杨新　刘曼君　吴献

摘要：目的观察乙癸舒心丸治疗阴虚血瘀型冠心病稳定型心绞痛的临床疗效。方法将100例符合入选标准的患者分为治疗组与对照组各50例。对照组采用规范西药治疗，治疗组在西药治疗基础上加用乙癸舒心丸口服，疗程4周，并追踪观察停药后1个月内的心血管事件发生情况。观察2组患者治疗前后胸痹心痛证候、心绞痛症状、心电图及其血脂水平的改变。结果中医证候疗效、心绞痛疗效、心电图疗效，组间比较具有显著差异（P<0.05）；血脂变化情况：2组治疗均能有效降低血脂水平，但治疗组疗效明显优于对照组；近期预后情况：治疗组心血管事件发生率为28.57%，对照组为31.91%，组间比较无显著差异（P>0.05）。结论乙癸舒心丸治疗阴虚血瘀型冠心病稳定型心绞痛的临床疗效肯定，能显著改善胸痹心痛证候，缓解心绞痛症状，改善心肌缺血，降低血脂水平，但不能改善患者近期预后。

关键词：冠心病稳定型心绞痛；乙癸舒心丸；阴虚血瘀；临床观察

中图分类号：R256.22文献标志码：B文章编号：1007-2349（2015）05-0049-03

【Abstract】Objective： To observe the clinical effect of Yikuishuxin Pills on the treatment of coronary heart disease patients with stable angina. Methods： 100 patients were randomly divided into a treatment group and a control group， 50 cases per group. The control group was treated with standardized western medicine while the treatment group was added with Yikuishuxin Pills on the basis of western medicine for 4 weeks. A follow-up observation of cardiovascular occurrence was made within a month. The chest stiffiness and pain syndromes， change angina symptoms， ECG and blood lipid levels of the patients of the two groups were observed. Results： The comparison of the curative effect of their TCM syndrome， angina and ECG was significant difference （P<0.05）. The blood lipid levels of the two groups effectively reduced after the treatment， but the curative effect of the treatment group was better than that of the control group. For recent prognosis， the rate of the cardiovascular incidence of the treatment group was 28.57% while that of the control group was 31.91%. There was no significant difference between the groups （P>0.05）. Conclusion： Yikuishuxin Pills are certain to have a good clinical effect on the treatment of coronary heart disease patients with stable angina and can significantly improve chest stifiness and pain syndrome， relieve angina symptom， improve myocardial ischemia and lower blood lipid levels， but cannot improve the recent prognosis of patients.

【Key words】coronary heart disease with stable angina， Yikuishuxin Pills， yin deficiency and blood stasis， clinical observation

冠心病心绞痛以发作性胸痛为主要临床表现，属于中医胸痹心痛的范畴。经过不断的临床实践和理论总结，中医学对胸痹心痛的认识逐步完善，气虚血瘀为基本病机，痰瘀为主要病理产物，益气、活血、化痰为基本治法。也有学者提出“心肝失调”、“心肾同治”的理论，采用疏肝解郁、滋阴补肾、活血化瘀之法防治冠心病心绞痛。乙癸舒心丸即是在此理论基础上研发的中成药制剂。本研究旨在通过临床试验客观评价乙癸舒心丸治疗阴虚血瘀型冠心病稳定型心绞痛的临床疗效，并观察其对患者近期预后的影响，为中医药防治冠心病心绞痛提供新的思路。……