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目的:观察针刺联合西医规范化治疗对不同心肌梗死溶栓(the thrombolysis in myocardial infarction,TIMI)危险程度分层不稳定型心绞痛(unstable angina,UA)患者血瘀证的干预作用。方法:根据TIMI评分量表的危险评分值,纳入符合标准的UA患者72例,其中低危(0~2分)组24例、中危(3~4分)组24例与高危(5~7分)组24例。3组患者均在采用常规西医规范治疗基础上,配合针刺心俞、血海、膈俞、膻中、厥阴俞、郄门、内关等穴,每天1次,14d为一疗程,1个疗程后观察心绞痛症状、四肢末端紫绀或麻木、口唇及齿龈色暗、舌下脉络曲张、舌质紫暗或有瘀斑、脉涩或结代各单项症状积分及血瘀证总积分变化。结果:各组分别脱落1例,每组23例纳入统计。3组治疗后心绞痛症状评分、血瘀证总积分均显著改善(均P<0.01),高危组血瘀证中各单项症状积分及总积分的改善程度优于低危组及中危组(P<0.05,P<0.01)。结论:随着UA患者TIMI评分的增加,血瘀程度也随之加重,针刺联合西医规范治疗可有效干预血瘀证,尤其对TIMI评分高危组患者治疗后血瘀证积分的改善更为明显。
Objective: To observe the intervention effect of acupuncture combined with western medicine on blood stasis syndrome in patients with unstable angina (UA) with different risk of thrombolysis in myocardial infarction (TIMI). Methods: According to the risk score of TIMI scale, 72 patients with UA were enrolled in this study. Among them, 24 patients were in low risk (0-2) group, 24 patients in moderate risk (3-4 patients) group and high risk 7 points) group of 24 cases. All patients in the three groups were treated with conventional western medicine and standard acupuncture combined with acupuncture at Xinshu, Xuehai, Geshu, Langzhong, Jueyinjushu, Huangmen and Neiguan, once a day for 14 days After a course of treatment of angina symptoms, extremities cyanosis or numbness, dark lips and gums, sublingual choroidal varicose veins, dark purple tongue or petechiae, pulse astringent or combined with each single symptom score and blood stasis syndrome total score changes. Results: Each group were shedding one case, 23 cases in each group were included in the statistics. The score of angina pectoris and the total score of blood stasis syndrome in the three groups were significantly improved (all P <0.01). The improvement of individual symptom score and total score in the high risk group was better than that in the low risk group and the intermediate risk group (P <0.05, P <0.01). Conclusion: With the increase of TIMI score in UA patients, the blood stasis degree also aggravates. Acupuncture plus western medicine can effectively intervene the blood stasis syndrome, especially for the patients with high risk TIMI score .