2025 年第 1 期 第 20 卷

通冠益心方治疗冠状动脉痉挛性心绞痛患者的临床效果观察

Clinical effect observation of Tongguan Yixin decoction in treating patients with vasospastic angina

作者：舒鹏钦  陈铁龙  刘昭

英文作者：Shu Pengqin Chen Tielong Liu Zhao

单位：浙江省杭州市中医院心内科，杭州310000

英文单位：Department of Cardiology Hangzhou Traditional Chinese Medicine Hospital Zhejiang Province Hangzhou 310000 China

关键词：冠状动脉痉挛性心绞痛；  通冠益心方；  血管内皮功能；  心肌微循环

英文关键词：Vasospasticangina;  TongguanYixindecoction;  Vascularendothelialfunction;  Myocardialmicrocirculation

• 摘要：

• 目的  探讨通冠益心方治疗冠状动脉痉挛性心绞痛（VSA）的临床效果。方法  选取2022年9月至2023年9月于浙江省杭州市中医院就诊的VSA患者96例，采用简单化随机分组方法分为观察组和对照组，各48例。对照组给予常规西药治疗，观察组在对照组基础上给予通冠益心方治疗，2组均连续治疗2个月。治疗期间，对照组剔除2例，观察组脱落2例。观察2组患者治疗前后心绞痛发作情况、中医证候评分、血管内皮功能、西雅图心绞痛量表（SAQ）评分、心肌微循环指标（左回旋支、前降支、右冠状动脉的校正时间流帧计数）及临床疗效。结果  治疗后，2组中医证候评分、血清丙二醛水平、心绞痛发作次数、心绞痛持续时间、左回旋支校正时间流帧计数、前降支校正时间流帧计数、右冠状动脉校正时间流帧计数水平均低于/少于/短于治疗前，且观察组均低于/少于/短于对照组（均P＜0.05）。治疗后2组血清一氧化氮、超氧化物歧化酶水平、SAQ评分均高于治疗前，且观察组均高于对照组（均P＜0.05）。治疗后观察组总有效率高于对照组［95.6%（44/46）比82.6%（38/46）］(P＜0.05)。结论  通冠益心方可以改善VSA患者血管内皮功能并改善心肌微循环。

• Objective  To investigate the clinical effect of Tongguan Yixin decoction in the treatment of vasospastic angina (VSA). Methods   Totally 96 patients with VSA visited to Hangzhou Traditional Chinese Medicine Hospital, Zhejiang Province from September 2022 to September 2023 were selected and divided into the observation group and the control group adopting a simplified random grouping method, both 48 cases. The control group was treated with western treatment and the observation group was treated with Tongguan Yixin decoction. Both groups were treated for 2 months. During the treatment, 2 cases were dropped out of the control group and 2 cases were dropped out of the observation group. Angina pectoris attack, traditional Chinese medicine (TCM) syndrome score, vascular endothelial function, Seattle Angina Pectoris Scale (SAQ) score, myocardial microcirculation index (corrected time flow frame count of left circumflex branch, anterior descending branch and right crown) and clinical effect were observed in the two groups before and after treatment. Results   After treatment, TCM syndrome score, serum malondialdehyde level, angina pectoris attack frequency, angina pectoris duration, left circumflex branch correction time flow frame count, anterior descending branch correction time flow frame count, right crown correction time flow frame count levels in the two groups were lower/less/shorter than before treatment, and the observation group was lower than the control group (all P<0.05). After treatment, the levels of serum nitric oxide, superoxide dismutase and SAQ scores in the two groups were higher than those before treatment, and the observation group was higher than the control group (all P<0.05). After treatment, the total effective rate in the observation group was higher than that in the control group ［95.6%（44/46） vs 82.6%（38/46）］(P<0.05). Conclusion   Tongguan Yixin decoction can improve vascular endothelial function and myocardial microcirculation in patients with coronary spastic angina.