补肾健脾理气活血法治疗老年女性冠心病不稳定型心绞痛的临床探究.pdfVIP

提 要 目的：观察补肾健脾理气活血法治疗老年女性冠心病不稳定型心绞痛脾肾两虚、 痰瘀阻络证的临床疗效，并探讨其作用机制。方法：60 例老年女性不稳定型心绞痛 脾肾两虚、痰瘀阻络证病人随机分为A、B两组，每组30例。A组为治疗组，在西医 常规治疗基础上加服补肾健脾汤；B 组为对照组，采用西医常规治疗。治疗周期为 1 个月。观察治疗前后患者主要临床症状改善情况，治疗期间每周心绞痛发作次数，动 态心电图心肌缺血总负荷 (TIB)，雌激素，血脂，血管内皮功能，超敏 C 反应蛋白 (hs-CRP)等指标的变化。结果：治疗组治疗后心绞痛疗效、中医症状总疗效与对照组 相比，均有显著性差异。治疗组能明显降低心绞痛的发作次数、动态心电图TIB水平， 与对照组相比，有显著性差异。治疗组治疗后TC、TG、LDL-C、LP(a)、ET-1、hsCRP 水平明显下降，E2、NO 水平明显上升，与对照组相比，有显著性差异。结论：补肾 健脾汤能明显改善心梗后心绞痛患者的临床症状，提高临床疗效。显著改善血脂代谢 紊乱，调节雌激素水平，保护血管内皮，稳定斑块，控制炎性反应，减轻不稳定斑块 破裂后血栓的形成，最终达到抗心肌缺血、缺氧，防止不稳定型心绞痛发作，预防心 梗、猝死的目的。本研究结果为老年女性不稳定型心绞痛的防治提供了新的思路和方 法。 关键词 补肾健脾理气活血法；老年女性不稳定型心绞痛；脾肾亏虚、痰瘀阻络 证；临床研究 The Clinical Research on Unstable Angina pectoris of elderly women with Coronary Heart Disease by the method of Reinforcing the kidney and strengthening the spleen and promoting the qi and activating the blood Speciality ：Clinical study on the treatment of heart system disease with Traditional Chinese Medicine Tutor ：Prof.Bao Peirong Author ：Sun Bingqian Abstract Objective:To evaluate the effects of reinforcing the kidney and strengthening the spleen and promting the qi and activating the blood on the deficiency of both kidney and spleen , and phlegm stagnation in collaterals of the elderly women unstable angina patients with coronary heart disease , and investigate the mechanism of it. Methods: Divided 60 elderly female unstable angina patients into two groups equally. A group named treatment group, B group named control group. We gave Bu Shen Jian Pi Tang to A group besides western medicine for one month. For B group, we only used the same western medicine. When the treatment cycle was over, we observed the effects of Chinese materia medica. Indexes including frequency of angina pectoris attacks, t