冠心病辨证论治临床疗效的自身对照观察

作者	单位
鲍延熙	上海第二医科大学附属仁济医院内科心血管研究室
郑道声	上海第二医科大学附属仁济医院内科心血管研究室
俞国瑞	上海第二医科大学附属仁济医院内科心血管研究室

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中文摘要:

本文通过动态心电图、甲皱微循环、血粘度、血小板聚集性、血浆高密度脂蛋白及血浆总胆固醇与高密度脂蛋白比值(TC/H)以及临床症状6个方面指标,进行临床观察用中医辨证论治、消心痛汤剂、活血Ⅱ号方三种方法治疗冠心病的疗效。观察结果:中医辨证论治的方法疗效满意,6个指标中除全血比粘度、血浆比粘度外,其余5项都出现较其它二法为好的疗效;虽然其中除症状疗效外,在统计学上尚未见到差异,但其有趋向能改善患者心肌缺血状况、改善甲皱微循环、抑制血小板的聚集功能以及升高血浆高密度脂蛋白等作用。

英文摘要:

Twelve cases of coronary heart disease were randomized by following treatments:(1)Measures of Bian Zheng Shi Zhi(BZSZ),or diagnosis and treatment based on syndrome differentiation;(2)Isosorbide dissolved in placebo decoction;(3)Coronary Heart No.Ⅱ,including Salvia miltiorrhiza,Ligusticum chuanxiong,Paeonia rubra,Carthamus tinctorius and Dalbergla oderifera.Each measure was given for four weeks.One week before and after the treatment,following parameters were observed and compared:(1) Holter’s monitering;(2)microcirculation of nail bed;(3)viscosity of blood;(4)aggregation of platelet;(5) plasma HDL,plasma TC/HDL ratio.The results were as follows:(1)marked improvement of symptoms in patients treated by BZSZ as compared with the other two measures(P<0.01);(2)All the three measures were effective by the Holter’s monitering,however,there seemed to have better improvement in the BZSZ group as compared with the two others but statistically insignificant;(3)The improvement of microcirculation in all three groups was insignificant,although a slightly better result in BZSZ was observed; (4)The improvement of blood viscosity was also insignificant,with a better outcome with Coronary Heart No.Ⅱ;(5)The platelet aggregation was inhibited by BZSZ and Isosorbide,and enhanced by Coronary Heart No.Ⅱ;(6)There was a slight but insignificant increase of HDL,with higher elevation in BZSZ;and a significant decrease of TC/HDL ratio in patients with Isosorbide,and a significant difference of change as compared with the other two.It was concluded that Bian Zheng Shi Zhi seemed to be a better measure for patients of coronary heart disease.

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