杨霞 邹景霞 娄伦田 苏凯

摘要 目的：探討健脾降浊护心汤在冠心病心绞痛的治疗中的应用价值及对血脂指标的影响。方法：选取2018年3年至2020年3月四川省第二中医医院心内科收治的冠心病心绞痛患者62例作为研究对象，按照随机数字表分为对照组和观察组，每组31例。对照组患者采用内科综合治疗，口服阿司匹林肠溶片及阿托伐他汀，使患者的血压、血脂控制在较为理想状态。观察组在此基础上口服健脾降浊护心汤治疗，比较2组治疗前后脾虚痰湿证相关证候积分，并采取尼莫地平法制定疗效评价标准。比较2组治疗前后心绞痛发作的持续时间长短变化及发作频数的变化，心电图ST段下移程度。比较2组治疗前后心功能和血脂指标变化。结果：观察组疗效优于对照组（P<0.05）;2组治疗后中医证候积分较治疗前降低，且观察组降低优于对照组（P<0.05）;2组治疗后心功能指标左心室射血分数（LVEF）、心输出量（CO）较治疗前升高，左心室收缩末期内径（LVESD）较治疗前降低;观察组改善优于对照组（P<0.05）;2组治疗后发作频次、持续时间和ST段下移程度较治疗前降低，观察组改善优于对照组（P<0.05）;观察组血脂指标水平改善优于对照组（P<0.05）。结论：健脾降浊护心汤治疗冠心病心绞痛疗效确切，能够改善心功能和血脂指标。

关键词 健脾降浊护心汤;冠心病心绞痛;临床疗效;心功能;中医证候积分;发作频次;持续时间;血脂水平

Value of Jianpi Jiangzhuo Huxin Decoction in the Treatment of Angina Pectoris of Coronary Heart Disease

YANG Xia，ZOU Jingxia，LOU Luntian，SU Kai

（Department of Cardiology，Sichuan Second Hospital of Traditional Chinese Medicine，Chengdu 610031，China）

Abstract Objective：This study explored the value of Jianpi Jiangzhuo Huxin Decoction in the treatment of angina pectoris of coronary heart disease and the influence on blood lipid indexes.Methods：A total of 62 patients with angina pectoris of coronary heart disease who were treated in Sichuan Second Hospital of Traditional Chinese Medicine were selected and randomized into the control group and observation group with the random number table method，31 in either group.The control group received comprehensive internal medicine treatment（oral Aspirin Enteric-coated Tablets and atorvastatin） to control blood pressure and blood lipids at ideal levels，and the observation group was treated with Jianpi Jiangzhuo Huxin Decoction，oral Aspirin Enteric-coated Tablets，and atorvastatin.The score of spleen deficiency and phlegm-dampness syndrome in the two groups was compared before and after treatment，and nimodipine method was adopted to establish the efficacy evaluation criteria.The duration and frequency of angina pectoris attack and electrocardiogram ST-segment depression were compared between the two groups before and after treatment.The changes of cardiac function and blood lipid were also compared between the two groups before and after treatment.Results：The therapeutic effect of the observation group was better than that of the control group（P<0.05）.TCM syndrome scores of the two groups after treatment were lower than those before treatment，and the decrease in the observation group was larger than that in the control group（P<0.05）.After treatment，the indexes of cardiac function，left ventricular ejection fraction（LVEF） and cardiac output（CO），increased and left ventricular end-systolic diameter（LVESD） decreased in both groups.The improvement of the indexes in observation group was better than that in control group（P<0.05）.The duration and frequency of angina pectoris attack and electrocardiogram ST-segment depression in the two groups were decreased after treatment，especially the observation group which demonstrated significant difference from the control group（P<0.05）.The improvement of serum lipid indexes in observation group was better than that in control group（P<0.05）.Conclusion：Jianpi Jiangzhuo Huxin Decoction is effective in treating angina pectoris of coronary heart disease and can improve cardiac function and blood lipid indexes.D98314C3-6D34-49C5-9D09-4B6D3E9EFBDE

Keywords Jianpi Jiangzhuo Huxin Decoction; Coronary heart disease angina pectoris; Clinical efficacy; Cardiac function; TCM syndrome score; Attack frequency; Duration; Blood lipid level

中圖分类号：R541.4文献标识码：Adoi：10.3969/j.issn.1673-7202.2022.08.015

冠心病是由于冠状动脉粥样硬化导致冠状动脉固定性、动力学阻塞，当患者体力活动、环境改变或精神应激时，动脉血流不能满足心肌需求，导致心肌功能障碍的临床综合征，心绞痛是最常见的临床表现，若治疗不及时，可诱发心肌梗死等不良心血管事件，甚至导致患者死亡[1]。随着我国人口老龄化的加剧，冠心病发病人数逐年增多，目前，冠心病死亡人数是所有慢性疾病死亡之首。现代医学研究证实，高血压、高血脂均是冠心病发病的独立危险因素[2]。……