1.天津中医药大学,天津市静海区团泊新城西区鄱阳湖路10号,301617
2.天津医科大学
3.天津市胸科医院
ycq-4@163.com
收稿:2022-08-09,
修回:2022-10-20,
纸质出版:2023-01-17
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于鲁,李珠,王朔等.血府逐瘀胶囊对冠心病心绞痛患者西雅图心绞痛量表评分影响的多中心前瞻性队列研究[J].中医杂志,2023,64(02):146-152.
YU Lu,LI Zhu,WANG Shuo,et al.Seattle Angina Questionnaire Changes of Patients with Coronary Heart Disease and Angina Pectoris Treated by Xuefu Zhuyu Capsules (血府逐瘀胶囊): A Multicenter Prospective Cohort Study[J].Journal of Traditional Chinese Medicine,2023,64(02):146-152.
于鲁,李珠,王朔等.血府逐瘀胶囊对冠心病心绞痛患者西雅图心绞痛量表评分影响的多中心前瞻性队列研究[J].中医杂志,2023,64(02):146-152. DOI: 10.13288/j.11-2166/r.2023.02.008.
YU Lu,LI Zhu,WANG Shuo,et al.Seattle Angina Questionnaire Changes of Patients with Coronary Heart Disease and Angina Pectoris Treated by Xuefu Zhuyu Capsules (血府逐瘀胶囊): A Multicenter Prospective Cohort Study[J].Journal of Traditional Chinese Medicine,2023,64(02):146-152. DOI: 10.13288/j.11-2166/r.2023.02.008.
目的
2
评价血府逐瘀胶囊治疗冠心病心绞痛的临床疗效。
方法
2
通过多中心前瞻性队列研究,共纳入冠心病心绞痛患者543例,根据冠心病心绞痛患者是否使用血府逐瘀胶囊分为治疗组262例和对照组281例。对照组给予西医常规药物治疗,治疗组在西医常规药物治疗的基础上给予口服血府逐瘀胶囊(每粒0.4 g),每次6粒,每日2次。两组疗程均为8周。治疗前后比较两组患者西雅图心绞痛量表(SAQ)评分[包括躯体运动受限情况(PL)、心绞痛平稳状况(AS)、心绞痛发生状况(AF)、医疗满意度(TS)和病情认知能力(DP)],并对两组患者治疗后SAQ评分影响因素进行多元线性回归分析。根据不同类型(稳定型心绞痛和不稳定型心绞痛)、性别(男/女)、年龄段(<65岁和≥65岁)和合并高血压病情况(是/否)进一步比较两组患者治疗后SAQ评分情况。
结果
2
研究过程中脱落41例,最终纳入分析治疗组253例,对照组249例。与本组治疗前比较,治疗后两组SAQ中PL、AS、AF、TS和DP评分均明显升高,且治疗组SAQ各项评分均优于对照组(
P
<0.05)。与对照组比较,治疗后治疗组不稳定型心绞痛患者治疗后SAQ各项目评分均明显升高(
P
<0.05);治疗组男性患者治疗后AS、TS、DP评分和女性患者治疗后PL、AF明显升高(
P
<0.05);治疗组≥65岁患者治疗后PL、AS、DP升高,<65岁患者治疗后AS、AF、TS、DP评分均明显升高(
P
<0.05);治疗组合并高血压病患者治疗后SAQ各项评分均明显高于对照组合并高血压病患者(
P
<0.05)。经多重线性回归分析校正年龄、性别、合并疾病及治疗用药等潜在混杂因素后,血府逐瘀胶囊联合西医常规治疗可明显改善SAQ评分(
P
<0.05)。
结论
2
在西医常规治疗基础上,应用血府逐瘀胶囊可改善冠心病心绞痛患者躯体运动、心绞痛发生状况,从而提高生活质量,可能在改善不稳定型心绞痛患者效果更佳,对合并高血压病患者亦有疗效。
Objective
2
To evaluate the clinical efficacy of
Xuefu Zhuyu Capsule
(血府逐瘀胶囊) in treating angina pectoris of coronary heart disease (CHD).
Methods
2
In this multicenter prospective cohort study, a total of 543 CHD patients with angina pectoris were included, and they were divided into treatment group (262 cases) and control group (281 cases) according to whether or not
Xuefu Zhuyu Capsule
was used. Both groups were given western medicine routine treatment, while the treatment group additionally received oral
Xuefu Zhuyu Capsule
(0.4 g each capsule), 6 capsules each time, twice a day. The treatment course of both groups was 8 weeks. Before and after treatment, the scores of Seattle Angina Questionnaire (SAQ) including physical limitation (PL), angina stability (AS), angina frequency (AF), treatment satisfaction (TS), and disease perception (DP) were compared between the two groups, and the SAQ scores were analyzed by multiple linear regression. According to different types (stable angina pectoris or unstable angina pectoris), gender (male or female), age (<65 years old or ≥65 years old) and hypertension (yes or no), the SAQ scores of the two groups after treatment were further compared.
Results
2
During the study, 41 cases fell off, and finally 253 cases in treatment group and 249 cases in the control group were included in the analysis. The scores of PL, AS, AF, TS and DP in SAQ of both groups significantly increased after treatment, and all SAQ scores in the treatment group were better than those in the control group (
P
<0.05). Compared to those in the control group, SAQ scores of patients with unstable angina pectoris in the treatment group were significantly increased after treatment (
P
<0.05); the scores of AS, TS and DP of male patients and PL and AF of female patients significantly increased (
P
<0.05); the PL, AS and DP of patients ≥65 years old increased after treatment, as well as the scores of AS, AF, TS and DP of patients <65 years old (
P
<0.05). After treatment, all SAQ scores of patients concomitant with hypertension were significantly higher in the treatment group than in the control group (
P
<0.05). After adjusting for potential confounding factors such as age, gender, comorbidities, and treatment medications by multiple linear regression analysis,
Xuefu Zhuyu Capsules
combined with western medicine routine treatment could significantly improve the SAQ score (
P
<0.05).
Conclusion
2
Xuefu Zhuyu Capsule
in addition to western medicine routine treatment can significantly improve body movement and angina pectoris, thereby improving the quality of life of CHD patients with angina pectoris. The effect may be more obvious in patients with unstable angina or concomitant with hypertension.
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