中国中药杂志

2004, (08)

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血府逐瘀汤拆方临床研究
Clinical study on compatibility and dismantlement of Xuefu Zhuyu decoction

王阶,荆鲁,衷敬柏,王永炎,马丽红,刘剑刚
WANG Jie~1, JING Lu~1, ZHONG Jing-bai~1, WANG Yong-yan~2, MA Li-hong~3, LIU Jian-gang~1 (1.Xiyuan Hospital of China Academy of Traditional Chinese Medicine, Beijing 100091, China; 2. China Academy of Traditional Chinese Medicine, Beijing 100700, China; 3. Fuwai Hospital of Chinese Academy of Medical Sciences, Beijing 100037, China)

摘要(Abstract):

目的 :探讨血府逐瘀汤不同拆方治疗冠心病心绞痛血瘀气滞证的临床疗效 ,以期进一步阐明该方作用机理及配伍规律。方法 :12 3例冠心病心绞痛病人随机分为血府逐瘀汤原方组、精制血府逐瘀组、药对配伍组、安慰剂组 4组进行干预治疗。结果 :① 4组心绞痛与血瘀气滞证证候疗效依次为血府逐瘀组 ,精制血府逐瘀组 ,药对组 ,安慰剂组 (P <0 .0 1) ;②血液流变学 :疗后血府逐瘀组全血黏度、血小板黏附性降低 ,红细胞变形性升高 (P <0 .0 5 ) ;精制血府逐瘀组全血黏度、血小板黏附降低 (P <0 .0 5 ) ;药对组血小板黏附、血浆黏度降低 (P <0 .0 1) ;安慰剂组血小板黏附降低、红细胞变形性升高 (P <0 .0 1) ;③ 4组治疗后血脂变化无显著性差异。④ 4组治疗后一氧化氮升高 ,拆方各组有显著性差异 (P <0 .0 5 ) ;4组间治疗后ET无显著性差异 (P >0 .0 5 )。血府逐瘀组组织型纤溶酶原激活物疗后有显著性差异 (P <0 .0 5 ) ;⑤炎症指标 :血府逐瘀组、精制血府逐瘀组、药对组治疗后IL 6均降低 ,安慰剂组治疗后IL 6升高 ,经t检验有显著性差异 (P <0 .0 5 ) ,4组间比较有显著性差异 (P <0 .0 5 )。结论 :①临床疗效及客观指标改善与方剂组成及方证对应的程度相关 ;②血府逐瘀系列拆方药物具有其相同的物质作用基础 ,随着复?
Objective: To investigate the regularity of traditional Chinese compound prescription by observing the clinical effect of the compatibility and dismantlement of Xuefu Zhuyu decoction on blood stasis and stagnation of qi syndrome of angina. Method: 123 outpatients were randomly divided into Xuefu Zhuyu group(XF), Jingzhi Xuefu Zhuyu group(JZ), Yaodui group(YD) and placebo group and treated. Result: The array of angina effect and blood stasis and qi stagnation of syndrome effect was XF group, JZ group, YD group, placebo group(P<0.01). The levels of blood viscosity, platelet adhesiveness ,RED transfigure were significantly different before and after treatment in XF group (P<0.05). The levels of blood viscosity, platelet adhesiveness were significant different before and after treatment in JZ group (P<0.05). The levels of blood plasma viscosity, platelet adhesiveness were significantly different before and after treatment in YD group (P<0.05). The levels of platelet adhesiveness, RED transfigure were significantly different before and after treatment in placebo group (P<0.05). There are no difference among levels of blood lipopritein and ET of four groups (P>0.05). Significant difference was found among four groups in increase of NO and t-PA and decrease of IL-6 (P<0.05). Conclusion: ①The clinical effect and indexes amelioration are correlated to the combination of prescription and the corresponding degree of prescription to syndrome. ②There are same material foundation in the series of Xuefu Zhuyu dismantle decoction, but the function degree and targets are different with the change of herbs. ③The method of conjugating disease and syndromes, and prescription to syndromes are a practical pattern to expound the relationship between disease and syndrome.

关键词(KeyWords): 血府逐瘀汤;拆方;心绞痛;随机双盲安慰剂对照临床研究
Xuefu Zhuyu decoction; prescription dismantlement; angina; randomized doubled-blind placebo-control clinical trial

Abstract:

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基金项目(Foundation): 国家重点基础研究发展规划项目 ( 19990 5 44 0 8)

作者(Author): 王阶,荆鲁,衷敬柏,王永炎,马丽红,刘剑刚
WANG Jie~1, JING Lu~1, ZHONG Jing-bai~1, WANG Yong-yan~2, MA Li-hong~3, LIU Jian-gang~1 (1.Xiyuan Hospital of China Academy of Traditional Chinese Medicine, Beijing 100091, China; 2. China Academy of Traditional Chinese Medicine, Beijing 100700, China; 3. Fuwai Hospital of Chinese Academy of Medical Sciences, Beijing 100037, China)

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