【摘要】：目的:通過觀察精靈方(益氣養(yǎng)陰、清熱化痰活血法)對(duì)不穩(wěn)定型心絞痛患者中醫(yī)癥狀、心絞痛有效率、心電圖、血脂、血液流變學(xué)、炎癥因子等指標(biāo)的影響,評(píng)價(jià)"益氣養(yǎng)陰、清熱化痰活血法"治療不穩(wěn)定型心絞痛的臨床療效。方法:選擇符合納入標(biāo)準(zhǔn)的氣陰兩虛、痰熱瘀阻型不穩(wěn)定型心絞痛患者40例,采用隨機(jī)分組的方法,分為治療組20例,對(duì)照組20例。對(duì)照組給予西醫(yī)規(guī)范化治療,治療組在對(duì)照組的基礎(chǔ)上聯(lián)合精靈方,兩組均治療8周。比較兩組患者治療前后中醫(yī)癥狀積分療效、心絞痛有效率、心電圖、血脂、血液流變學(xué)、炎癥因子等指標(biāo)的變化情況,分析臨床療效。結(jié)果:(1)中醫(yī)癥狀積分及療效:治療后兩組中醫(yī)癥狀積分均有顯著改善(P0.05),治療組總有效率90%,對(duì)照組總有效率60%,治療組改善優(yōu)于對(duì)照組(P0.05);(2)心絞痛有效率:治療后兩組心絞痛癥狀均有顯著改善(P0.05),治療組總有效率90%,對(duì)照組總有效率85%,治療組與對(duì)照組無差異(P0.05);(3)心電圖:治療后兩組心電圖均有顯著改善(P0.05),治療組總有效率75%,對(duì)照組總有效率55%,治療組與對(duì)照組無差異(P0.05);(4)血脂:治療后兩組TC、TG、LDL-c均顯著降低(P0.05),治療組優(yōu)于對(duì)照組(P0.05);治療后兩組HDL-c均無顯著升高(P0.05);(5)血液流變學(xué):治療后兩組全血高切、中切、低切、血漿黏度及血沉均顯著降低(P0.05),對(duì)血沉的影響治療組優(yōu)于對(duì)照組(P0.05);(6)炎癥因子:治療后兩組CRP、IL-6及TNF-a均顯著降低(P0.05),對(duì)CRP、IL-6的影響治療組優(yōu)于對(duì)照組(P0.05)。結(jié)論:精靈方可以有效改善氣陰兩虛、痰熱瘀阻型不穩(wěn)定型心絞痛患者的臨床癥狀、心電圖、血脂、血液流變學(xué)、炎癥因子等指標(biāo),是臨床上治療不穩(wěn)定型心絞痛的有效方劑,具有良好的藥物安全性。
[Abstract]:Objective: to observe the effect of elfin recipe (tonifying qi and nourishing yin, clearing heat, resolving phlegm and activating blood circulation) on symptoms of TCM, effective rate of angina pectoris, electrocardiogram, blood lipid, hemorheology and inflammatory factors in patients with unstable angina pectoris. To evaluate the clinical efficacy of "tonifying qi and nourishing yin, clearing heat, resolving phlegm and activating blood circulation" in the treatment of unstable angina pectoris. Methods: 40 patients with unstable angina pectoris with qi-yin deficiency and phlegm-heat stasis obstruction were randomly divided into two groups: treatment group (n = 20) and control group (n = 20). The patients were divided into two groups: treatment group (n = 20) and control group (n = 20). The control group received standardized treatment of western medicine, the treatment group combined with Jingling recipe on the basis of the control group, both groups were treated for 8 weeks. The changes of TCM symptom integral effect, angina pectoris effective rate, electrocardiogram, blood lipid, hemorheology and inflammatory factors were compared between the two groups before and after treatment, and the clinical curative effect was analyzed. Results: (1) TCM symptom score and curative effect: after treatment, the TCM symptom score of the two groups were significantly improved (P0.05), the total effective rate of the treatment group was 90%, the total effective rate of the control group was 60%, the improvement of the treatment group was better than that of the control group (P0.05); (2) the effective rate of angina pectoris: after treatment, the symptoms of angina pectoris in the two groups were significantly improved (P0.05), the total effective rate of the treatment group was 90%, the total effective rate of the control group was 85%, there was no difference between the treatment group and the control group (P0.05); (3) ECG: after treatment, the ECG of the two groups were significantly improved (P0.05), the total effective rate of the treatment group was 75%, the total effective rate of the control group was 55%, and there was no difference between the treatment group and the control group (P0.05); (4) Blood lipid: after treatment, the TC,TG,LDL-c of the two groups decreased significantly (P0.05), the treatment group was superior to the control group (P0.05), and the HDL-c of the two groups did not increase significantly after treatment (P0.05). (5) Hemorheology: after treatment, the blood viscosity and erythrocyte sedimentation rate (ESR) of the two groups decreased significantly (P0.05), and the effect of the treatment group on ESR was better than that of the control group (P0.05). (6) inflammatory factors: after treatment, both CRP,IL-6 and TNF-a were significantly decreased in the two groups (P0.05), and the effect on CRP,IL-6 in the treatment group was better than that in the control group (P0.05). Conclusion: Jingling recipe can effectively improve the clinical symptoms, electrocardiogram, blood lipid, hemorheology and inflammatory factors in patients with unstable angina pectoris due to deficiency of both qi and yin and phlegm-heat stasis. It is an effective prescription for treating unstable angina pectoris. It has good drug safety.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

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