研究疾病:
|
稳定性冠心病合并焦虑抑郁状态
|
研究疾病代码:
|
|
Target disease:
|
Stable coronary heart disease complicated with anxiety and depression
|
Target disease code:
|
研究类型:
Study type:
|
干预性研究
Interventional study
|
研究设计:
Study design:
|
随机平行对照
randomized controlled trial(parallel group design)
|
研究所处阶段:
Study phase:
|
探索性研究/预试验
Pilot clinical trial
|
研究目的:
|
评价血府逐瘀汤治疗稳定性冠心病合并焦虑抑郁状态气滞血瘀证的临床疗效和安全性,为临床治疗提供客观证据。
|
Objectives of Study:
|
Evaluate the clinical efficacy and safety of Xuefu Zhuyu Tang in treating stable coronary heart disease with anxiety and depression qi stagnation and blood stasis syndrome and provide objective evidence for clinical treatment.
|
药物成份或治疗方案详述:
|
1.受试者基础治疗
(1)药物:两组患者西药治疗均参考《慢性稳定性心绞痛诊断与治疗指南》,选用以下药物:
阿司匹林肠溶片100 mg,每日一次,口服;或硫酸氯吡格雷片75 mg,每日一次,口服。
琥珀酸美托洛尔缓释片11.875-95 mg,每日一次,口服。
阿托伐他汀钙片20 mg,每晚一次,口服;或瑞舒伐他汀钙片5-10 mg,每晚一次。
单硝酸异山梨酯片20 mg,每日两次,口服。
必要时可加用CCB类。
(2)精神干预:每周由研究团队的本院身心医学科医师进行线上心理健康宣教。统一宣教内容,每周定时发送即可,对所有入组患者做健康宣教和引导。
2.试验组:在冠心病的常规西药治疗基础上给予血府逐瘀汤颗粒剂治疗。血府逐瘀汤的组成:桃仁9 g(批号G4041033,山东一方制药有限公司)、红花9 g(批号G4060283,山东一方制药有限公司)、当归9 g(批号G4060313,山东一方制药有限公司)、生地黄9 g(批号G4050073,山东一方制药有限公司)、川芎9 g(批号G4040723,山东一方制药有限公司)、赤芍9 g(批号G4031103,山东一方制药有限公司)、牛膝9 g(批号G4050203,山东一方制药有限公司)、桔梗6 g(批号G4040393,山东一方制药有限公司)、柴胡9 g(批号G4020553,山东一方制药有限公司)、枳壳9 g(批号G4030783,山东一方制药有限公司)、甘草6 g(批号G4031053,山东一方制药有限公司)。上述中药颗粒剂均由山东一方制药有限公司制备。每日1剂,分2次用温开水150 ml冲服,早晚各1次。
3.对照组:在冠心病的常规西药治疗基础上给予血府逐瘀汤颗粒安慰剂。
4.疗程:4周。
|
Description for medicine or protocol of treatment in detail:
|
1. Basic treatment for subjects
(1) Medication: Both groups of patients were treated with Western medicine in accordance with the Diagnosis and Treatment Guidelines for Chronic Stable Angina Pectoris and the following medications were selected:
Aspirin enteric coated tablets 100 mg once daily orally administered; Or clopidogrel sulfate tablets 75 mg once daily orally.
Metoprolol Succinate Extended Release Tablets 11.875-95 mg once daily orally.
Atorvastatin Calcium Tablets 20mg once per night orally administered; Or Rosuvastatin Calcium Tablets 5-10 mg once a night.
Isosorbide Mononitrate Tablets 20mg taken orally twice daily.
If necessary CCB type can be added.
(2) Psychological intervention: Weekly online mental health education is conducted by the physical and mental medicine physicians of our research team. Unified educational content can be sent on a weekly basis providing health education and guidance to all enrolled patients.
2. Experimental group: On the basis of conventional Western medicine treatment for coronary heart disease Xuefu Zhuyu Tang granules were given for treatment. The composition of Xuefu Zhuyu Tang: Taoren 9g (batch number G4041033 Shandong Yifang Pharmaceutical Co. Ltd.) Honghua 9g (batch number G4060283 Shandong Yifang Pharmaceutical Co. Ltd.) Danggui 9g (batch number G4060313 Shandong Yifang Pharmaceutical Co. Ltd.) Shengdihuang 9g (batch number G4050073 Shandong Yifang Pharmaceutical Co. Ltd.) Chuanxiong 9g (batch number G4040723 Shandong Yifang Pharmaceutical Co. Ltd.) Chishao 9g (batch number G4031103 Shandong Yifang Pharmaceutical Co. Ltd.) Achyranthes 9g (batch number G4050203 Shandong Yifang Pharmaceutical Co. Ltd.) Campanula 6g (batch number G4040393 Shandong Yifang Pharmaceutical Co. Ltd.) Chaihu 9g (batch number G4020553 Shandong Yifang Pharmaceutical Co. Ltd.) Fructus Aurantii 9g (batch number G4030783 Shandong Yifang Pharmaceutical Co. Ltd.) Licorice 6g (batch number G4031053 Shandong Yifang Pharmaceutical Co. Ltd.). The above-mentioned traditional Chinese medicine granules were prepared by Shandong Yifang Pharmaceutical Co. Ltd. Take 1 dose per day divided into 2 times and diluted with 150ml of warm water once in the morning and once in the evening.
3. Control group: On the basis of conventional Western medicine treatment for coronary heart disease Xuefu Zhuyu Tang granules were given as a placebo.
4. Course of treatment: 4 weeks.
|
纳入标准:
|
1.符合稳定性冠心病西医诊断标准,并伴有焦虑抑郁状态情绪的患者;
2.符合中医胸痹心痛气滞血瘀证诊断标准;
3.HAMA评分7-28 分和/或 HAMD评分 8-35分,属于轻中度焦虑抑郁状态者;
4.近4周未使用其他抗焦虑抑郁的药物;
5.年龄18-80周岁(包括18周岁和80周岁),不限性别;
6.受试者自愿参加本次试验研究,依从性好且能长期随访者,并签署知情同意书。
|
Inclusion criteria
|
1. Patients who meet the Western diagnostic criteria for stable coronary heart disease and are accompanied by anxiety and depression;
2. Meet the diagnostic criteria of traditional Chinese medicine for chest obstruction heartache qi stagnation and blood stasis syndrome;
3. Individuals with a HAMA score of 7-28 and/or a HAMD score of 8-35 are classified as having mild to moderate anxiety and depression;
4. Have not used other anti anxiety and depression medications in the past 4 weeks;
5. Age range of 18-80 years old (including 18 and 80 years old) regardless of gender;
6. The subjects voluntarily participate in this experimental study have good compliance and can be followed up for a long time and sign an informed consent form.
|
排除标准:
|
1.急性心肌梗死、不稳定型心绞痛、心绞痛严重程度分级IV级患者;
2.因洋地黄药物、心肌肥厚、左束支传导阻滞等其它原因导致心电图ST-T改变者;
3.预期或计划在临床研究过程中行冠状动脉、脑血管或外周动脉血运重建术或其它较大的外科手术者;
4.冠脉造影显示严重血管病变:左主干直径狭窄>50%;前降支近段直径狭窄>70%;病变血管直径狭窄≥90%;当病变血管直径狭窄<90%时,血流储备分数≤0.8;
5.同时合并以下器官损害或疾病者:合并有严重脑血管病(脑出血、蛛网膜下腔出血、大面积脑梗死);控制不良的糖尿病(空腹血糖>11 mmol/L)或合并肾病、周围神经病变者;失代偿性心力衰竭(NYHA III—IV级)、恶性心律失常反复发作者、控制不良的高血压(控制后收缩压≥180 mmHg或舒张压大≥100 mmHg);应用心脏起搏器及脑血管疾病发作史在1年内者;呼吸衰竭、慢性肺病伴有呼吸困难者;肾功能不全者(肌酐大于正常值上限,肾小球滤过率(eGFR)<30 ml·min-1·(1.73 m²)-1);肝功能异常(ALT、AST大于3倍正常值上限);胃肠病变或胃肠手术后有可能影响药物吸收及其他消化系统严重疾病;合并恶性肿瘤、血液系统疾病或其他系统严重或进行性疾病者。合并其他疾病,并经研究者判定不宜入组的情况;
6.入组前3个月内参加过其他药物临床试验的患者;
7.妊娠、哺乳期妇女或近期有计划妊娠者;
8.合并其他精神疾病、意识障碍、认知障碍或其他原因而无法合作或不愿合作患者;
9.怀疑或确有酒精、药物滥用史者;
10.过敏体质或对药物成分过敏者;
11.研究者认为其他不宜参加本临床试验患者。
|
Exclusion criteria:
|
1. Patients with acute myocardial infarction unstable angina and angina severity grade IV;
2. Patients with ST-T changes on electrocardiogram due to digitalis drugs myocardial hypertrophy left bundle branch block and other reasons;
3. Patients who expect or plan to undergo coronary artery cerebrovascular or peripheral artery revascularization surgery or other major surgical procedures during the clinical research process;
4. Coronary angiography shows severe vascular disease: left main artery diameter stenosis>50%; The diameter stenosis of the proximal segment of the anterior descending branch is greater than 70%; Disease vessel diameter stenosis ≥ 90%; When the diameter of the diseased vessel is narrowed by less than 90% the fractional flow reserve is ≤ 0.8;
5. Patients with concurrent organ damage or disease: those with severe cerebrovascular disease (cerebral hemorrhage subarachnoid hemorrhage extensive cerebral infarction); Poor control of diabetes (fasting blood glucose>11 mmol/L) or patients with kidney disease and peripheral neuropathy; Decompensated heart failure (NYHA class III-IV) recurrent malignant arrhythmias poorly controlled hypertension (controlled systolic blood pressure ≥ 180 mmHg or diastolic blood pressure ≥ 100 mmHg); Individuals who have used pacemakers and have a history of cerebrovascular disease within one year; People with respiratory failure chronic lung disease accompanied by breathing difficulties; Individuals with renal insufficiency (creatinine greater than the upper limit of normal glomerular filtration rate (eGFR)<30 ml · min-1 · (1.73 m ²) -1); Abnormal liver function (ALT AST greater than 3 times the upper limit of normal); Gastrointestinal lesions or gastrointestinal surgery may affect drug absorption and other serious digestive system diseases; Those who have combined malignant tumors hematological diseases or other serious or progressive systemic diseases. Combining other diseases and being deemed unsuitable for inclusion by researchers;
6. Patients who have participated in clinical trials of other drugs within the past 3 months prior to enrollment;
7. Pregnant or lactating women or those who have recently planned a pregnancy;
8. Patients with other mental illnesses consciousness disorders cognitive impairments or other reasons who are unable or unwilling to cooperate;
9. Suspect or have a history of alcohol or drug abuse;
10. Individuals with allergies or allergies to drug ingredients;
11. Researchers believe that other patients who are not suitable to participate in this clinical trial.
|
研究实施时间:
Study execute time:
|
从From
2025-05-01
至To
2026-03-01
|
征募观察对象时间:
Recruiting time:
|
从From
2025-05-01
至To
2026-01-01
|