【目的】探讨血府逐瘀汤加减联合穴位贴敷治疗冠心病稳定型心绞痛患者的临床疗效，评价其在冠心病稳定型心绞痛 治疗中的应用价值。 【方法】将92例冠心病稳定型心绞痛心血瘀阻兼气虚证患者随机分为对照组和观察组，每组各46例。对 照组给予单纯常规西药治疗，观察组在对照组的基础上给予血府逐瘀汤加减联合穴位贴敷治疗，疗程为4周。观察2组患者 治疗前后中医证候积分、匹兹堡睡眠质量指数 （PSQI） 评分、心功能指标[包括左心室射血分数 （LVEF） 、左心室收缩末期内径 （LVESD） 和左心室舒张末期内径 （LVEDD） ]以及心绞疼发作频率及持续时间的变化情况，并评价2组患者的中医证候疗效。 【结果】（1） 疗效方面：治疗4周后，观察组的总有效率为91.30% （42/46） ，对照组为76.09% （35/46） ，组间比较 （χ2 检验） ，观 察组的中医证候疗效明显优于对照组 （P＜0.05） 。 （2） 中医证候积分方面：治疗后，2组患者的中医证候积分均较治疗前降低 （P＜0.05） ，且观察组对中医证候积分的降低幅度明显优于对照组 （P＜0.05） 。 （3） 睡眠质量方面：治疗后，2组患者的PSQI评 分均较治疗前降低 （P＜0.05） ，且观察组对PSQI评分的降低幅度明显优于对照组 （P＜0.05） 。 （4） 心功能方面：治疗后，2组患 者的LVEF均较治疗前升高 （P＜0.05） ，LVESD和LVEDD均较治疗前降低 （P＜0.05） ，且观察组对LVEF的升高幅度及对 LVESD和LVEDD的降低幅度均明显优于对照组 （P＜0.05） 。 （5） 心绞痛发作方面：治疗后，2组患者的心绞痛发作频率及持续 时间均较治疗前改善 （P＜0.05） ，且观察组对心绞痛发作频率及持续时间的改善幅度均明显优于对照组 （P＜0.05） 。 【结论】在 常规西药治疗基础上给予血府逐瘀汤加减联合穴位贴敷治疗冠心病稳定型心绞痛患者临床疗效确切，能有效改善患者心功 能，提高患者睡眠质量，减少患者心绞痛发作，缩短心绞痛发作持续时间，其疗效明显优于单纯常规西药治疗。

Abstract：Objective To explore the clinical efficacy of modified Xuefu Zhuyu Decoction combined with acupoint application for the treatment of patients with stable angina pectoris in coronary heart disease （SAP-CHD） ，and to evaluate its clinical value for the treatment of SAP-CHD. Methods A total of 92 patients with SAP-CHD of heart- blood stasis and obstruction complicated with qi deficiency type were randomly divided into control group and observation group，with 46 cases in each group. The control group was treated with conventional western medicine alone， and the observation group was treated with modified Xuefu Zhuyu Decoction combined with acupoint application on the basis of treatment for the control group. The two groups were treated for 4 weeks. The changes of traditional Chinese medicine（TCM） syndrome scores，Pittsburgh Sleep Quality Index（PSQI） scores，cardiac function indicators of left ventricular ejection fraction （LVEF），left ventricular end-systolic diameter （LVESD） and left ventricular end-diastolic diameter （LVEDD），and frequency and duration of angina pectoris in the two groups before and after treatment were observed. After treatment，the TCM syndrome efficacy in the two groups was evaluated. Results （1）After 4 weeks of treatment， the total effective rate of TCM syndrome efficacy in the observation group was 91.30%（42/46）， and that of the control group was 76.09%（35/46） . The intergroup comparison（tested by chi-square test） showed that the TCM syndrome efficacy in the observation group was significantly superior to that in the control group （P＜0.05） . （2） After treatment，the scores of TCM syndromes in the two groups were decreased compared with those before treatment（P＜0.05）， and the decrease in the observation group was more significant than that in the control group （P＜0.05） . （3）After treatment，the PSQI scores of sleep quality in the two groups were lower than those before treatment （P＜0.05），and the decrease of PSQI score in the observation group was significantly superior to that in the control group after treatment （P＜0.05） . （4） In terms of cardiac function，LVEF in the two groups after treatment was higher than that before treatment （P＜0.05） ，LVESD and LVEDD were lower than those before treatment （P＜0.05） . The increase of LVEF and the decrease of LVESD and LVEDD in the observation group were significantly superior to those in the control group after treatment（P＜0.05） . （5）After treatment，the frequency and duration of angina pectoris in the two groups were improved compared with those before treatment（P＜0.05），and the improvement in the frequency and duration of angina pectoris in the observation group was superior to that in the control group （P＜0.05） . Conclusion On the basis of conventional western medicine treatment， modified Xuefu Zhuyu Decoction combined with acupoint application exerts certain clinical effect for the treatment of patients with stable angina pectoris in coronary heart disease. The combined therapy is effective on improving the cardiac function and sleep quality of the patients， reducing the attack of angina pectoris and shortening the duration of angina pectoris，with stronger efficacy than that of conventional western medicine alone.

R259.414

国家重点研发计划项目 （编号：2022YFC3500103）