【作者】 孙建平；

【导师】 郭伟星；

【作者基本信息】 山东中医药大学 ， 中医内科学， 2009， 博士

【摘要】 目的:观察治风活络法在冠心病心绞痛治疗中的应用,并探讨其作用机理。方法:将65例冠心病稳定型劳力型心绞痛并符合中医胸痹(心血瘀阻证)诊断标准的患者随机分为血府逐瘀汤加治风活络药物试验组(33例)和复方丹参滴丸对照组(32例),同期对照治疗1个疗程(4周),分别观察各组治疗前后心绞痛疗效、心电图疗效、速效扩冠药(硝酸甘油)停减率、临床症状变化、超声心动指标、血脂、血液流变学指标变化和血浆中CRP、ET、NO、TXB2、6-keto-PGF1α等水平变化,并进行统计学分析。结果:血府逐瘀汤加治风活络药物内服治疗能有效地缓解心绞痛和临床症状;改善心电图;提高速效扩冠药的停减率;改善心脏的收缩及舒张功能;调节血脂;改善血液流变学;降低CRP、ET、TXB2的水平,升高NO、6-keto-PGF1α的水平等,与对照组相比,有显著的统计学意义,且未发现明显的不良反应。结论:瘀血内阻是冠心病心绞痛的主要病理基础,瘀血生风是冠心病心绞痛的重要病机,血府逐瘀汤加治风活络药物内服治疗冠心病心绞痛比较单纯应用复方丹参滴丸治疗具有更好的临床疗效,说明治风活络法在治疗冠心病心绞痛(心血瘀阻证)时较之单纯应用活血化瘀法疗效更加肯定。更多还原

【Abstract】 Purpose: Observe the application of the above mentioned method in treating coronary and discuss its functions.Method: Divide the 65 patients with stable angina pectoris and in agreement with the standard of TCM in diagnosing stagnation of heart blood into 2 groups: the treatment group (33) by Xuefu Zhuyu Tang and medicines which calm wind to activate collaterals,and the control group (32) by Fufang Danshen Diwan.These patients are treated for 4 weeks by contrast to observe such things before after treatment as: therapy effects,ECG effects,the stopped rate of nitroglycerin,symptom changes,ultrasonic cardiogram,blood fat,blood rheology changes of CRP、ET、NO、TXB2、6-keto-PGF1αin blood plasm.Finally statistical analysis is conducted.Result: Orally taking Xuefu Zhuyu Tang and calming-wind medicines can ease stenocardia,improve ECG,enhance the stopped rate of nitroglycerin,better the heart contraction and dilation,regulate blood fat,promote blood rheology,lower CRP、ET、TXB2,raise NO、6-keto-PGF1αand so on,compired with the control group,it is obviously statically meaningful without obvius adverse reaction.Conclusion: Accumulation of blood stasis is the main pathological foundation of coronary stenocardia.generating wind by blood stasis is the main pathological mechanism.It’s better clinically effective to treat the disease with Xuefu Zhuyu Tang and calming wind medicine than simply with Fufang Danshen Diwan.This shows the method of calming wind to activate collaterals is more positive in treating the disease.更多还原