加减瓜蒌薤白半夏汤联合西药治疗痰浊内阻型冠心病的效果及对心功能指标的影响

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摘要目的探讨加减瓜蒌薤白半夏汤联合西药治疗痰浊内阻型冠心病的临床效果。方法选择湖北省恩施州利川市民族中医院2018年10月至2020年6月收治的84 例痰浊内阻型冠心病患者，按随机数字表法分为研究组（42 例）及对照组（42 例）。对照组采用西医治疗，研究组于对照组的基础上联合加减瓜蒌薤白半夏汤治疗，两组均连续治疗30 d。比较两组的临床疗效、治疗前后中医证候积分、心功能指标及不良反应。结果研究组治疗的总有效率为95.24%，高于对照组的80.95%，差异有统计学意义（P＜0.05）。两组治疗后的胸闷、胸痛、气短喘促、身体困重、体胖多痰中医证候积分均低于治疗前，且研究组治疗后的胸闷、胸痛、气短喘促、身体困重、体胖多痰中医证候积分均低于对照组，差异有统计学意义（P＜0.05）。两组治疗后的左室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）均低于治疗前，左室射血分数（LVEF）高于治疗前；且研究组治疗后的LVEDD、LVESD 水平均低于对照组，LVEF 水平高于对照组，差异有统计学意义（P＜0.05）。两组的不良反应发生率比较，差异无统计学意义（P＞0.05）。结论加减瓜蒌薤白半夏汤联合西药在痰浊内阻型冠心病治疗中获得了较好效果，患者各临床症状均得到有效改善，心功能水平得到提高，不良反应少，安全性高，利于预后，值得推广。

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	向莉
	陈秋
	王建华

关键词 ：冠心病, 痰浊内阻型, 瓜蒌薤白半夏汤, 阿司匹林肠溶片, 美托洛尔, 心功能

Abstract：Objective To explore the clinical effect of Modified Gualou Xiebai Banxia Decoction combined with Western medicine in the treatment of coronary heart disease with turbid phlegm and internal obstruction.Methods A total of 84 patients with turbid phlegm and internal obstruction coronary heart disease who were admitted to the Lichuan National Hospital of Traditional Chinese Medicine in Enshi Prefecture of Hubei Province from October 2018 to June 2020 were selected,and they were divided into the study group (42 cases) and the control group (42 cases) according to random number table method.The ontrol group was treated with Western medicine,while the study group was treated with Modified Gualou Xiebai Banxia Decoction on the basis of the control group.Both groups were treated continuously for 30 days.The clinical efficacy,traditional Chinese medicine syndrome scores before and after treatment,cardiac function indexes and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the study group was 95.24%,which was higher than 80.95% in the control group,and the difference was statistically significant (P＜0.05).The traditional Chinese medicine syndromes score of chest tightness,chest pain,shortness of breath,body weight,body fat and phlegm after treatment in the two groups were lower than those before treatment,and the traditional Chinese medicine syndromes score of chest tightness,chest pain,shortness of breath,body fatness and phlegm after treatment in the study group were lower than those in the control group,the differences were statistically significant (P＜0.05).The left ventricular end diastolic diameter (LVEDD) and left ventricular end systolic diameter(LVESD) after treatment in the two groups were lower than those before treatment,and the left ventricular ejection fraction (LVEF) after treatment in the two groups were higher than those before treatment,the differences were statistically significant (P＜0.05).After treatment,the levels of LVEDD and LVESD in the study group were lower than those in the control group,and the levels of LVEF in the study group was higher than that in the control group,the differences were statistically significant (P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05).Conclusion Modified Gualou Xiebai Banxia Decoction combined with Western medicine has achieved good results in the treatment of turbid phlegm and internal obstruction coronary heart disease.The clinical symptoms of the patients have been effectively improved,the level of cardiac function is improved,the side effects are few,the safety is high,and it is good for prognosis and worth popularizing.

Key words： Coronary heart disease Turbid phlegm and internal obstruction type Gualou Xiebai Banxia Decoction Aspirin Enteric-Coated Tablets Metoprolol Heart function

引用本文:

向莉；陈秋；王建华. 加减瓜蒌薤白半夏汤联合西药治疗痰浊内阻型冠心病的效果及对心功能指标的影响[J]. 中国当代医药, 2022, 29(17): 154-157.
XIANG Li ；CHEN Qiu； WANG Jianhua. Effect of Modified Gualou Xiebai Banxia Decoction combined with Western medicine in the treatment of coronary heart disease with turbid phlegm and internal obstruction and its influence on indexes of cardiac function. 中国当代医药, 2022, 29(17): 154-157.

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