当归四逆汤辅助治疗冠状动脉粥样硬化性心脏病的效果及其机制研究

目的探索当归四逆汤辅助治疗冠状动脉粥样硬化性心脏病(冠心病)的疗效及其作用机制。方法选取2017年3月—2018年3月陕西中医药大学附属医院治疗的冠心病心绞痛患者60例,将患者随机分为对照组和实验组,每组30例。对照组采用常规西药治疗,实验组除了进行常规西药治疗外,同时给予当归四逆汤进行辅助治疗4周。比较2组的临床疗效,治疗前后动态心电图缺血性ST—T改变时间、血脂水平以及心脏功能指标的差异。结果实验组患者的心绞痛症状疗效治疗总有效率为86.7%(26/30),对照组总有效率为70.0%(21/30),实验组总有效率明显高于对照组(P<0.05);治疗后2组缺血性ST—T改变时间均较治疗前明显缩短(P均<0.05),且治疗后实验组患者的缺血性ST-T改变的时间明显短于对照组(P<0.05);治疗后2组的总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平相对于本组治疗前明显降低(P均<0.05),高密度脂蛋白胆固醇(HDL-C)水平均比本组治疗前明显升高(P均<0.05),且治疗后实验组患者血清中TC、TG、LDL-C水平明显低于对照组(P均<0.05),HDL-C水平明显高于对照组(P<0.05)。2组治疗后心排血量(CO)、室间隔厚度(IVST)、左室射血分数(LVEF)和左室舒张末期内径(LVEDD)均较治疗前明显改善(P均<0.05),且实验组各指标改善情况明显优于对照组(P<0.05)。结论当归四逆汤辅助治疗冠心病的疗效良好,其机制可能是通过调节血脂代谢,改善血液循环和心脏功能来实现的。

Study on the effect of Danggui Sini Decoction on coronary heart disease and its mechanism

Objective It is to explore the effect and mechanism of Danggui Sini Decoction in the treatment of coronary heart disease.Methods Sixty patients with coronary heart disease and angina pectoris treated from March 2017 to March 2018 in the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine were randomly divided into a control group and an experimental group,with 30 cases in each group.The control group was treated with conventional western medicine,additionally,the experimental group was given Danggui Sini Decoction for adjuvant therapy based on the control group.The clinical effects and the differences in ischemic ST-T changes of ECG,blood lipid levels,and cardiac function parameters before and after the treatment were compared between the two groups.Results The total treatment efficiency of angina pectoris symptoms in the experimental group was 86.7%(26/30),and the total effective rate in the control group was 70.0%(21/30).The total effective rate in the experimental group was significantly higher than that in the control group(P<0.05).The ischemic ST-T change time of the two groups after treatment was significantly shorter than that before treatment(P<0.05),the time in the experiment group was shorter than that of the control group(P<0.05).After treatment,the levels of total cholesterol(TC),triacylglycerol(TG),and low-density lipoprotein cholesterol(LDL-C)were significantly lower than before treatment,and that of the high-density lipoprotein cholesterol(HDL-C)was significantly higher than before treatment(P<0.05),and the levels of TC,TG,LDL-C in the treatment group were significantly lower than those in the control group(P<0.05),HDL-C level was significantly higher than that in the control group(P<0.05).After treatmetn,the cardiac output(CO),interventricular septal thickness(IVST),left ventricular ejection fraction(LVEF),and left ventricular end-diastolic diameter(LVEDD)were significantly improved compared with those before treatment in the two groups(P<0.05),and the improvement of these indicators in the experimental group was significantly better than that in the control group(P<0.05).Conclusion Danggui Sini Decoction has good curative effect on coronary heart disease,and its mechanism may be achieved by regulating blood lipid metabolism and improving blood circulation and heart function.