丹郁调心舒治疗射血分数保留性心衰患者的临床观察
发布时间：2019-03-27 13:02
【摘要】：研究目的:本课题旨在观察丹郁调心舒联合西药治疗中医辨证为肝肾不足,心血瘀阻证射血分数保留性心衰(HFPEF)患者的临床疗效及安全性,探讨其对HFPEF的心功能、超氧化物歧化酶(SOD)、血脂、中医症状及生活质量的影响,为临床开发治疗肝肾不足,心血瘀阻证HFPEF中药新药提供临床数据。研究方法:采用随机单盲法,将符合诊断纳入标准的72例患者分为治疗组、对照组。对照组采用常规西药治疗,治疗组在对照组基础上加用丹郁调心舒治疗,疗程3月。观察比较两组HFPEF患者治疗前后脑钠肽(BNP)、心脏超声(E/A、DT、LA、E/E’)、SOD、血脂(TC、TG、HDL-C、LDL-C)、6分钟步行试验(6MWD)、中医症状积分、明尼苏达生活质量评分(MLHFQ)、肝肾功能、电解质,并对治疗后两组间的数据进行对比分析和统计学处理。研究结果:1.研究期间,两组治疗前后肝功能(AST、ALT)、肾功能(Scr、BUN)、电解质(K+、Na+)进行比较,均无异常(P0.05)。2.两组治疗前后患者BNP、6MWD水平比较均有差异,其中对照组BNP、6MWD差异非常显著(P0.01),治疗组BNP、6MWD差异非常显著(P0.01)。治疗组与对照组治疗后比较BNP、6MWD差异显著(P0.05)。3.两组治疗前后患者心脏超声指标比较均有差异,其中对照组E/A、LA差异显著(P0.05),E/E’、DT差异非常显著(P0.01),治疗组DT差异显著(P0.05),E/A、E/E’、LA差异非常显著(P0.01)。治疗组与对照组治疗后比较无差异(P0.05)。4.两组治疗前后患者MLHFQ比较均有差异,其中对照组躯体状况、情绪状况、其他状况评分差异非常显著(P0.01),治疗组躯体状况、情绪状况、其他状况评分差异非常显著(P0.01)。治疗组与对照组治疗后比较,躯体状况、其他状况评分差异显著(P0.05),情绪状况评分差异非常显著(P0.01)。5.两组治疗前后患者血脂比较均有差异,其中对照组LDL-C差异显著(P0.05),TC、TG、HDL-C差异非常显著(P0.01);治疗组TC、TG、LDL-C、HDL-C差异非常显著(P0.01)。治疗组与对照组治疗后比较,TC、HDL-C无差异(P0.05),TG、LDL-C差异显著(P0.05)。6.两组治疗前后患者SOD比较均有差异,其中对照组SOD差异显著(P0.05),治疗组SOD差异非常显著(P0.01)。治疗组与对照组治疗后比较差异非常显著(P0.01)。7.两组治疗前后患者单项中医症状评分、中医症候疗效比较均有差异。治疗组与对照组单项中医症状评分治疗后比较,心悸、胸闷(痛)、气喘、气短、失眠、畏寒肢冷、面肢浮肿无差异(P0.05),眩晕、腰膝酸软、疲倦乏力差异显著(P0.05),耳鸣差异非常显著(P0.01)。治疗组与对照组中医症候积分疗效治疗后比较,心悸、气喘、气短、失眠、耳鸣、腰膝酸软、畏寒肢冷、面肢浮肿无差异(P0.05),胸闷(痛)、疲倦乏力差异显著(P0.05),眩晕差异非常显著(P0.01)。结论:1.丹郁调心舒组方有较好的安全性。2.两组治疗均能改善患者HFPEF心功能,治疗组疗效优于对照组。3.两组治疗均能改善患者的MLHFQ,治疗组疗效优于对照组,在情绪状况改善方面治疗组较为突出。4.两组治疗均能改善患者的血脂水平,治疗组TG、LDL-C疗效优于对照组。5.两组治疗均能改善患者的SOD水平,治疗组疗效显著优于对照组。6.两组均能改善患者的中医症状,治疗组改善优于对照组,其中以胸闷(痛)、眩晕、腰膝酸软、疲倦乏力、耳鸣症状改善较为显著。
[Abstract]:Objective: To observe the clinical effect and safety of the combination of the combination of Danone and the western medicine in the treatment of the deficiency of the liver and the kidney, the blood stasis and the ejection fraction of the patients with heart failure (HFPEF), and to study the cardiac function, the superoxide dismutase (SOD) and the blood lipid of the patients with HFPEF. The effect of the symptoms and the quality of life of the Chinese medicine is to provide clinical data for the clinical development of the traditional Chinese medicine for treating the deficiency of the liver and the kidney, the blood stasis and the blood stasis syndrome HFPEF. Methods:72 patients who met the criteria of diagnosis were divided into treatment group and control group by random single-blind method. The control group was treated with conventional western medicine, and the treatment group was treated with Danone's self-aligning shu on the basis of the control group, and the course of treatment was 3 months. The treatment of brain natriuretic peptide (BNP), cardiac ultrasound (E/ A, DT, LA, E/ E '), SOD, blood lipid (TC, TG, HDL-C, LDL-C),6-minute walk test (6MWD), symptom integration of TCM, Minnesota life quality score (MLHFQ), liver and kidney function, electrolyte, The results of the study were as follows:1. During the study, the liver function (AST, ALT), renal function (Scr, BUN), electrolyte (K +, Na +) before and after treatment were compared. The BNP and 6MWD of the control group were significantly different (P0.01), and the difference of BNP and 6MWD in the treatment group was very significant (P0.01). BNP was compared in the treatment group and the control group. The difference between the two groups was significant (P0.05). The difference between the two groups was significant (P0.05), the difference of E/ E 'and DT was very significant (P0.01), and the difference of DT in the treatment group was significant (P0.05), E/ A, E/ E', The LA difference was very significant (P0.01). There was no difference between the treatment group and the control group (P0.05). The scores of the other conditions were significantly different (P0.01). After the treatment group and the control group, the scores of body condition and other conditions were significantly different (P0.05), and the scores of emotional state scores were very significant (P0.01). In the control group, the difference of LDL-C was significant (P0.05), and the difference of TC, TG, HDL-C was very significant (P0.01). The difference of TC, TG, LDL-C and HDL-C in the treatment group was very significant (P0.01). The difference of SOD between the two groups was significant (P0.05). The difference of SOD in the control group was significant (P <0.01). The difference between the treatment group and the control group was very significant (P0.01). There was a difference in the curative effect of the symptom of the Chinese medicine. After the treatment group and the control group, the symptom scores of the single Chinese medicine were compared, the palpitations, the chest distress (pain), the asthma, the shortness of breath, the insomnia, the cold of the cold limbs and the edema of the surface limbs were not different (P0.05), the dizziness, the soreness of the waist and knees and the fatigue and weakness were significant (P0.05). The difference of tinnitus was very significant (P0.01). The treatment group and the control group were compared with the control group for the treatment of symptoms and symptoms, palpitations, asthma, shortness of breath, insomnia, tinnitus, soreness of the waist and knees, cold and cold limbs, no difference in edema of the surface limbs (P0.05), chest distress (pain) and fatigue and fatigue (P0.05). Conclusion:1. The combination of the two groups can improve the function of HFPEF in the patients, and the curative effect of the treatment group is better than that of the control group.3. Both groups can improve the MLHFQ of the patients, and the curative effect of the treatment group is better than that of the control group. 4. The treatment group was more prominent in the improvement of emotional state.4. Both groups can improve the blood lipid level of the patients, and the curative effect of TG and LDL-C in the treatment group is better than that of the control group.5. Both groups can improve the SOD level of the patients. The curative effect of the treatment group is better than that of the control group.6. Both groups can improve the symptoms of the Chinese medicine of the patient, and the improvement of the treatment group is better than that of the control group, in which the symptoms of chest distress (pain), vertigo, soreness of the waist and knees, fatigue and weakness, and the improvement of the tinnitus symptom are more remarkable.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.6
本文编号：2448205
[Abstract]:Objective: To observe the clinical effect and safety of the combination of the combination of Danone and the western medicine in the treatment of the deficiency of the liver and the kidney, the blood stasis and the ejection fraction of the patients with heart failure (HFPEF), and to study the cardiac function, the superoxide dismutase (SOD) and the blood lipid of the patients with HFPEF. The effect of the symptoms and the quality of life of the Chinese medicine is to provide clinical data for the clinical development of the traditional Chinese medicine for treating the deficiency of the liver and the kidney, the blood stasis and the blood stasis syndrome HFPEF. Methods:72 patients who met the criteria of diagnosis were divided into treatment group and control group by random single-blind method. The control group was treated with conventional western medicine, and the treatment group was treated with Danone's self-aligning shu on the basis of the control group, and the course of treatment was 3 months. The treatment of brain natriuretic peptide (BNP), cardiac ultrasound (E/ A, DT, LA, E/ E '), SOD, blood lipid (TC, TG, HDL-C, LDL-C),6-minute walk test (6MWD), symptom integration of TCM, Minnesota life quality score (MLHFQ), liver and kidney function, electrolyte, The results of the study were as follows:1. During the study, the liver function (AST, ALT), renal function (Scr, BUN), electrolyte (K +, Na +) before and after treatment were compared. The BNP and 6MWD of the control group were significantly different (P0.01), and the difference of BNP and 6MWD in the treatment group was very significant (P0.01). BNP was compared in the treatment group and the control group. The difference between the two groups was significant (P0.05). The difference between the two groups was significant (P0.05), the difference of E/ E 'and DT was very significant (P0.01), and the difference of DT in the treatment group was significant (P0.05), E/ A, E/ E', The LA difference was very significant (P0.01). There was no difference between the treatment group and the control group (P0.05). The scores of the other conditions were significantly different (P0.01). After the treatment group and the control group, the scores of body condition and other conditions were significantly different (P0.05), and the scores of emotional state scores were very significant (P0.01). In the control group, the difference of LDL-C was significant (P0.05), and the difference of TC, TG, HDL-C was very significant (P0.01). The difference of TC, TG, LDL-C and HDL-C in the treatment group was very significant (P0.01). The difference of SOD between the two groups was significant (P0.05). The difference of SOD in the control group was significant (P <0.01). The difference between the treatment group and the control group was very significant (P0.01). There was a difference in the curative effect of the symptom of the Chinese medicine. After the treatment group and the control group, the symptom scores of the single Chinese medicine were compared, the palpitations, the chest distress (pain), the asthma, the shortness of breath, the insomnia, the cold of the cold limbs and the edema of the surface limbs were not different (P0.05), the dizziness, the soreness of the waist and knees and the fatigue and weakness were significant (P0.05). The difference of tinnitus was very significant (P0.01). The treatment group and the control group were compared with the control group for the treatment of symptoms and symptoms, palpitations, asthma, shortness of breath, insomnia, tinnitus, soreness of the waist and knees, cold and cold limbs, no difference in edema of the surface limbs (P0.05), chest distress (pain) and fatigue and fatigue (P0.05). Conclusion:1. The combination of the two groups can improve the function of HFPEF in the patients, and the curative effect of the treatment group is better than that of the control group.3. Both groups can improve the MLHFQ of the patients, and the curative effect of the treatment group is better than that of the control group. 4. The treatment group was more prominent in the improvement of emotional state.4. Both groups can improve the blood lipid level of the patients, and the curative effect of TG and LDL-C in the treatment group is better than that of the control group.5. Both groups can improve the SOD level of the patients. The curative effect of the treatment group is better than that of the control group.6. Both groups can improve the symptoms of the Chinese medicine of the patient, and the improvement of the treatment group is better than that of the control group, in which the symptoms of chest distress (pain), vertigo, soreness of the waist and knees, fatigue and weakness, and the improvement of the tinnitus symptom are more remarkable.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.6
【参考文献】
相关期刊论文 前10条
1 李金伟;邓浪;严静;;射血分数保留的心力衰竭研究进展[J];中国医师进修杂志;2015年06期
2 任春琦;张盼;赵春勇;赵慧慧;;6分钟步行运动训练对射血分数保留的心力衰竭患者运动耐力的影响[J];中外医学研究;2014年30期
3 沈晓旭;马苏林;王君;李俊平;王显;王硕仁;;舒张性心力衰竭与中医证候分型相关性研究[J];中国中医药信息杂志;2014年09期
4 张健;邹长虹;;2014年中国心力衰竭指南更新亮点解读[J];中国循环杂志;2014年05期
5 林建民;宫丽鸿;于波;;中医药对舒张性心力衰竭患者的BNP和6min步行试验的影响[J];世界中西医结合杂志;2013年03期
6 闫明昌;赵春芝;张东菊;;6分钟步行试验和脑钠肽对缬沙坦治疗慢性充血性心力衰竭的疗效评价[J];中国医学创新;2013年04期
7 曹全;姜红;;左室射血分数保留的心力衰竭研究进展[J];中国实用内科杂志;2012年04期
8 牛天福;刘朋云;李娟;祁慧霞;耿强;;八味通络颗粒治疗舒张性心力衰竭30例临床观察[J];中西医结合心脑血管病杂志;2011年01期
9 朱明军;李彬;王永霞;;充血性心力衰竭中医病因病机分析[J];世界中西医结合杂志;2009年01期
10 李松松;刘克强;张东玲;;脑钠肽对左室舒张功能不全诊断价值的研究[J];天津医药;2008年01期
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