人参养荣汤加减方对心肺气虚型慢性心力衰竭合并缺铁性贫血的疗效观察

发布时间：2018-03-18 04:38

本文选题：人参养荣汤　切入点：慢性心力衰竭　出处：《福建中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究旨在观察人参养荣汤加减方对心肺气虚型慢性心力衰竭合并缺铁性贫血的临床疗效,为慢性心力衰竭合并缺铁性贫血的治疗提供新的中医思路。方法:将2016年1月-2017年1月期间在我院门诊及病房诊断为慢性心力衰竭合并缺铁性贫血(中医辨证为心肺气虚型)的60例患者,根据随机对照原则,将其分成对照组与治疗组各30例。对照组采用慢性心力衰竭的常规西药治疗:β受体阻滞剂(美托洛尔缓释片(倍他乐克)23.75-47.5mgqd;醛固酮拮抗剂(螺内酯20-40mgqd);血管紧张素转换酶抑制剂(ACEI)类药物(培哚普利(雅施达)4-8mgqd),有合并症者相应对症治疗;治疗组在对照组常规抗心衰西药治疗基础上,同时予人参养荣汤加减方,每日两次(方药组成固定:人参10g,当归15g,黄芪20g,白术10g,茯苓茶10g,陈皮10g,益母草20g,白芍10g,丹参15g,炙甘草10g)。两组疗程均为4周,观察治疗前后心功能、NT-proBNP、Hb、转铁蛋白饱和度、HFEI、中医证候量化评分的变化,并监测肝肾功能及其不良反应。结果采用SPSS20统计软件进行数据分析。结果:1、两组心衰患者年龄、性别构成、原发疾病、NT-proBNP、Hb、转铁蛋白饱和度、纽约心功能分级、HFEI等病情程度分布差异无统计学意义(P0.05)。2、两组均能改善临床中医证候,与对照组相比,治疗组改善临床证候效果更明显(P0.05)。3、两组NT-proBNP、转铁蛋白饱和度、HFEI、心功能分级较治疗前相比均有明显改善,与对照组相比,治疗组效果更优于对照组(P0.05)。4、两组患者均顺利完成试验,未发生明显或严重不良反应。结论:1、人参养荣汤加减方对心肺气虚型慢性心力衰竭合并缺铁性贫血的患者能较好的减轻临床症状,改善NT-proBNP,提高心功能分级,减少心力衰竭超声心动图综合参数,优于常规抗心衰治疗对照组。2、人参养荣汤加减方对心肺气虚型慢性心力衰竭合并缺铁性贫血的患者能较好改善Hb、转铁蛋白饱和度指标,优于常规抗心衰治疗对照组。3、人参养荣汤加减方在治疗观察过程中未见明显的不良反应及毒副作用,故其安全性良好。
[Abstract]:Objective: to observe the clinical effect of Shenyangrong decoction on chronic heart failure complicated with iron deficiency anemia of heart and lung qi deficiency type. Methods: from January 2016 to January 2017, the outpatients and wards of our hospital were diagnosed as chronic heart failure with iron deficiency anemia. Of 60 patients with deficiency of heart and lung qi, According to the principle of random control, The control group was divided into control group (n = 30) and treatment group (n = 30). The control group was treated with conventional western medicine for chronic heart failure: 尾 -receptor blocker (metoprolol sustained release tablet (betaloprolol 23.75-47.5 mg / qd); aldosterone antagonist (spironolactone 20-40mgqdN; angiotensin converting). Enzyme exchange inhibitor ACEI (perindopril 4-8mgqdD) for patients with complications; The treatment group was treated with Ginseng Yangrong decoction on the basis of routine anti-heart failure medicine in the control group. Two times a day (prescription composition: ginseng 10g, Angelica 15g, Astragalus 20g, Atractylodes macrocephala 10g, Poria cocos tea 10g, old skin 10g, motherwort 20g, Radix Paeoniae Alba 10g, Salvia miltiorrhiza 15g, Radix Glycyrrhiza 10g). Before and after treatment, the changes of NT-proBNPN HB, transferrin saturation and the quantitative score of TCM syndromes were observed, and the liver and kidney function and its adverse reactions were monitored. Results the data were analyzed by SPSS20 software. Results the age and sex composition of the two groups of patients with heart failure were analyzed by SPSS20 software. The distribution of NT-proBNPN Hb, transferrin saturation, New York cardiac function grading and HFEI were not significantly different between the two groups. The two groups could improve the clinical syndrome of TCM, compared with the control group. NT-proBNPP, transferrin saturation, HFEI, cardiac function grade were improved significantly in the treatment group. Compared with the control group, the effect of the treatment group was better than that of the control group (P 0.05 .4), and the two groups completed the test successfully, and compared with the control group, the effect of the treatment group was better than that of the control group. No significant or serious adverse reactions occurred. Conclusion the decoction of "1: 1", "Ginseng Yangrong decoction" can relieve the clinical symptoms, improve NT-proBNPs and improve the classification of cardiac function in patients with chronic heart failure complicated with iron deficiency anemia of cardiopulmonary qi deficiency type. Reducing the comprehensive parameters of heart failure echocardiography was better than that of the control group of routine anti-heart failure therapy. The decoction of Ginseng Yangrong decoction could improve the indexes of HB and transferrin saturation in patients with chronic heart failure with deficiency anemia of heart and lung qi deficiency. It is superior to the control group of routine anti-heart failure treatment. The decoction of Ginseng Yangrong decoction has no obvious side effects and side effects in the course of treatment observation, so its safety is good.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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