| 引用本文:李静1，刘亚荣2，任得志2，朱海慧2，王东亮1，李婷1.柴胡加龙骨牡蛎汤治疗冠心病合并抑郁的临床效果[J].世界中医药,2020,(10):. |
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| 柴胡加龙骨牡蛎汤治疗冠心病合并抑郁的临床效果 |
| Clinical Research on the Radix Bupleuri Plus Longgu Muli Decoction in the Treatment of Coronary Heart Disease with Depression |
| 投稿时间：2018-12-05 |
| DOI：10.3969/j.issn.1673-7202.2020.10.013 |
| 中文关键词: 冠心病 抑郁 柴胡加龙骨牡蛎汤 双心同治 常规疗法 炎性反应递质 脂代谢 临床疗效 |
| English Keywords:Coronary heart disease Depression Radix Bupleuri plus Longgu Muli Decoction Treatment of both psycho and cardiology Conventional therapy Inflammatory factors Lipid metabolism level Clinical therapeutic effects |
| 基金项目:陕西省科技计划项目（2014K14-03-08） |
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| 中文摘要: |
| 目的：观察经方柴胡加龙骨牡蛎汤治疗冠心病合并抑郁的临床疗效。方法：选取2015年1月至2017年6月陕西省人民医院中医科收治的冠心病合并抑郁患者126例作为研究对象，按照随机数字表法随机分为对照组和观察组，每组63例，对照组给予西医常规疗法，观察组在对照组基础上给予经方柴胡加龙骨牡蛎汤，3个月为1个疗程，治疗后观察2组中医证候积分、超声心动图、血清炎性反应递质、脂代谢水平变化，并采用五维健康量表评分（EQ-5D）及汉密尔顿抑郁量表（HAMD）评价生命治疗及抑郁程度。结果:治疗后观察组在胸闷、胸痛、心烦气躁评分、左室收缩末内径（LVESD）方面均低于对照组，差异有统计学意义（P<0.05）；左室射血分数（LVEF）、心输出量（CO）和每搏输出量（SV）均高于对照组，差异有统计学意义（P<0.05）；治疗后观察组白细胞介素-6（IL-6）、C反应蛋白（CRP）、肿瘤坏死因子-α(TNF-α)、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）均低于对照组，差异有统计学意义（P<0.05），观察组高密度脂蛋白胆固醇（HDL-C）与对照组比较，差异无统计学意义（P>0.05）；治疗后观察组EQ-5D高于对照组、HAMD低于对照组，差异有统计学意义（P<0.05）。结论:在“双心同治”理念指导下，冠心病合并抑郁患者给予经方柴胡加龙骨牡蛎汤配合西医常规疗法治疗能够有效缓解临床症状、提高心功能、降低血脂水平、改善生命质量。 |
| English Summary: |
| To observe the clinical therapeutic effects of Radix Bupleuri plus Longgu Muli Decoction，the classical prescription，in the treatment of coronary heart disease with depression.Methods:A total of 126 cases patients with coronary heart disease and depression admitted to the Department of Traditional Chinese Medicine of Shaanxi Provincial People's Hospital from January 2015 to June 2017 were selected as the research objects according to the method of random number table，and were randomly divided into a control group and an observation group，with 63 cases in each group.The control group was given conventional Western medicine therapy，and the observation group was given the Radix Bupleuri plus Longgu Muli Decoction，the classical prescription on the basis of the control group.Patients in both groups received 1 course of treatment for 3 months; the changes of TCM symptom scores，echocardiography，serum inflammatory factors and lipid metabolism levels in the 2 groups were observed; Five dimensional health scale score (EQ-5D) and Hamilton depression scale (HAMD) were used to evaluate life treatment and the degree of depression.Results:After treatment，the scores of chest tightness，chest pain，irritability and LVESD in the observation group were lower than those in the control group (P<0.05)，and LVEF，CO，SV were higher than those in the control group (P<0.05).After treatment，IL-6，CRP，TNF-α，TG，TC and LDL-C in observation group were lower than those in control group (P<0.05).There was no significant difference between observation group and the control group (P<0.05).After treatment，EQ-5D in the observation group was higher than that in the control group，and HAMD was lower than that in the control group (P<0.05).Conclusion:Under the guidance of the concept of “treatment of both psycho and cardiology”，the Radix Bupleuri plus Longgu Muli Decoction，classical prescription combined with Western medicine conventional treatment can effectively alleviate the clinical symptoms of patients with coronary heart disease complicated with depression，improve heart function，reduce blood lipid level，improve the quality of life，which is worthy of promotion. |
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