黄连斌

【摘要】 目的：觀察黄芪桂枝五物汤加味治疗冠心病稳定型心绞痛（阳虚脉阻证）的临床效果。方法：选取2018年2月-2019年10月笔者所在医院收治的冠心病稳定型心绞痛（阳虚脉阻证）患者82例。按照随机数字表法将其分为两组，每组41例。参照组采用辛伐他汀片与阿司匹林肠溶片治疗，研究组在参照组基础上采用黄芪桂枝五物汤加味治疗。比较两组临床疗效、心功能及血管内皮功能改善情况。结果：研究组治疗总有效率优于参照组，差异有统计学意义（P<0.05）。治疗后研究组LVEDD及LVESD水平均低于参照组，LVEF水平高于参照组，差异有统计学意义（P<0.05）。研究组TXB2及ET-1水平均低于参照组，NO水平高于参照组，差异有统计学意义（P<0.05）。结论：黄芪桂枝五物汤加味治疗冠心病稳定型心绞痛（阳虚脉阻证）效果显著，可改善患者心功能及血管内皮功能。

【关键词】 黄芪桂枝五物汤 冠心病 稳定型心绞痛 临床疗效

doi：10.14033/j.cnki.cfmr.2020.17.006 文献标识码 A 文章编号 1674-6805（2020）17-00-03

Clinical Study of Huangqi Guizhi Wuwu Decoction in the Treatment of Coronary Heart Disease Stable Angina Pectoris （Yang Deficiency Pulse Obstruction Syndrome）/HUANG Lianbin. //Chinese and Foreign Medical Research， 2020， 18（17）： -17

[Abstract] Objective： To observe the clinical effect of Huangqi Guizhi Wuwu Decoction in the treatment of coronary heart disease stable angina pectoris （Yang deficiency pulse obstruction syndrome）. Method： A total of 82 patients with coronary heart disease stable angina pectoris （Yang deficiency pulse obstruction syndrome） admitted in our hospital from February 2018 to October 2019 were selected. According to the random number table method， they were divided into two groups， with 41 cases in each group. The reference group was treated with Simvastatin Tablets and Aspirin Enteric-coated Tablets， and the study group was treated with Huangqi Guizhi Wuwu Decoction on the basis of the control group. The clinical efficacy， cardiac function and vascular endothelial function of the two groups were compared. Result： The total effective rate of treatment in the study group was better than that in the reference group， and the difference was statistically significant （P<0.05）. After treatment， LVEDD and LVESD levels in the study group were lower than those in the reference group， while LVEF levels was higher than that in the reference group， and the differences were statistically significant （P<0.05）. The level of TXB2 and ET-1 in the study group were lower than those in the reference group， and the level of NO was higher than that in the reference group， and the differences were statistically significant （P<0.05）. Conclusion： Huangqi Guizhi Wuwu Decoction has a significant effect in the treatment of coronary heart disease stable angina pectoris （Yang deficiency pulse obstruction syndrome）， which can improve the cardiac function and vascular endothelial function of patients.

[Key words] Huangqi Guizhi Wuwu Decoction Coronary heart disease Stable angina pectoris Clinical efficacy

First-authors address： Shaowu Municipal Hospital， Shaowu 354000， China

西药在冠心病心绞痛患者治疗中有着广泛应用，降脂效果较为理想，但是用药后副作用发生率较高。黄芪桂枝五物汤可促进脂质代谢、改善患者血流动力学、抑制血管平滑肌细胞增殖、增加心肌血液灌注，而且药效温和、持久，用药安全性较高[1-2]。本次调查研究选取冠心病稳定型心绞痛患者82例，选取时间为2018年2月-2019年10月，探讨西药联合黄芪桂枝五物汤加味治疗冠心病稳定型心绞痛（阳虚脉阻证）的效果，现报道如下。

1 资料与方法

1.1 一般资料

将82例冠心病稳定型心绞痛（阳虚脉阻证）患者纳入本次研究，纳入标准：（1）经体格检查、超声心动图、胸部X线检查及心肌标志物等实验室检查确诊冠心病稳定型心绞痛，临床表现主要包括发作性胸痛，胸闷等，发作时间通常短于10 min，舌下含服硝酸甘油片病情即可缓解;（2）冠心病稳定型心绞痛（阳虚脉阻证）与《中药新药临床研究指导原则》中阳虚脉阻证相关诊断标准相符，主症包括胸闷、胸痛等，次症包括腰酸无力、畏寒肢冷、神疲乏力、心悸、气短等，脉涩、沉弱或者沉细，舌下脉络紫胀、紫暗或者淡胖等。……