[1]张雁,黄晓佳,曹守沛,等.人参养营汤合桃仁四物汤加减治疗冠心病介入术后再发心绞痛临床研究[J].陕西中医,2025,46(11):1487-1491.[doi:DOI:10.3969/j.issn.1000-7369.2025.11.008]
　ZHANG Yan,HUANG Xiaojia,CAO Shoupei,et al.Clinical study on modified Renshen Yangying decoction combined with Taoren Siwu decoction in treatment of recurrent angina pectoris after PCI[J].,2025,46(11):1487-1491.[doi:DOI:10.3969/j.issn.1000-7369.2025.11.008]
点击复制

人参养营汤合桃仁四物汤加减治疗冠心病介入术后再发心绞痛临床研究

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年11期
页码:
1487-1491
栏目:
临床研究
出版日期:
2025-11-05

文章信息/Info

Title:
Clinical study on modified Renshen Yangying decoction combined with Taoren Siwu decoction in treatment of recurrent angina pectoris after PCI
作者:
张雁1; 黄晓佳1; 曹守沛1; 刘学谦2
（1.南京中医药大学附属南京中医院，江苏 南京 210022；2.南京中医药大学太仓附属医院，江苏 太仓 215499）
Author(s):
ZHANG Yan1; HUANG Xiaojia1; CAO Shoupei1; LIU Xueqian2
(1.Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing 210022,China；2.Taicang Affiliated Hospital of Nanjing University of Chinese Medicine,Taicang 215499,China)
关键词:
冠心病; 心绞痛; 气虚血瘀; 经皮冠状动脉介入术; 人参养营汤; 桃仁四物汤
Keywords:
Coronary heart disease; Angina pectoris; Qi deficiency and blood stasis; Percutaneous coronary intervention; Renshen Yangying decoction; Taoren Siwu decoction
分类号:
R 541.4
DOI:
DOI:10.3969/j.issn.1000-7369.2025.11.008
文献标志码:
A
摘要:
目的：探讨人参养营汤合桃仁四物汤加减治疗气虚血瘀型冠心病经皮冠状动脉介入术（PCI）后再发心绞痛的临床疗效。方法：将98例气虚血瘀证冠心病PCI术后再发心绞痛患者依据计算机生成序列联合密封信封分配为对照组、观察组，各49例。两组均采用西医常规治疗。观察组在常规治疗基础上联合人参养营汤合桃仁四物汤加减方治疗。治疗后评估两组患者临床疗效、中医证候积分、心功能指标、心绞痛症状评分、心肌损伤指标、主要不良心血管事件（MACE）发生率和治疗安全性。结果：观察组总有效率高于对照组（P＜0.05）。观察组中医证候积分低于对照组（均P＜0.05）。观察组左心室射血分数（LVEF）、心输出量（CO）高于对照组，而左心室舒张末期容积（LVEDV）和左心室舒张末期内径（LVEDD）低于对照组（均P＜0.05）。观察组西雅图心绞痛量表评分均高于对照组（P＜0.05）。治疗后，观察组心型脂肪酸结合蛋白、肌红蛋白、心肌肌钙蛋白Ⅰ水平低于对照组（均P＜0.05）。随访6个月期间，观察组MACE发生率低于对照组（均P＜0.05）。两组间不良反应发生率比较，差异无统计学意义（均P＞0.05）。结论：人参养营汤合桃仁四物汤加减治疗气虚血瘀证冠心病PCI术后再发心绞痛的疗效较好，可减轻患者主要中医证候，改善心功能水平和心绞痛症状，降低心肌损伤标志物水平及随访期间 MACE 发生率，安全性较好。
Abstract:
Objective:To investigate clinical efficacy of modified Renshen Yangying decoction combined with Taoren Siwu decoction in treating angina pectoris recurrence after percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD) of Qi-deficiency and blood-stasis syndrome type.Methods:A total of 98 CHD patients with Qi-deficiency and blood-stasis syndrome who experienced angina pectoris recurrence after PCI were randomly assigned to either control group or observation group (n=49 each) via computer-generated randomization sequences sealed in envelopes.Both groups received conventional Western medical therapy.The observation group were additionally treated with modified Renshen Yangying decoction combined with Taoren Siwu decoction,clinical efficacy,traditional Chinese medicine (TCM) syndrome scores,cardiac function indicators,angina symptom scores,myocardial injury markers,major adverse cardiovascular events (MACE) incidence,and treatment safety were evaluated post-treatment.Results:The total effective rate was significantly higher in the observation group than in the control group (P＜0.05).TCM syndrome scores were lower in the observation group (all P＜0.05).Left ventricular ejection fraction (LVEF) and cardiac output (CO) were higher,whereas left ventricular end-diastolic volume (LVEDV) and left ventricular end-diastolic diameter (LVEDD) were lower in the observation group compared to the control group (all P＜0.05).Seattle angina questionnaire scores were higher in the observation group (all P＜0.05).Post-treatment levels of heart-type fatty acid-binding protein,myoglobin,and cardiac troponin I were lower in the observation group (all P＜0.05).During the 6-month follow-up,the MACE incidence was lower in the observation group (all P＜0.05).No significant difference in adverse reaction rates was observed between the two groups (all P＞0.05).Conclusion:Modified Renshen Yangying decoction combined with Taoren Siwu decoction demonstrates favorable efficacy in treating angina pectoris recurrence after PCI in CHD patients with Qi-deficiency and blood-stasis syndrome.It alleviates key TCM symptoms,improves cardiac function and angina symptoms,reduces myocardial injury markers,and lowers MACE incidence during follow-up,with good treatment safety.

参考文献/References:

[1]STONE P H,LIBBY P,BODEN W E.Fundamental pathobiology of coronary atherosclerosis and clinical implications for chronic ischemic heart disease management-the plaque hypothesis:A narrative review[J].JAMA Cardiol,2023,18(2):192-201.
[2]梁燕敏,段舒晨,李刚,等.经桡动脉入径与腕背支动脉入径穿刺行经皮冠脉介入治疗的疗效比较[J].中国中西医结合急救杂志,2023,30(3):329-332.
[3]FIGTREE G A,ADAMSON P D,ANTONIADES C,et al.Noninvasive plaque imaging to accelerate coronary artery disease drug development[J].Circulation,2022,29(22):1712-1727.
[4]周秀,朱洪斌,廖晓现.血清内皮细胞特异性分子1、低氧诱导因子1α水平与不稳定型心绞痛PCI术后支架内再狭窄的相关性分析[J].中国动脉硬化杂志,2022,30(4):347-351.
[5]罗文宽,卢健棋,周家谭,等.中医疗法治疗冠心病心绞痛的研究进展[J].辽宁中医杂志,2023,50(7):247-252.
[6]蒋淑莲,何明大,张东山,等.人参养营汤对免疫介导再障小鼠骨髓微环境作用的研究[J].湖南中医药大学学报,2022,22(3):8-12.
[7]王召建,陈杰,陆阳,等.术前用桃仁四物汤加减治疗骨折患者的消肿止痛效果[J].内蒙古中医药,2022,41(2):1041-1045.
[8]中华医学会,中华医学会杂志社,中华医学会全科医学分会,等.稳定性冠心病基层诊疗指南(2020年)[J].中华全科医师杂志,2021,20(3):265-273.
[9]中华医学会,中华医学会杂志社,中华医学会全科医学分会,等.冠心病心脏康复基层指南(2020年)[J].中华全科医师杂志,2021,20(2):150-165.
[10]国家中医药管理局.中药新药临床研究指导原则:试行[M].北京:中国医药科技出版社,2002:181-182.
[11]中华中医药学会心血管病分会.冠心病稳定型心绞痛中医诊疗专家共识[J].中医杂志,2018,29(12):672-679.
[12]LANGFORD B,HUNT C,LERMAN A,et al.The use of the seattle angina questionnaire in patients who underwent spinal cord stimulation for refractory angina pectoris[J].Pain Medicine,2021,22(2):1821-1827.
[13]卞华兴,庄燕,高永兴.桃红四物汤联合西药治疗心力衰竭合并心绞痛的效果及对ET-1、NT-proBNP及心衰标志物的影响[J].辽宁中医杂志,2024,51(7):119-122.
[14]马晓慧,刘江涵子,罗淦清,等.磷脂过氧化在冠心病发病机制中的研究进展[J].中国药理学通报,2022,38(8):1121-1127.
[15]章丽云,赵娜,吴寅莹.心电图QRS-T夹角联合入院超敏C反应蛋白对冠心病患者经皮冠脉介入术后并发恶性心律失常的预测价值[J].中国医药导报,2022,19(17):63-66.
[16]张纯,张然然,刘明娜,等.芪红散对冠心病稳定型心绞痛患者VEGF、TXB2、sICAM-1及CT-1水平的影响[J].陕西中医,2025,46(1):56-59.
[17]汪吴娇,杨志飞,李宇轩,等.益气凉血生肌方对冠心病气虚血瘀兼瘀热互结证患者经皮冠状动脉介入治疗术后心绞痛复发和生活质量的影响——一项随机、三盲、安慰剂平行对照试验[J].中医杂志,2023,64(22):2322-2328.
[18]刘博,李天力,常佩芬.益气活血法治疗经皮冠状动脉介入术后气虚血瘀证心绞痛的Meta分析与GRADE评价[J].中西医结合心脑血管病杂志,2022,20(24):4429-4438.
[19]杨治,张亚楠.桃红四物汤治疗冠心病的临床运用及机制研究进展[J].辽宁中医杂志,2023,50(2):209-212.
[20]王朝菊,兰建军,吴登轩,等.冠心病心绞痛患者血清内脏脂肪特异性丝氨酸蛋白酶抑制剂、不规则趋化因子、单核细胞趋化蛋白-1与心功能、心肌损伤指标相关性分析[J].陕西医学杂志,2024,53(4):548-551，572.
[21]张婷,李颖,裴雯,等.胸痹3号方治疗PCI术后心绞痛的临床研究[J].中西医结合心脑血管病杂志,2025,23(10):1533-1537.
[22]赵航,杨建飞.基于“阳虚阴结”论治经皮冠脉介入术后心绞痛临证经验[J].中国医药导报,2025,22(12):150-153.
[23]俞婷婷,白贺莹,邹国良,等.血府逐瘀汤治疗PCI术后再发心绞痛的研究进展[J].中国中医急症,2025,34(4):745-748.
[24]夏琀,刘东,张明,等.不稳定性心绞痛患者可溶性程序性细胞死亡配体1水平及其与预后的相关性 [J].中华老年心脑血管病杂志,2025,27 (2): 149-153.
[25]叶沃若,刘书宇,刘睿.益气活血方联合双联抗血小板聚集对冠心病PCI术后不稳定型心绞痛的影响[J].湖北中医药大学学报,2024,26(6):33-36.

相似文献/References:

[1]郭辉.温阳通脉方联合氯吡格雷治疗不稳定型心绞痛临床观察[J].陕西中医,2017,(06):692.
[2]李娜,陈雪斌,王利民,等.活血通络方对冠心病心绞痛患者血液流变学和心电图心率变异性的影响[J].陕西中医,2018,(11):1551.
[3]时晓华.丹参多酚酸盐注射液辅助介入治疗冠心病 及对患者心、肾功能和心肌损伤的影响*[J].陕西中医,2019,(5):568.
　SHI Xiaohua..Effects of salvianolate injection on cardiac function, renal function, myocardial injury in percutaneous coronary intervention postoperative patients with coronary heart disease[J].,2019,(11):568.
[4]吕永飞,陈爱莲.益心康泰胶囊治疗冠心病经皮冠状动脉介入术术后疗效及对患者血流变、血管内皮功能的影响*[J].陕西中医,2019,(6):714.
　LV Yongfei,CHEN Ailian..Effect of Yixin Kangtai capsule on the curative effect hemorheology and vascular endothelial function after coronary artery disease PCI[J].,2019,(11):714.
[5]解洪涛,张 顺△,曾广伟.当归补血方联合西药治疗冠脉搭桥术后疗效及对患者血瘀证证候评分和凝血功能的影响*[J].陕西中医,2019,(10):1341.
　XIE Hongtao,ZHANG Shun,ZENG Guangwei..Effects of Danggui Buxue prescription combined with western medicine on blood stasis and coagulation function after coronary artery bypass grafting[J].,2019,(11):1341.
[6]索晓菲,王亚红△,王居新,等.软坚通脉汤治疗冠心病PCI术后Ⅱ期心脏康复疗效〖JZ〗及对患者生活质量的影响*[J].陕西中医,2020,(1):29.
[7]尹 毅,李小兰△.益气活血汤联合尼可地尔治疗稳定性心绞痛疗效及对患者T淋巴细胞亚群的影响[J].陕西中医,2020,(7):888.[doi:DOI:10.3969/j.issn.10007369.2020.07.014]
[8]季学清,刘 萍△,陈宝瑾,等.冠心康方加减联合西药治疗冠心病合并2型糖尿病气虚痰瘀证疗效研究*[J].陕西中医,2020,(9):1208.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.008]
　JI Xueqing,LIU Ping,CHEN Baojin,et al.Efficacy of Guanxinkang preparation combined with western medicine in the treatment of coronary heart disease and type 2 diabetes mellitus with syndrome of Qixu Tanyu[J].,2020,(11):1208.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.008]
[9]钱 伟,白 桦,郝志晔△.养心通脉汤治疗心绞痛疗效及对患者炎性反应指标和血管内皮功能的影响*[J].陕西中医,2020,(11):1591.[doi:DOI:10.3969/j.issn.1000-7369.2020.11.020]
　QIAN Wei,BAI Hua,HAO Zhiye..Effect of Yangxin Tongmai decoction on the inflammatory response and thromboxane of patients with angina pectoris[J].,2020,(11):1591.[doi:DOI:10.3969/j.issn.1000-7369.2020.11.020]
[10]董其浩,邓 兵.益脉强心汤对冠心病合并心衰患者心室重构及血清血小板活化因子、转化生长因子-β1的影响[J].陕西中医,2021,(7):883.[doi:DOI:10.3969/j.issn.1000-7369.2020.07.018]
[11]朱 薇.通脉调脂方治疗冠心病稳定性心绞痛疗效及对患者血流变、VCAM1〖JZ〗及ICAM1影响的研究*[J].陕西中医,2019,(3):290.
　ZHU Wei..Effect of Tongmai Tiaozhi recipe on the efficacy, Hemorheology, VCAM1 and ICAM1 〖JZ〗in patients with stable angina pectoris of coronary heart disease[J].,2019,(11):290.
[12]刘 红,张玲燕,杨 玲.血府逐瘀汤治疗冠心病介入术后心绞痛临床研究[J].陕西中医,2019,(5):594.
　LIU Hong,ZHANG Lingyan,YANG Ling..Clinical observation of Xuefu Zhuyu decoction in the treatment of angina pectoris after PCI for coronary heart disease[J].,2019,(11):594.
[13]贺建涛,胡宇才,刘 磊.活血通络散治疗冠心病PCI术后心绞痛疗效研究*[J].陕西中医,2019,(7):854.
　HE Jiantao,HU Yucai,LIU Lei..Efficacy observation of Huoxue Tongluo powder in the treatment of angina pectoris after coronary heart disease PCI[J].,2019,(11):854.
[14]林钰莹,陈全福.补阳还五汤联合瑞舒伐他汀治疗冠心病心绞痛疗效研究[J].陕西中医,2025,46(7):924.[doi:DOI:10.3969/j.issn.1000-7369.2025.07.012]
　LIN Yuying,CHEN Quanfu.Study on therapeutic effect of Buyang Huanwu decoction combined with rosuvastatin in treatment of angina pectoris in coronary heart disease[J].,2025,46(11):924.[doi:DOI:10.3969/j.issn.1000-7369.2025.07.012]

备注/Memo

备注/Memo:
国家自然科学基金资助项目（82305126）
更新日期/Last Update: 2025-11-04