化瘀心痛胶囊治疗冠心病心绞痛（气滞血瘀证）的临床研究

【作者】 汤峰；

【导师】 姜丽红；

【作者基本信息】 长春中医药大学 ， 中医内科学， 2007， 硕士

【摘要】 目的：冠心病心绞痛近年呈高发病趋势，严重危害人类健康，影响生活质量，积极预防和治疗冠心病是目前医学研究的重要课题，而其基本病机总属本虚标实，本虚为心脾肝肾之阴阳气血亏虚，功能失调为主；标实为气滞、寒凝、痰阻、血瘀，痹遏胸阳，阻滞心脉为主，均可影响血液的正常进行，导致血行瘀滞，心脉痹阻而致胸痹，且气血之间又具有非常密切的关系，气机顺畅则津液运行无阻，亦无痰浊可成，经脉畅通。若气机郁滞，血行不畅，日久则心血瘀阻，胸脉痹阻而引起心痛。可见益气活血化瘀是中医治疗冠心病的最常见的有效方法，本课题旨在观察与评价化瘀心痛胶囊治疗冠心病心绞痛(气滞血瘀证)的临床疗效与安全性。方法：将符合条件的胸痹心痛患者共60例，采用随机双盲对照分组，分为治疗组30例和对照组30例，治疗组给予化瘀心痛胶囊3粒，日三次口服，治疗组给予保心宁胶囊3粒，日三次口服，治疗时间均为28天。观察两组患者心绞痛症状的变化(包括心绞痛发作次数、持续时间、疼痛程度的变化及减少硝酸甘油用量的积分)、中医症状积分(包括胸痛、胸闷、心悸、气短、憋气、胸胁胀痛)、心电图的变化情况及安全性等。结果：治疗前后两组自身比较，在心绞痛发作次数、持续时间、疼痛程度的变化及减少硝酸甘油用量，中医症状胸痛、胸闷、心悸、气短、憋气、胸胁胀痛，心电图等方面均有显著差异(p＜0.01)，治疗后两组间比较，心绞痛症状积分、中医症状积分及心电图等方面有显著差异(p＜0.05)，治疗组优于对照组。运动平板试验结果两组患者治疗前后试验级别、ST段下降幅度、血压、心率均无显著差异(p＞0.05)，与治疗前比较，两组患者运动量均有提高。其中治疗组差异显著(p＜0.05)，但与对照组比较无显著差异(p＞0.05)。化瘀心痛胶囊的临床控制率13.3％，显效56.7％，有效26.7％，无效3.3％，总有效率96.7％。两组在服药过程中未见明显不良反应，一般体检项目，血、尿常规，肝、肾功能试验前正常者，试验后无异常。结论：化瘀心痛胶囊治疗冠心病心绞痛(气滞血瘀证)安全，疗效确切。是一种治疗冠心病心绞痛的有效中药新药。更多还原

【Abstract】 Goal: The coronary disease angina pectoris recent years assumed igharises the tendency, the serious harm humanity health, affected thequality of life, positively prevents and treats the coronary diseaseis at present medical research important topic, But its basic pathogenesis always is this empty sign to be solid, thise mpty owes empty for the heart spleen hepatorenal masculine andfeminine elem ents vitality, the function is out of balance primarily; The sign actually tagnation of flow of vital energy, coldly congeals,the phlegm anti-, the blood stasis, the he umatism stops the chest tobe positive, hinders the heart arteries primarily, to be ossible toaffect the blood normally to carry on, causes the blood good stasis to stagnate, the heart arteries rheumatism anti- sends the chestrheumatism, Also be tween the vitality also has extremely close relationship, theinternal combustion engine smooth then body fluids movement unimpeded,also does not have ephlegm to be possible to become, thepassages through which vital energy circulates are unimpeded. If theinternal combustion engine strongly fragrant stagnates, blood line ofimpeded, in the course of time then painstaking care stasis anti-,thech est arteries rheumatism anti- causes the heart pain. Obviously benefits the gas to invigorate the blood is theChinese medicine treats the coronary disease the most common effectivemethod, this topic is for the purpose of observes and the ppraisal grieved capsule treats the coronary disease angina pectoris(stagnation of low of vital energy blood stasis card) the clinicalcurative effect and the securety.Method: Will conform to the condition chest rheumatism grievedpatientaltogether 60 examples, will use the stochastic double blindcomparison grouping, will divide into the treatment group 30 examplesand the comparison group 30 examples, the treatment group gives the grieved capsule 3 grains, the date three time takes orally, thetreatment group will give guarantees the heart rather apsule 3grains,the date three time takes orally, The treatment time is 28 days. Observes two groups of patients anginapectoris symptom the change (to manifest uddenly number of timesincluding angina pectoris, duration, ache degree change and reducetion blasting oil amount used integral), the Chinese medicine symptomintegral(including chest pain, the chest is stuffy, palpitation,pants, feels suffocated, the chest coerces pain), theelectrocardiogram change situation and secure and so on.Finally: The treatment own comparison, manifests uddenlythe number of times in the angina pectoris, the duration, the achedegree change and the reduction blasting oil amount used, the Chinesemedicine symptom chest pain, the chest is stuffy, the palpitation,pants, feels uffocated, the chest coerces the pain, aspect and soon electrocardiogram has the remarkable difference (p < 0.01), Treats the latter two groups of comparisons, angina pectoris aspectand so on symptom inte gral, Chinese medicine symptom integral andelectrocardiogram has the remark able difference (p < 0.05), thetreatment group surpasses the comparison group. Around the movementplate test result two group of patients treat experiment the rank, theST section drop scope, the blood pressure, the heart rate notremarkable difference (p > 0.05), compares with the treatment before,two groups of patients physiological loads of exercise have theenhancement. Treatment group difference is remarkable (p < 0.05), but compares thenot remarkable difference with the comparison group (p > 0.05). the grieved capsule clinical control rate 13.3%, shows results 56.7%, effective 26.7%, is invalid 3.3%, total effectiveness 96.7%.Twogroups in take medicine in the process not to see obviously notgood responded, the common physical examination project, the blood,the routine urine test, the liver, before the kidney functionexperiment the normalcy, after the experiment do not haveexceptionally.Conclusion: the grieved capsule treats the coronary diseaseangina pectoris (stagnation of flow of vital energy blood stasis card)safely, the curative effect is accurate. Is one kind treats thecoronary disease angina pectoris the effective Chinese native medicine new medicine.更多还原