【摘要】 背景:在心绞痛患者的干预效果评估中,症状和体征改善的同时,其生活质量提高与否也是一个非常重要的因素。目的:探讨经典方四逆汤对冠心病心绞痛的干预效果,比较单纯中药、西药及中西医结合对患者生活质量的影响。设计:以冠心病心绞痛患者为研究对象的前瞻性观察对比研究。单位:一所大学医院的中医科。对象:病例为2003-02/2003-08在中山大学附属第一医院中医科门诊就诊的冠心病心绞痛患者,共88例。纳入标准:符合“心血管系统药物临床研究指导原则和冠心病中医辨证标准”者。排除标准:合并各”“种严重疾病者。所有患者随机分为四逆汤组、消心痛组和联合用药组,各组分别为29,30和29例。方法:四逆汤组、消心痛组和联合用药组分别用四逆汤、消心痛和四逆汤联合消心痛治疗。在治疗开始前及结束,观察心绞痛发作次数、条件、程度、持续时间,记录心电图,分别在患者服药前及服药两周应用统一的调查表和检测工具进行生活质量评分。主要观察指标:各组控制心绞痛发作的疗效、心电图表现及患者的生活质量评分的比较。结果:消心痛和四逆汤均能明显缓解患者心绞痛,改善心电图表现,从躯体症状、健康愉快感和抑郁水平三方面提高生活质量评分(P<0.01),四逆汤提高以上三方面生活质量评分的效果好于消心痛P(<0.01),但四逆汤?更多还原

【Abstract】 BACKGROUND:In the evaluation on the effects of intervention on the patients with angina pectoris,whether the quality of life is improved or not is a very important factor while the symptoms and physical signs are benefited. OBJECTIVE:To probe into the intervention effects of sini tang, the classic formula, on angina pectoris of coronary heart disease and compare the effects of simple Chinese herbs,western medicine and integrated traditional Chinese and western medicine on quality of life.DESIGN:Prospective observation and control study in which the patients with angina pectoris of coronary heart disease were taken as the objects.SETTING:Department of Traditional Chinese Medicine of a Hospital Affiliated to a University.PARTICIPANTS:The 88 cases in total were the patients with angina pectoris of coronary heart disease in the clinic of Department of Traditional Chinese Medicine of First Hospital Affiliated to Sun Yat sen University from February to August 2003.Inclusion criteria: those compiled with “ Guide Principles of Pharmaceutical Clinical Study in Cardiac Vascular System” and “ Standards on Differentiation of Coronary Heart Disease with Chinese Medicine” . Exclusion criteria:those complicated with various severe diseases. All the patients were randomized into sini tang group,isosrbide dinitrate group and allied medication group of 29,30 and 29 cases successively.METHODS:In sini tang group,isosrbide dinitrate group and allied medication group,sini tang,isosrbide dinitrate and sini tang allied with isosrbide dinitrate were prescribed successively.At the beginning and the end of treatment,it was to observe the attack frequency, condition,severity and persistent duration of angina pectoris and to record electrocardiogram(ECG).The evaluation on quality of life was carried on before and two weeks after medication with the unified inventory and determination device.MAIN OUTCOME MEASURES:Comparisons of therapeutic effect on angina pectoris control,ECG and evaluation on life quality in every group. RESULTS:Both isosrbide dinitrate and sini tang relieved remarkably angina pectoris,improved ECG and quality of life in physical symptoms,health pleasure and depression level(P< 0.01).The result of sini tang on improving the quality of life in above mentioned three aspects was better than that of isosrbide dinitrate(P< 0.01).But the allied medication improved clinical therapeutic effects and quality of life(health pleasure and depression level) best(P< 0.01).CONCLUSION:Sini tang benefits the improvement of quality of life of patients with angina pectoris.But during clinical medical intervention, the advantages of integrated traditional Chinese and western medicine should be adopted.更多还原