沈虹 韦婧 章怡祎 毛美娇 刘萍

〔摘要〕 目的 探討调心方对冠心病稳定型心绞痛气滞痰瘀证伴焦虑状态患者的治疗作用，客观评价该方缓解焦虑的有效性，为临床应用和推广提供依据。方法 共纳入66例冠心病稳定型心绞痛气滞痰瘀证伴焦虑状态的患者，随机分为试验组33例、对照组33例。两组均行冠心病心绞痛常规治疗，试验组在常规治疗基础上加用调心方，对照组在常规治疗基础上加用氟哌噻吨美利曲辛片，疗程均为8周。比较两组患者治疗前后广泛性焦虑障碍量表（generalized anxiety disorder-7， GAD-7）、中医证候积分、心绞痛量表、睡眠状况自评量表（self-rating scale of sleep， SRSS）的变化。结果 治疗后，试验组GAD-7有效率为78.8%，对照组为90.9%，两组比较差异无统计学意义（P>0.05）;试验组中医证候积分有效率为93.9%，对照组为60.6%，试验组疗效及有效率均明显优于对照组（P<0.05）;治疗后，试验组心绞痛量表有效率为57.5%，对照组为27.3%，试验组疗效及有效率均优于对照组（P<0.05）;治疗后，两组SRSS总分较治疗前均明显降低（P<0.01）。结论 中药复方调心方能有效缓解冠心病稳定型心绞痛气滞痰瘀证伴焦虑状态患者的焦虑症状，并改善相关中医证候、提高生活质量、改善睡眠质量，可以同时从躯体和精神心理两方面发挥治疗作用，具有“双心同治”的特点。

〔关键词〕 冠心病;稳定型心绞痛;气滞痰瘀证;焦虑状态;调心方

〔中图分类号〕R256.22;R259       〔文献标志码〕B       〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.04.022

〔Abstract〕 Objective To discuss the therapeutic effect of Tiaoxin Formula on patients with stable angina pectoris of coronary heart disease （CHD） with syndrome of qi stagnation and phlegm stasis accompanied by anxiety， and to objectively evaluate the effectiveness of Tiaoxin Formula in alleviating anxiety， so as to provide basis for clinical application and promotion. Methods 66 patients with stable angina pectoris of CHD with syndrome of qi stagnation and phlegm stasis accompanied by anxiety were randomly divided into experimental  group （33 cases） and control group （33 cases）. Both groups received routine treatment of CHD angina pectoris， the experimental group was additionally treated with Tiaoxin Formula， and the control group was additionally treated with flupentixol meritracine tablets， for a course of 8 weeks. The changes of generalized anxiety disorder-7 （GAD-7）， TCM syndrome score， angina pectoris scale， self-rating scale of sleep （SRSS） were compared before and after treatment in 2 groups. Results After treatment， the effective rate of GAD-7 was 78.8% in the experimental group and 90.9% in the control group， and there was no significant difference between the two groups （P>0.05）. The effective rate of TCM syndrome score in experimental group was 93.9%， and that in control group was 60.6%. The efficacy and effective rate in experimental group were significantly better than that in control group （P<0.05）. After treatment， the effective rate of angina pectoris scale in experimental group was 57.5%， and that in control group was 27.3%. The efficacy and effective rate in experimental group were better than those in control group （P<0.05）. After treatment， the total score of the SRSS in both groups was significantly lower than that before treatment （P<0.01）. Conclusion TCM Tiaoxin Formula can effectively relieve anxiety symptom and the relevant TCM syndromes， improve the quality of life and sleep of patients with stable angina pectoris of CHD with syndrome of qi stagnation and phlegm stasis accompanied by anxiety， and can play a therapeutic role from both physical and mental aspects at the same time， has the characteristic of "double heart treatment".

〔Keywords〕 coronary heart disease; stable angina pectoris; qi stagnation and phlegm stasis syndrome; state of anxiety; Tiaoxin Formula

冠状动脉粥样硬化性心脏病（corocary heartdisease， CHD，简称为冠心病）作为危害我国居民最常见的心血管疾病，因其常高并发精神心理障碍等特点，已被世界公认为“双心疾病”[1]。常见精神心理障碍主要有抑郁、焦虑、恐惧、紧张、失眠等，而其中，焦虑和抑郁是其独立危险因素[2]。本试验以冠心病稳定型心绞痛气滞痰瘀证伴焦虑状态患者为研究对象，观察具有行气解郁、活血化瘀、理气化痰、养心安神功效的中药复方调心方对冠心病气滞痰瘀证合并焦虑状态的改善作用，为“双心异常”患者提供一种有效且安全的中医药治疗方法，补充“双心医学”的中医内涵，为临床进一步应用提供基础，现报道如下。