【目的】 观察柴胡疏肝散合丹参饮治疗冠状动脉粥样硬化性心脏病（简称冠心病）经皮冠状动脉介入（PCI）术后伴焦虑抑 郁状态气滞血瘀型患者的临床疗效及安全性。【方法】 将 60例冠心病 PCI术后伴焦虑抑郁状态气滞血瘀型患者随机分为对照 组和观察组，每组各30例。2组患者均给予冠心病PCI术后规范的二级预防用药，在此基础上，观察组给予柴胡疏肝散合丹 参饮治疗，疗程为4周。观察2组患者治疗前后中医证候积分及9条目患者健康问卷（PHQ-9）、广泛性焦虑障碍量表（GAD-7）、 汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表17项（HAMD-17）评分的变化情况，并评价2组患者的焦虑、抑郁改善疗效 和中医证候疗效以及安全性。【结果】（1）焦虑、抑郁改善疗效方面，治疗4周后，观察组的焦虑、抑郁改善疗效的总有效率 分别为 86.67%（26/30）、90.00%（27/30），对照组分别为 40.00%（12/30）、56.67%（17/30），组间比较（χ2检验），观察组的焦 虑、抑郁改善疗效均明显优于对照组（P＜0.05）。（2）中医证候疗效方面，治疗 4 周后，观察组中医证候疗效的总有效率为 93.33%（28/30），对照组为 53.33%（16/30），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）。（3）量表 评分方面，治疗后，2组患者的中医证候积分、PHQ-9评分、GAD-7评分、HAMA评分及HAMD-17评分均较治疗前明显降 低（P＜0.01），且观察组的降低作用均明显优于对照组（P＜0.01）。（4）安全性方面，治疗过程中，2组患者均无明显不良反应 发生，且患者的生命体征、血常规和肝肾功能等安全性指标均未见异常，具有较高的安全性。【结论】 在西医常规治疗基础 上联合柴胡疏肝散合丹参饮治疗，可显著改善冠心病PCI术后伴焦虑抑郁状态气滞血瘀型患者的临床症状和焦虑抑郁状态， 降低中医证候积分，提高患者生活质量。

Objective To observe the clinical efficacy and safety of Chaihu Shugan Powder and Danshen Decoction in the treatment of patients with anxiety and depression of qi stagnation and blood stasis type after percutaneous coronary intervention（PCI）for coronary atherosclerotic heart disease（shortened as“coronary heart disease”， CHD）. Methods Sixty patients with anxiety and depression of qi stagnation and blood stasis type after PCI for CHD were randomly divided into a control group and an observation group，30 cases in each group. Both groups were given medicines for standard secondary prevention after PCI for CHD. Additionally， the observation group was treated with Chaihu Shugan Powder and Danshen Decoction for 4 weeks. The changes in the scores of traditional Chinese medicine（TCM） syndrome， 9-item Patient Health Questionnaire（PHQ-9）， Generalized Anxiety Disorder Scale（GAD-7），Hamilton Anxiety Scale（HAMA）and Hamilton Depression Scale 17-item（HAMD-17） in the two groups were observed before and after treatment. After treatment，the efficacy for the improvement of anxiety and depression， TCM syndrome efficacy and clinical safety were evaluated in the two groups. Results （1）After 4 weeks of treatment， the total effective rates for the improvement of anxiety and depression in the observation group were 86.67%（26/30）and 90.00%（27/30）， respectively， while those in the control group were 40.00%（12/30）and 56.67%（17/30），respectively. The intergroup comparison（tested by chi-square test） showed that the improvement of anxiety and depression in the observation group was significantly superior to that in the control group（P＜0.05）.（2）After 4 weeks of treatment，the total effective rate for the improvement of TCM syndromes in the observation group was 93.33%（28/30），and that in the control group was 53.33%（16/30）. The intergroup comparison（tested by chi-square test）showed that the efficacy for the improvement of TCM syndromes in the observation group was significantly superior to that in the control group（P＜0.05）.（3）After treatment，the scores of TCM syndromes，PHQ-9，GAD-7，HAMA and HAMD-17 in the two groups were significantly lower than those before treatment（P＜0.01），and the decrease in the observation group was significantly superior to that in the control group（P＜0.01）.（4）During the treatment，there were no obvious adverse reactions occurring in the two groups，and there were no abnormalities in the safety indicators such as vital signs，blood routine test and liver and kidney function indicators of the patients，showing high safety. Conclusion On the basis of conventional western medicine treatment，Chaihu Shugan Powder combined with Danshen Decoction can significantly improve the clinical symptoms and anxiety and depression of qi stagnation and blood stasis type in the patients after PCI for CHD，reduce TCM syndrome scores，and improve the quality of life of patients.

R259.414

广东省中医药局科研项目（编号：20203009）