| 摘要: |
| 目的：观察不同灸量温针灸治疗气虚血瘀型老年性稳定型心绞痛（stable angina pectoris ，SAP）的临床疗效。方法：将90例气虚血瘀型老年性SAP患者随机分为治疗组、对照1组和对照2组，每组各30例。3组均予以常规西药治疗，治疗组在常规西药治疗基础上，针刺内关、膻中、气海、心俞、膈俞，并于内关、气海行3壮温针灸治疗；对照1组针刺取穴、施灸部位同治疗组，但仅行1壮温针灸治疗；对照2组针刺取穴同治疗组，但不予施灸治疗；3组均治疗30 d。观察3组治疗前后血清总胆固醇（total cholesterol，TC）、三酰甘油（triglycerides，TG）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol， LDL-C）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol，HDL-C）、心绞痛发作情况（心绞痛发作持续时间、心绞痛发作频率）、中医证候积分，并观察3组不良反应发生情况，比较临床疗效。结果：治疗组脱落2例，对照1组脱落1例，对照2组脱落1例。总有效率治疗组为92.86%（26/28），对照1组为82.76%（24/29），对照2组为68.97%（20/29），3组比较，差异均有统计学意义（P<0.05）。3组治疗后TC、TG、 LDL-C、HDL-C、心绞痛发作持续时间、心绞痛发作频率和中医证候积分均较治疗前显著改善（P<0.05），且治疗组和对照1组治疗后各项指标改善程度均优于对照2组（P<0.05），治疗组改善程度优于对照1组（P<0.05）；治疗组、对照1组、对照2组不良反应发生率分别为3.57%（1/28）、3.45%（1/29）、0%（0/29），3组比较，差异均无统计学意义（P>0.05）。结论：温针灸治疗气虚血瘀型老年性SAP疗效明确，可有效改善血脂各项指标，缩短患者心绞痛发作持续时间和频率，缓解胸痛、胸闷等症状，且不同灸量对疗效的影响较为显著，3壮温针灸疗效优于1壮。 |
| 关键词: 老年性稳定型心绞痛 气虚血瘀型 温针灸 灸量 血脂 心绞痛 中医证候积分 临床疗效 |
| DOI： |
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| Clinical effect of warming acupuncture-moxibustion with different dosages in treatment of elderly stable angina pectoris with Qi deficiency and blood stasis: An analysis of 60 cases |
| HE Chensi,LI Qiang,LIU Xinye,WANG Houlian |
| (Hunan Traditional Chinese Medical College，Zhuzhou 412012，Hunan，China) |
| Abstract: |
| Objective: To investigate the clinical effect of warming acupuncture-moxibustion with different dosages in the treatment of elderly stable angina pectoris （SAP） with Qi deficiency and blood stasis. Methods: A total of 90 patients with elderly SAP with Qi deficiency and blood stasis were randomly divided into treatment group，control group 1，and control group 2，with 30 patients in each group. All three groups were given conventional Western medicine treatment; the patients in the treatment group were given acupuncture at Neiguan，Danzhong，Qihai，Xinshu，and Geshu and warming acupuncture-moxibustion with 3 moxa cones at Neiguan and Qihai; the patients in the control group 1 were given acupuncture and moxibustion at the same acupoints as the treatment group，but with only 1 moxa cone for warming acupuncture-moxibustion; the patients in the control group 2 were given acupuncture at the same acupoints as the treatment group，while moxibustion was not performed; the course of treatment was 30 days for all three groups. All three groups were observed in terms of serum total cholesterol （TC），triglyceride （TG），low-density lipoprotein cholesterol （LDL-C），high-density lipoprotein cholesterol （HDL-C），anginal attack （duration and frequency），and traditional Chinese medicine （TCM） syndrome score before and after treatment，and the three groups were compared in terms of the incidence rate of adverse reactions and clinical outcome. Results: Two patients in the treatment group，1 in the control group 1，and 1 in the control group 2 were lost to follow-up. The overall response rate was 92.9% （26/28） in the treatment group，82.8% （24/29） in the control group 1，and 69.0% （20/29） in the control group 2，with a significant difference between the three groups （P < 0.05）. After treatment，all three groups had significant improvements in TC，TG，LDL-C，HDL-C，the duration and frequency of anginal attack，and TCM syndrome score （P < 0.05），and the treatment group and the control group 1 had significantly greater improvements than the control group 2 （P < 0.05），while the treatment group had significantly greater improvements than the control group 1 （P < 0.05）. The incidence rate of adverse reactions was 3.57% （1/28） in the treatment group，3.45% （1/29） in the control group 1，and 0% （0/29） in the control group 2，with no significant difference between the three groups （P > 0.05）. Conclusion: Warming acupuncture-moxibustion has a marked clinical effect in the treatment of elderly SAP and can effectively improve blood lipid parameters，shorten the duration of anginal attack，reduce the frequency of anginal attack，and alleviate the symptoms of chest pain and chest distress. The dosage of moxibustion has a significant impact on clinical outcome，and warming acupuncture-moxibustion with 3 moxa cones has a better effect than that with 1 moxa cone. |
| Key words: elderly stable angina pectoris Qi deficiency and blood stasis warming acupuncture-moxibustion moxibustion dosage blood lipids angina pectoris traditional Chinese medicine syndrome score clinical outcome |
