【目的】 观察调卫和营宣痹方与常规西药联合治疗对冠心病经皮冠状动脉介入（PCI）术后再发心绞痛的治疗效果。 【方法】 将90例冠心病PCI术后再发心绞痛寒凝心脉证患者随机分为对照组和治疗组，每组各45例。对照组给予常规西药治 疗，治疗组在对照组的基础上联合调卫和营宣痹方治疗，疗程为 12周。观察 2组患者治疗前后中医证候积分、心绞痛疗效 积分、西雅图心绞痛量表（SAQ）评分以及左心室射血分数（LVEF）、室间隔厚度（IVS）的变化情况，并评定2组患者的临床疗 效和用药安全性。【结果】（1）脱落情况方面，研究过程中，对照组和治疗组各有 1 例患者脱落，最终对照组和治疗组各有 44 例患者纳入疗效统计。（2）疗效方面，治疗 12 周后，治疗组的总有效率为 93.18%（41/44），对照组为 81.82%（36/44），组 间比较（χ2检验），治疗组的疗效明显优于对照组（P＜0.05）。（3）心绞痛疗效积分方面，治疗后，2组患者的心绞痛发作次数 评分、持续时间评分、疼痛程度评分、硝酸甘油使用量评分及总积分均较治疗前明显降低（P＜0.05），且治疗组治疗后的各 项评分及总积分均明显低于对照组（P＜0.05）。（4）SAQ评分方面，治疗后，2组患者 SAQ量表的身体活动受限程度（PL）、心 绞痛稳定状态（AS）、心绞痛发作情况（AF）、治疗满意程度（TS）、疾病认知程度（DS）评分均较治疗前明显升高（P＜0.05）， 且治疗组治疗后SAQ量表的各项评分均明显高于对照组（P＜0.05）。（5）中医证候积分方面，治疗后，2组患者的胸痛、胸闷、 气短、乏力、口唇紫暗等证候积分均较治疗前明显降低（P＜0.05），且治疗组治疗后的各项中医证候积分均明显低于对照组 （P＜0.05）。（6）心脏彩超指标方面，治疗后，2组患者的LVEF均较治疗前有所改善（P＜0.05），而2组患者的IVS治疗前后均 无明显变化（P＞0.05）；治疗后组间比较，治疗组的LVEF改善幅度明显优于对照组（P＜0.05）。（7）安全性方面，治疗过程中， 治疗组的不良事件发生率为2.27%（1/44），对照组为18.18%（8/44），组间比较，差异无统计学意义（P＞0.05）；且2组患者的 血、尿、大便常规及肝功能、肾功能、心电图等安全性指标均无明显变化。【结论】 在常规西药治疗基础上联合调卫和营宣 痹方治疗，能有效缓解冠心病PCI术后再发心绞痛寒凝心脉证患者的临床症状，改善患者的中医证候及左心室射血分数，临 床疗效显著。

Objective To observe the therapeutic effect of Tiaowei Heying Xuanbi Prescription combined with conventional western medicine on the recurrence of angina pectoris after percutaneous coronary intervention（PCI） for coronary heart disease（CHD）. Methods Ninety patients with recurrent angina pectoris of congealing cold in the heart vessel type after PCI for CHD were randomly divided into a control group and a treatment group，with 45 patients in each group. The control group was treated with conventional western medicine，and the treatment group was additionally treated with Tiaowei Heying Xuanbi Prescription on the basis treatment for the control group. The course of treatment for the two groups covered 12 weeks. The changes of traditional Chinese medicine（TCM） syndrome score， angina efficacy score， Seattle Angina Questionnaire（SAQ）score， left ventricular ejection fraction（LVEF）and interventricular septal thickness（IVS）in the two groups were observed before and after the treatment. And after treatment，the clinical efficacy and safety of the two groups were evaluated. Results（1）Both of the control group and treatment group had one case dropped out during the trial，and eventually 44 patients in each of the two groups were included in the efficacy statistics.（2）After 12 weeks of treatment，the total effective rate of the treatment group was 93.18%（41/44），and that of the control group was 81.82%（36/44）. The intergroup comparison（tested by chi-square test）showed that the curative effect of the treatment group was significantly superior to that of the control group（P＜0.05）.（3）After treatment，the scores of angina attack score，duration of angina，pain level，and nitroglycerin dosage as well as the overall angina efficacy scores in the two groups were significantly lower than those before treatment（P＜0.05），and the scores of each item as well as overall angina efficacy scores of the treatment group were significantly lower than those of the control group after treatment（P＜ 0.05）.（4）After treatment， the SAQ item scores of physical limitation（PL）， angina stability（AS）， angina frequency（AF），treatment satisfaction（TS），and disease perception（DS）in the two groups were significantly increased than those before treatment（P＜0.05），and the scores of each SAQ item in the treatment group were significantly higher than those in the control group after treatment（P＜0.05）.（5）After treatment，the symptom scores of chest pain， chest tightness， shortness of breath， fatigue， and dark purple lips in both groups were significantly lower than those before treatment（P＜0.05），and the TCM syndrome scores of the treatment group were significantly lower than those of the control group after treatment（P＜0.05）. （6）The results of echocardiography showed that after treatment，the LVEF of the two groups of patients was improved compared with that before treatment（P＜0.05），while no obvious change of IVS in the two groups was presented before and after treatment（P＞0.05）. The intergroup comparison showed that the improvement of LVEF in the treatment group was significantly superior to that of the control group（P＜0.05）. （7）During the treatment， the incidence rate of adverse events in the treatment group was 2.27%（1/44）and that in the control group was 18.18%（8/44），and the difference was not statistically significant when compared between the two groups （P＞0.05）. There were no significant changes in the safety indexes associated with the blood，urine，and stool routine test，liver function， renal function， and electrocardiogram in the two groups. Conclusion Tiaowei Heying Xuanbi Prescription combined with conventional western medicine can effectively alleviate the clinical symptoms of patients with recurrent angina pectoris of congealing cold in the heart vessel type after PCI for CHD，and improve the patients' TCM syndromes and left ventricular ejection fraction，with remarkable clinical efficacy.

R259.414

湖北省自然科学基金创新发展联合基金项目（编号：2022CFD074）