吴娟 程丑夫

摘要：目的 观察益气活血化痰养心汤治疗不稳定型心绞痛的临床疗效及安全性。方法 采用半随机法将165例患者分为观察组84例和对照组81例。2组均予常规治疗。观察组并予益气活血化痰养心汤，每日1剂，每日2次，口服。连续治疗4周，随访4周。观察2组治疗前后心绞痛分级、心电图疗效，检测全血黏度、纤维蛋白原、血清一氧化氮（NO）、超氧化物歧化酶（SOD）及血浆内皮素（ET）、血栓素B2（TXB2）、6-酮-前列腺素F1α（6-keto-PGF1α）水平，观察中医证候积分，评价不良反应与安全性。结果 与本组治疗前比较，2组心绞痛分级显著降低（P<0.05）。观察组心电图总有效率为69.0%（58/84），对照组为65.4%（53/81），2组比较差异无统计学意义（P>0.05）。与本组治疗前比较，2组全血黏度和血浆纤维蛋白原及ET、TXB2水平下降，NO、6-keto-PGF1α水平升高（P<0.05）；观察组治疗后全血黏度和血浆纤维蛋白原及ET、6-keto-PGF1α水平低于对照组，NO水平高于对照组，差异有统计学意义（P<0.05）。2组治疗前后中醫证候积分比较差异无统计学意义（P>0.05），治疗及随访均未见肝、肾功能异常。结论 益气活血化痰养心汤能明显缓解不稳定型心绞痛症状，且可维持血管收缩功能及血小板聚集作用的平衡。

关键词：不稳定型心绞痛；益气活血化痰养心汤；临床研究

DOI：10.3969/j.issn.1005-5304.2018.01.004

中图分类号：R259.422 文献标识码：A 文章编号：1005-5304（2018）01-0015-04

Clinical Study on Yiqi Huoxue Huatan Yangxin Decoction for Treatment of Unstable Angina Pectoris

WU Juan1， CHENG Chou-fu2

1. School of Chinese Medicine， Hunan University of Chinese Medicine， Changsha 410208， China；

2. The First Hospital of Hunan University of Chinese Medicine， Changsha 410007， China

Abstract： Objective To observe the clinical efficacy and safety of Yiqi Huoxue Huatan Yangxin （IHHY） Decoction for treatment of unstable angina pectoris patients. Methods Totally 165 cases of patients with unstable angina pectoris were collected and divided into observation group （84 groups） and control group （81 patients） by semi-random method. Patients in both groups received western medical， and patients in observation group were added with IHHY Decoction， one dosage a day， twice a day， orally. The therapeutic course for both groups was 4 weeks， with 4 weeks follow up. Angina pectoris grade and ECG effect in both groups were observed. Blood viscosity， fibrinogen， serum NO， superoxide dismutase （SOD）， plasma levels of endothelin （ET）， thromboxane B2 （TXB2）， 6-keto-PGF1α， were measured， and TCM syndrome score was observed. The incidence of all adverse reactions was recorded. Results After treatment， the angina pectoris grade of both groups were lower than before， with statistical significance （P<0.05）. The total effective rate of ECG was 69.0% （58/84） in the observation group and 65.4% （53/81） in the control group， without statistical significance （P>0.05）. Compared with before treatment， whole blood viscosity， plasma fibrinogen， levels of ET and TXB2 decreased， while the levels of NO and 6-keto-PGF1α increased （P<0.05）. Whole blood viscosity， plasma fibrinogen， levels of ET and TXB2 in the observation group were lower than the control group after treatment， while the level of NO was higher than the control group， with statistical significance （P<0.05）. There was no statistical significance in TCM syndrome before and after treatment in both groups. There was no abnormality in liver and kidney. Conclusion On the basis of routine treatment， IHHY Decoction can significantly relieve the symptoms of unstable angina and maintain the balance of vasoconstriction and platelet aggregation.

Keywords： unstable angina pectoris； Yiqi Huoxue Huatan Yangxin Decoction； clinical study

基金项目：湖南中医药大学校级科研项目（2015CX02）

通讯作者：程丑夫，E-mail：ccf66@163.com

心绞痛包括稳定型心绞痛和不稳定型心绞痛2种类型，不稳定型心绞痛多由于冠状动脉内粥样斑块不稳定、破裂，导致心肌缺血、缺氧，引发的心肌痉挛和心功能障碍[1]。目前冠心病的发病率与死亡率仍在快速上升。为提高不稳定型心绞痛患者临床疗效及生活质量，笔者在常规治疗基础上加用自拟益气活血化痰养心汤，观察其临床疗效及维持血管收缩功能与血小板聚集作用平衡等情况，现报道如下。……