广州中医药大学学报2026，Vol.43Issue(2)：312-320,9.DOI:10.13359/j.cnki.gzxbtcm.2026.02.005
疏肝温胆汤治疗冠心病稳定型心绞痛合并焦虑抑郁的疗效观察
Observation on the Therapeutic Effect of Shugan Wendan Decoction on Stable Angina Pectoris of Coronary Heart Disease Complicated by Anxiety and Depression
摘要
Abstract
Objective To observe the clinical efficacy and mechanism of Shugan Wendan Decoction(SGWDD,modified from Chaihu Shugan San and Wendan Decoction)in treating patients with stable angina pectoris(SAP)of coronary heart disease complicated by anxiety and depression.Methods A total of 130 patients with SAP complicated by anxiety and depression,presenting with the TCM syndrome of qi stagnation and phlegm-blood stasis,admitted to Guangzhou Nansha Hospital of Traditional Chinese Medicine between January 2023 and June 2024 were selected.Patients were randomly divided into an observation group and a control group using a random number table,with 65 patients in each group.The control group received conventional western medicine treatment,while the observation group received SGWDD in addition to the conventional treatment for 12 weeks.The following parameters were observed before and after treatment in both groups:angina attack frequency,Seattle Angina Questionnaire(SAQ)scores,Generalized Anxiety Disorder-7(GAD-7)scores,Patient Health Questionnaire-9(PHQ-9)scores,TCM syndrome scores,lipid profiles[total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)],serum monoamine neurotransmitters[dopamine(DA),5-hydroxytryptamine(5-HT),norepinephrine(NE)],inflammatory factors[interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],and endothelial function indicators[nitric oxide(NO),endothelin-1(ET-1)].The TCM syndrome efficacy was also evaluated in both groups.Results(1)Therapeutic effect:After 12 weeks of treatment,the total effective rate was 93.85%(61/65)in the observation group and 78.46%(51/65)in the control group.The intergroup comparison(by chi-square test)showed that the TCM syndrome efficacy in the observation group was significantly superior to that in the control group(P＜0.05).(2)Angina attacks:After treatment,both groups showed improvement in the frequency of angina attacks and pain duration compared to before treatment(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group(P＜0.05).(3)Lipid profiles:After treatment,TC,TG,and LDL-C levels decreased(P＜0.05),while HDL-C levels increased(P＜0.05)in both groups compared to before treatment;the reductions in TC,TG,and LDL-C levels and the increase in HDL-C level were significantly greater in the observation group than in the control group(P＜0.05).(4)Scale scores:After treatment,SAQ scores increased(P＜0.05),while GAD-7,PHQ-9 scores,and TCM syndrome scores decreased(P＜0.05)in both groups compared to before treatment;the increase in SAQ scores and the reductions in GAD-7,PHQ-9 scores,and TCM syndrome scores were significantly greater in the observation group than in the control group(P＜0.05).(5)Monoamine neurotransmitters:After treatment,serum levels of DA,5-HT,and NE increased in both groups compared to before treatment(P＜0.05),and the increases were significantly greater in the observation group than in the control group(P＜0.05).(6)Inflammatory factors:After treatment,serum levels of IL-1β,IL-6,and TNF-α decreased in both groups compared to before treatment(P＜0.05),and the decreases were significantly greater in the observation group than in the control group(P＜0.05).(7)Endothelial function:After treatment,serum NO levels increased(P＜0.05)and ET-1 levels decreased(P＜0.05)in both groups compared to before treatment;the increase in serum NO level and the decrease in serum ET-1 level were significantly greater in the observation group than in the control group(P＜0.05).Conclusion SGWDD combined with conventional western medicine demonstrates definite efficacy in treating patients with SAP complicated by anxiety and depression of qi stagnation and phlegm-blood stasis syndrome.It effectively alleviates angina symptoms,improves anxiety and depression status,and enhances quality of life.The mechanism may be related to regulating monoamine neurotransmitters,inhibiting inflammatory responses,and improving vascular endothelial function.关键词
疏肝温胆汤/柴胡疏肝散/温胆汤/冠心病稳定型心绞痛/焦虑抑郁/气滞痰瘀证/血脂指标/炎症因子/内皮功能/神经递质分类
医药卫生引用本文复制引用
谭景光,蔡海荣,黄斯琪,黎丽娴,谭文进,陈伯钧..疏肝温胆汤治疗冠心病稳定型心绞痛合并焦虑抑郁的疗效观察[J].广州中医药大学学报,2026,43(2):312-320,9.基金项目
国家自然科学基金面上项目(编号:82074342) （编号:82074342）
广州市科技计划项目(编号:2024A04J3302) （编号:2024A04J3302）
广东省中医药局科研项目(编号:20251135) （编号:20251135）
广州市南沙区民生科技计划项目(编号:2023MS014) （编号:2023MS014）
