四川中医

目的：对桃红四物汤合瓜蒌薤白半夏汤治疗不稳定型心绞痛(UAP)痰瘀互结证临床观察进行探讨。方法：回顾选取2021年1月～2023年12月大庆市人民医院中医科收治的UAP患者共89例，辨证为痰瘀互结证，按照不同给药方法分为联合组48例及对照组41例。两组均以常规西药进行治疗，联合组加用桃红四物汤合瓜蒌薤白半夏汤进行治疗，比较两组治疗前后中医症候积分、心绞痛发作情况、血液流变学[全血高切、低切黏度、血小板聚集率、血浆黏度、红细胞比容]、炎症指标[白细胞介素-18(IL-18)、人基质金属蛋白酶(MMP-9)、细胞间黏附分子-1(ICAM-1)、同型半胱氨酸(Hcy)],并比较两组临床疗效及硝酸甘油减停率。结果：两组治疗后中医症候积分、心绞痛发作次数、发作持续时间相较治疗前均有降低，且联合组下降幅度更大(P<0.05);两组治疗后血液流变学均低于治疗前，且联合组低于对照组(P<0.05);两组治疗后血清Hcy、MMP-9、IL-18及ICAM-1水平均有下降，且联合组下降幅度更大(P<0.05);联合组临床疗效及硝酸甘油减停率均高于对照组(P<0.05)。结论：桃红四物汤合瓜蒌薤白半夏汤可有效改善UAP患者血液流变学指标和炎症指标，缓解心绞痛症状，临床疗效确切。

Objective: To discuss the clinical observation of Taohong Siwu Decoction combined with Gualou Xiebai Banxia Decoction in the treatment of unstable angina pectoris(UAP) syndrome of phlegm-stasis interformation. Methods: A total of 89UAP patients admitted to the Department of Traditional Chinese Medicine of Daqing People's Hospital from January 2021to December 2023were retrospectively selected, and they were dialectical as phlegm and blood stasis interformation syndrome. According to different administration methods, they were divided into a combination group(48cases) and a control group(41cases). Both groups were treated with conventional western medicine, and the combined group was treated with Gualou Xiebai Banxia Decoction and Taohong Siwu decoction. TCM symptom score, angina pectoris attack, hemorheology [whole blood high incision viscosity, low incision viscosity, platelet aggregation rate, plasma viscosity, erythrocyte specific volume],inflammatory index [interleukin-18(IL-18),human matrix metalloproteinase(MMP-9),intercellular adhesion molecule-1(ICAM-1),homocysteine] were compared between the two groups before and after treatment(Hcy)],and compared the clinical efficacy and the reduction rate of nitroglycerin between the two groups. Results: The scores of TCM symptoms, the frequency of angina pectoris attacks and the duration of angina pectoris attacks were decreased after treatment in both groups, and the decrease was greater in the combined group(P<0.05). The hemorheology of the two groups after treatment was lower than that before treatment, and the combined group was lower than the control group(P<0.05). The serum levels of Hcy, MMP-9,IL-18and ICAM-1in 2groups were decreased after treatment, and the decrease was greater in the combined group(P<0.05). The clinical efficacy and the reduction rate of nitroglycerin in combination group were higher than those in control group(P<0.05). Conclusion: Gualou Xiebai Banxia Decoction and Taohong Siwu decoction can effectively improve the hemorheology index and inflammation index of UAP patients, relieve the symptoms of angina pectoris, and the clinical effect is accurate