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研究

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1、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

2、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

3、阻络证；临床研究TheClinicalResearchonUnstableAnginapectorisofelderlywomenwithCoronaryHeartDiseasebythemethodofReinforcingthekidneyandstrengtheningthespleenandpromotingtheqiandactivatingthebloodSpeciality：ClinicalstudyonthetreatmentofheartsystemdiseasewithTraditionalChineseMedicineTutor：Prof.Ba

4、oPeirongAuthor：SunBingqianAbstractObjective:Toevaluatetheeffectsofreinforcingthekidneyandstrengtheningthespleenandpromtingtheqiandactivatingthebloodonthedeficiencyofbothkidneyandspleen,andphlegmstagnationincollateralsoftheelderlywomenunstableanginapatientswithcoronaryheartdisease,andin

5、vestigatethemechanismofit.Methods:Divided60elderlyfemaleunstableanginapatientsintotwogroupsequally.Agroupnamedtreatmentgroup,Bgroupnamedcontrolgroup.WegaveBuShenJianPiTangtoAgroupbesideswesternmedicineforonemonth.ForBgroup,weonlyusedthesamewesternmedicine.Whenthetreatmentcyclewasover,w

6、eobservedtheeffectsofChinesemateriamedica.Indexesincludingfrequencyofanginapectorisattacks,totalischemiaburdenofdynamicelectrocardiogram,estrogen,blood-fat,thefunctionofbloodvesselendothelium,high-sensitivityC-ReactiveProteinofbloodserumweremeasuredrespectively.Results:BuShenJianPiTang

7、obviouslydecreasedtheanginalfrequencyandtheTIB,andtheexpressionofE2、TC、TG、LDL-C、LP(a)、ET-1、hs-CRP.ItalsoincreasedthelevelofNO.Conclusion:BuShenJianPiTanghasgoodeffecttotheelderlyfemalepatientsofUnstableAngina.Throughthisresearchwethinkthemechanismincludingsuchaspects:improvingthemeta