西药对治疗冠心病PCI术后气虚血瘀证患者心绞痛有很好的疗效,能够明显改善中医症候,减少心绞痛发作症状,改善血脂指标,且安全性高,可以广泛应用于临床推广。
[Abstract]:Objective: to observe the clinical effect of Jiawei Dan GE Zhitong recipe, which is beneficial to qi and promoting blood circulation, on patients with angina pectoris due to qi deficiency and blood stasis after percutaneous coronary intervention. Methods: from January 2015 to January 2017, 67 patients with angina pectoris with Qi deficiency and blood stasis syndrome after PCI were randomly divided into observation group (n = 34) and control group (n = 33). Observation group on the basis of routine western medicine treatment group plus the treatment of Dan GE Zhitong prescription for clinical treatment; the control group directly for routine treatment of western medicine. The course of treatment was 4 weeks, followed up for 3 months. The clinical efficacy of Jiawei Dan GE Zhitong prescription was evaluated mainly from the times and duration of angina pectoris, the score of Seattle angina pectoris scale, the score of TCM symptom, the reduction of stopping rate of nitroglycerin and the blood lipid. Results: before treatment, age, sex, course of disease, history of BMI, history of allergies, respiration, pulse, blood pressure, number and duration of angina pectoris, Seattle angina scale, There was no significant difference in the distribution of TCM symptom scores and blood lipids between the two groups (P 0.05), which was comparable. After 4 weeks of treatment, the improvement of chest pain, chest tightness, palpitations, shortness of breath, fatigue and other symptoms in patients with Qi deficiency and blood stasis syndrome after PCI was more significant, and the scores of TCM symptoms and Seattle angina pectoris scale were compared. Compared with the control group, the times and duration of angina pectoris attack and the reduction rate of nitroglycerin in the observation group were better than those in the control group, and the difference was statistically significant (P 0.05). After treatment, compared with the control group, TC and LDL-C in the observation group were significantly lower than those in the control group. The increase of HDL-C was significantly improved in the observation group, and the difference was statistically significant (P 0.05). However, there was no significant difference in TG between the observation group and the control group after treatment (P 0.05). Conclusion: Jiawei Dan GE Zhitong recipe combined with western medicine has a good curative effect on angina pectoris of patients with Qi deficiency and blood stasis syndrome after PCI, can obviously improve TCM symptoms, reduce angina pectoris attack symptoms, improve blood lipid index, and have high safety. It can be widely used in clinical application.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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