抵挡汤加减治疗慢性稳定型心绞痛合并抑郁症临床研究OA
Clinical Study on Modified Resistance Decoction in the Treatment of Chronic Stable Angina Pectoris Complicated with Depression
目的:观察抵挡汤加减治疗慢性稳定型心绞痛合并抑郁症患者的临床疗效及其对患者自主神经功能、甲状腺功能的影响.方法:将96 例慢性稳定型心绞痛合并抑郁症患者按照随机数字表法分为对照组和治疗组,每组各48 例.对照组给予常规西医治疗,治疗组在对照组治疗的基础上给予抵挡汤加减治疗.比较两组患者心电图疗效及治疗前后中医证候评分、西雅图心绞痛量表评分(seattle angina questionnaire,SAQ)、抑郁自评量表评分(self-rating depression scale,SDS评分)、汉密尔顿抑郁量表(hamilton depression scale,HAMD).检测两组患者治疗前后甲状腺功能指标[血清游离三碘甲状腺激素(three iodine thyroid hormone,T3)、游离四碘甲状腺激素(four iodine thyroid hormone,T4)、促甲状腺激素(thyroid stimulating hormone,TSH)]及自主神经功能指标[多巴胺(dopamine,DA)、去甲肾上腺素(norepinephrine,NE)、肾上腺素].结果:治疗组有效率为89.13%,对照组有效率为69.57%,治疗组有效率高于对照组(P<0.05).两组患者治疗后各项血清甲状腺功能指标低于本组治疗前,且治疗后治疗组低于对照组(P<0.05).两组患者治疗后DA、NE、肾上腺素水平低于本组治疗前,且治疗后治疗组低于对照组(P<0.05).两组患者治疗后SDS量表评分、HAMD评分低于本组治疗前,且治疗后治疗组低于对照组(P<0.05).治疗组西雅图心绞痛5 个维度评分高于较治疗前及对照组(P<0.05);对照组躯体活动受限程度及心绞痛稳定状态评分高于本组治疗前(P<0.05),其余维度评分比较,差异无统计学意义(P>0.05).两组患者治疗后中医证候评分低于本组治疗前,且治疗后治疗组低于对照组(P<0.05).结论:抵挡汤加减治疗稳定型心绞痛合并抑郁症,可缓解患者的临床症状,降低甲状腺激素水平,发挥激素正向调节作用,恢复患者自主神经功能,改善抑郁状态.
Objective:To observe the clinical efficacy of Modified Resistance Decoction onchronic stable angina pectoris(CSAP)compli-cated with depression and its influence on autonomic nervous function and thyroid function.Methods:A total of 96 patients with CSAP complicated with depression were divided into the control group and the treatment group according to the random number table method,with 48 cases in each group.The control group was given conventional Western medicine treatment,while the treatment group was fur-ther given Modified Resistance Decoction on the basis of the treatment of the control group.The efficacy of electrocardiogram and the scores of TCM syndromes,Seattle angina questionnaire(SAQ),self-rating depression scale(SDS)and Hamilton depression scale(HAMD)before and after treatment were compared between the two groups.The thyroid function indexes[including serum free three i-odine thyroid hormone(T3),free four iodine thyroid hormone(T4),thyroid stimulating hormone(TSH)]and autonomic nervous func-tion indexes[including dopamine(DA),norepinephrine(NE),epinephrine]before and after treatment were detected in the two groups.Results:The effective rate of the treatment group was89.13%,which was higher than that of the control group:69.57%(P<0.05).After treatment,the serum thyroid function indexes of the two groups were lower than those before treatment,and the treatment group's indexes were lower than those of the control group(P<0.05);the levels of DA,NE and epinephrine of the two groups were lower than those before treatment,and the treatment group's above levels were lower than those of the control group(P<0.05);the SDS score and HAMD score of the two groups were lower than those before treatment,and the treatment group's above scores were lower than those of the control group(P<0.05);the five dimensions of Seattle angina score of the treatment group were higher than those be-fore treatment and the control group(P<0.05);the PL and AS scores of the control group were higher than those before treatment(P<0.05),and there were no statistically significant differences in the other dimensions(P>0.05);the TCM syndrome scores of the two groups were lower than those before treatment,and the treatment group's scores were lower than those of the control group(P<0.05).Conclusion:For patients with CSAP complicated with depression,Modified Resistance Decoction can relieve the clinical symp-toms,reduce the thyroid hormone level,play a positive role in hormone regulation,restore the autonomic nervous function,and improve the depression state.
刘许彦
镇平县中医院,河南 镇平 474250
中医学
稳定型心绞痛合并抑郁症抵挡汤加减中西医结合疗法自主神经功能甲状腺功能《伤寒论》张仲景
stable angina pectoris complicated with depressionModified Resistance Decoctionintegrated traditional Chinese and West-ern medicine therapyautonomic nervous functionthyroid functionTreatise on Cold Damage DiseasesZhang Zhongjing
《河南中医》 2024 (005)
664-669 / 6
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