首页> 中文期刊> 《南京中医药大学学报》 >双心汤干预冠心病合并心理障碍的临床研究

双心汤干预冠心病合并心理障碍的临床研究

         

摘要

OBJECTIVE To explore the clinical effects of Shuangxin Decoction in treating coronary heart disease accompa-nied with psychological disorder.METHODS 80 cases with coronary heart disease manifested as chest pain,chest distress plus psychological disorders like depression and anxiety were randomly divided into treatment group and control group.Patients in both groups were treated with routine western medicine plus psychological counseling.Based on which,patients in the treat-ment group were further given Chinese medicine Shuangxin Decoction,while those in the control group were added deanxit, with the course lasting for 6 weeks.Chest pain(distress) integral score scale,traditional Chinese medicine(TCM) syndrome score scale and comprehensive hospital anxiety and depression scale were evaluated to explore the therapeutic effects of chest pain,psychological disorder and clinical TCM syndromes before and after treatment of both groups,together with the changes of electrocardiogram test results and cardiac markers.RESULT Chest pain(distress) integral scores of treatment group were lower than those of control group(P <0.05),with the total curative rate being 82.50%,notably higher than 52.5% of the control group(P <0.01).The anxiety and depression scores of both groups were evidently reduced after treatment(P <0.01). The comparison of the two groups was P >0.05.TCM syndrome scores of both groups were notably declined(P <0.01).The total curative rate was 75%,which was superior to 20% of the control group(P <0.01).Both electrocardiogram test results and cardiac markers in both groups experienced an evident improvement than before(P <0.05).The comparison of the two groups showed P >0.05.No abnormality was detected in blood,urine,stool or liver and kidney function test in patients of both groups.CONCLUSION Shuangxin Decoction can efficiently improve chest pain,chest distress symptoms as well as TCM clinical syndromes due to coronary heart disease accompanied with psychological disorder.Also,it is helpful for improving de-pression and anxiety,which has been considered as a safe and effective formula for treating these two disorders,worthy of clin-ical application and promotion.%目的:观察双心汤干预冠心病合并心理障碍的临床疗效。方法冠心病胸闷胸痛伴心理障碍(抑郁、焦虑)患者共80例,随机分为治疗组和对照组各40例。2组基础治疗均为冠心病常规口服西药及心理疏导,治疗组加服中药双心汤,对照组加服黛力新(氟哌噻吨美利曲辛片),疗程均为6周。采用胸(闷)痛症状积分表、中医证候积分表、综合医院焦虑/抑郁(HAD)情绪测定表观察评定2组治疗前后胸(闷)痛症状疗效、心理障碍疗效及临床中医证候疗效,同时观察心电图、心肌标志物的变化。结果治疗后治疗组胸(闷)痛症状积分明显低于对照组(P <0.05),其总有效率82.50%,显著高于对照组(52.5%,P <0.01);2组抑郁、焦虑情绪(HAD)积分均较治疗前明显减少(P <0.01),2组比较,P >0.05;2组中医证候积分均明显减少(P<0.01),2组相比治疗组总有效率75%,明显优于对照组(20%,P <0.01)。2组心电图、心肌标志物较治疗前明显改善(P <0.05),2组比较,P >0.05。2组患者治疗前后血、尿、粪常规及肝肾功能等检查均无明显异常。结论双心汤具有明显改善冠心病伴心理障碍患者胸闷胸痛症状及中医临床证候的疗效,同时能改善患者的抑郁、焦虑情绪,是治疗“双心”疾病的一种安全有效的方药,值得临床推广应用。

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