【目的】 探讨化痰通络汤加味方（由半夏、橘红、茯苓、枳实、丹参、川芎、红花、石菖蒲、远志等组成）对冠心病经 皮冠状动脉介入（PCI）术后心绞痛痰瘀互结型患者的临床疗效及生活质量的影响。【方法】 将广州中医药大学附属阳江市中医 医院 2023年 1月至 2024年 1月期间收治的 80例冠心病 PCI术后心绞痛痰瘀互结型患者按随机数字表法随机分为对照组和治 疗组，每组各 40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化痰通络汤加味方治疗，疗程为 1个月。观 察2组患者治疗前后中医证候积分、生活质量西雅图心绞痛量表（SAQ）评分的变化情况，并评价2组患者的中医证候疗效和 心电图疗效。【结果】（1）SAQ评分方面，治疗后，2组患者的躯体活动受限程度、心绞痛稳定状态、心绞痛发作情况、治疗 满意程度、疾病认知程度等各项 SAQ 评分均较治疗前升高（P < 0.05），且治疗组的升高幅度均明显优于对照组（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），且治疗组的降低幅度明显优于对照 组，差异有统计学意义（P < 0.05）。（3）中医证候疗效方面，治疗 1个月后，治疗组的总有效率为 90.00%（36/40），对照组为 82.50%（33/40）；组间比较，治疗组的总体疗效（秩和检验）明显优于对照组，差异有统计学意义（P < 0.05）；总有效率（χ2 检验）有优于对照组趋势，但差异无统计学意义（P > 0.05）。（4）心电图疗效方面，治疗1个月后，2组患者的心电图均呈现出 明显的改善趋势，治疗组的总有效率为 87.50%（35/40），对照组为 70.00%（28/40）；组间比较，治疗组的总体疗效（秩和检 验）和总有效率（χ2检验）均明显优于对照组（P < 0.05）。【结论】 针对冠心病 PCI术后心绞痛痰瘀互结型患者，在常规西药治 疗基础上联合化痰通络汤加味方治疗，对提高患者临床疗效、改善患者生活质量有积极影响。

Objective To investigate the clinical efficacy of modified Huatan Tongluo Decoction（mainly composed of Chinese medicines of Pinelliae Rhizoma， Citri Grandis Exocarpium， Poria， Aurantii Fructus Immaturus， Salviae Miltiorrhizae Radix et Rhizoma，Chuanxiong Rhizoma，Carthami Flos，Acori Tatarinowii Rhizoma，and Polygalae Radix）in the treatment of angina pectoris of phlegm blended with blood stasis type after percutaneous coronary intervention（PCI）for coronary heart disease（CHD），and to observe its effect on patients􀆳 quality of life （QOL）. Methods Eighty patients with angina pectoris of phlegm blended with blood stasis type after PCI for CHD admitted to Yangjiang Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine between January 2023 and January 2024 were randomly divided into a control group and a treatment group according to the random number table method，with 40 patients in each group. The control group was treated with conventional western medicine，and the treatment group was treated with modified Huatan Tongluo Decoction orally on the basis of treatment for the control group， and the treatment covered one month. The changes of traditional Chinese medicine（TCM）syndrome scores and Seattle Angina Questionnaire（SAQ）scores for QOL before and after treatment in the two groups were observed. After treatment， the TCM syndrome efficacy and electrocardiogram efficacy in the two groups of patients were evaluated. Results（1）After treatment，the scores of various items of SAQ such as the physical limitation（PL）， anginal stability（AS）， anginal frequency（AF）， treatment satisfaction（TS），and disease perception（DP）in the two groups of patients were all increased compared with those before treatment（P < 0.05），and the increase of scores of PL，AS，AF，TS，and DP in the treatment group was significantly superior to that in the control group（P < 0.05）.（2）After treatment，the TCM syndrome scores in the two groups of patients were decreased compared with those before treatment（P < 0.05），and the decrease in the treatment group was significantly superior to that in the control group， the difference being statistically significant（P < 0.05）.（3）After one month of treatment，the total effective rate for TCM syndrome efficacy of the treatment group was 90.00%（36 / 40）， and that of the control group was 82.50%（33 / 40）. The intergroup comparison showed that the overall efficacy of the treatment group（tested by rank sum test） was significantly superior to that of the control group， and the difference was statistically significant（P < 0.05）. However，the total effective rate of the treatment group（tested by chi-square test）tended to be better than that of the control group，but the difference was not statistically significant（P > 0.05）.（4）After one month of treatment， the results of electrocardiogram in the two groups of patients were improved，with a total effective rate of 87.50% （35/40）in the treatment group and 70.00%（28/40）in the control group. The intergroup comparison showed that the overall efficacy（tested by rank sum test）and the total effective rate（tested by chi-square test）of the treatment group were significantly superior to those of the control group（P < 0.05）. Conclusion For patients with angina pectoris of phlegm blended with blood stasis type after PCI for CHD， the combined use of modified Huatan Tongluo Decoction and conventional western medicine exerts a positive impact on improving the clinical efficacy and QOL of the patients.

R259.414

广东省中医药局科研立项课题（编号：20231391）