2021 年第 2 期 第 16 卷

通脉化瘀汤对老年冠心病经皮冠状动脉介入术后患者临床症状和冠状动脉内再狭窄的影响

Effect of Tongmai Huayu decoction on clinical symptoms and coronary restenosis in elderly patients with coronary heart disease after percutaneous coronary intervention 

作者：唐珍漆其良

英文作者：Tang Zhen Qi Qiliang

单位：湖南中医药高等专科学校附属第一医院老年病科，湖南省株洲市412000

英文单位：Department of Geriatrics the First Affiliated Hospital of Hunan Traditional Chinese Medical College Hunan Province Zhuzhou 412000 China

关键词：冠心病(冠状动脉粥样硬化性心脏病)；经皮冠状动脉介入术后；通脉化瘀汤；临床症状；冠状动脉内再狭窄

英文关键词：Coronaryatheroscleroticheartdisease;Postoperationofpercutaneouscoronaryintervention;Tongmaihuayudecoction;Clinicalsymptoms;Coronaryrestenosis

• 摘要：

• 目的 探讨通脉化瘀汤对老年冠心病(冠状动脉粥样硬化性心脏病)经皮冠状动脉介入（PCI）术后患者临床症状和冠状动脉内再狭窄的影响。方法 选取2018年3月至2020年3月湖南中医药高等专科学校附属第一医院收治的84例老年冠心病PCI术后患者，根据随机数字表法将其分为对照组和观察组，各42例。对照组口服氯吡格雷+阿司匹林，观察组在对照组基础上口服通脉化痰汤，均治疗6个月。比较2组患者中医证候评分、血脂及高敏C反应蛋白（hs-CRP）水平、冠状动脉内再狭窄及心血管事件发生率。结果 治疗3、6个月后，2组中医证候评分均低于治疗前，且观察组均低于对照组，差异均有统计学意义（均P<0.05）。治疗6个月后，2组低密度脂蛋白胆固醇、总胆固醇、三酰甘油及高敏C反应蛋白水平均低于治疗前，高密度脂蛋白胆固醇水平均高于治疗前，且观察组均低于/高于对照组［（2.16±0.29）mmol/L比（2.51±0.39）mmol/L、（3.1±0.3）mmol/L比（4.2±1.2）mmol/L、（1.01±0.29）mmol/L比（1.53±0.41）mmol/L、（4.1±1.3）mg/L比（8.5±2.3）mg/L、（1.71±0.37）mmol/L比（1.19±0.28）mmol/L］（均P<0.05）。观察组治疗6个月后冠状动脉内再狭窄、心血管不良事件发生率均低于对照组［7.1%（3/42）比19.0%（8/42）、2.4%（1/42）比11.9%（5/42）］（均P<0.05）。结论 通脉化瘀汤可提高老年冠心病PCI术后患者西医常用药物疗效，缓解临床症状，预防冠状动脉内再狭窄的发生。

• Objective To investigate the effect of Tongmai Huayu decoction on clinical symptoms and coronary restenosis in elderly patients with coronary atherosclerotic heart disease after percutaneous coronary intervention (PCI). Methods Totally 84 cases of elderly patients with coronary atherosclerotic heart disease after PCI admitted to the First Affiliated Hospital of Hunan Traditional Chinese Medical College from March 2018 to March 2020 were randomly divided into control group and observation group, with 42 cases in each group. The control group was treated with clopidogrel and aspirin orally, and the observation group was treated with Tongmai Huayu decoction on the basis of control group. Both groups were treated for 6 months. The traditional Chinese medicine（TCM）syndrome score, levels of blood lipid and high sensitive C-reactive protein (hs-CRP), and incidences of coronary restenosis and cardiovascular events were compared between the two groups. Results  After 3 and 6 months of treatment, the TCM syndrome scores of the two groups were lower than those before treatment, and the scores of observation group were lower than those of control group(all P<0.05). After  6 months of treatment, the levels of low-density lipoprotein cholesterol, total cholesterol, triacylglycerol and hs-CRP in the both groups were lower than those before treatment, high-density lipoprotein cholesterol levels in the both groups were higher than those before treatment, and those in observation group were lower/higher than those in control group［（2.16±0.29）mmol/L vs （2.51±0.39）mmol/L,（3.1±0.3）mmol/L vs （4.2±1.2）mmol/L,（1.01±0.29）mmol/L vs （1.53±0.41）mmol/L,（4.1±1.3）mg/L vs （8.5±2.3）mg/L, （1.71±0.37）mmol/L vs （1.19±0.28）mmol/L］(all P<0.05). The incidences of coronary restenosis and cardiovascular adverse events in observation group were lower than those in control group after 6 months of treatment［7.1%（3/42） vs 19.0%（8/42）, 2.4%（1/42） vs 11.9%（5/42）］(both P<0.05). Conclusion Tongmai Huayu decoction can improve the curative effect of common western medicine in elderly patients with coronary atherosclerotic heart disease, relieve clinical symptoms, and prevent the occurrence of coronary restenosis.