活络利水饮治疗钙离子拮抗剂导致下肢水肿（瘀水互结型）临床观察

发布时间：2019-06-25 14:40

【摘要】：目的：评价活络利水饮治疗瘀水互结型钙离子拮抗剂导致下肢水肿病的临床疗效及中医证候积分,并初步探讨其作用机理。方法：2014年6月至2015年3月,60例服用氨氯地平(22例)、硝苯地平(38例)后出现水肿的轻、中度原发性高血压患者纳入研究。将60例患者随机分为治疗组与对照组,各30例。治疗组西医标准降压基础上加服活络利水饮,对照组西医标准降压加服一定剂量的利尿剂,观察期6周。观察和比较治疗前后水肿程度、中医证候评分的变化情况及其他不良反应事件,采用SPSS19.0软件对数据进行统计分析。结果：1.治疗组与对照组在用药后消肿综合疗效比较,在治疗后中药治疗组未见水肿者13例,轻度水肿者15例,足背仍水肿者2例,利尿剂对照组未见水肿者4例,轻度水肿者6例,足背仍水肿者20例。两组经卡方检验,治疗组比对照组有明显优势(P0.01)。2.治疗组足背凹陷程度在治疗前2.67±0.52mmm,治疗后0.55±0.44mmm,治疗幅度为0.78±0.16；对照组足背凹陷程度在治疗前为2.58±0.55mmm,治疗后1.51±0.76mm,治疗幅度为0.43±0.25,两组治疗前后及治疗幅度经t检验P0.01,有统计学意义。3.治疗组小腿围洗脱后35.59±4.24cm,治疗前为37.90±4.12cm,治疗后35.77±4.25cm,治疗幅度为0.92±0.42；对照组小腿围洗脱后36.22±4.80cm,治疗前为38.5±4.70cm,治疗后37.53±4.64cm,治疗幅度为0.43±0.08,两组治疗前后及治疗幅度经t检验P0.01,有统计学意义。4.治疗组足颈围洗脱后25.53±3.55cm,治疗前为28.08±3.60cm,治疗后25.77±3.55cm,治疗幅度为0.90±0.03。对照组足颈围洗脱后25.88±4.53cm,治疗前为28.23±4.41cm,治疗后26.85±4.54cm,治疗幅度为0.41±0.07。两组治疗前后经t检验皆有明显差异(P0.01)。两组治疗幅度经成组t检验,有明显差异,治疗组明显优于对照组。5.治疗组与对照组在用药后中医证候总积分有显著降低(P0.01),但是治疗后治疗组总积分明显低于对照组,有显著性差异(P0.01)。治疗组中医证候综合疗效总有效率为100%,明显高于对照组40.00%,具有显著差异(P0.01)。在各个症状总有效率上,治疗组优于对照组,各项症状的改善明显优于对照组,具有显著性差异(P0.01)。结论：治疗组在改善钙离子拮抗剂导致下肢水肿病消肿疗效及中医临床症状方面优于对照组。
[Abstract]:Objective: to evaluate the clinical efficacy and TCM syndrome score of Huoluo Lishuiyin in the treatment of lower extremity edema caused by water stasis type calcium antagonists, and to explore its mechanism. Methods: from June 2014 to March 2015, 60 patients with mild to moderate essential hypertension with edema after taking amlodipine (22 cases) and nifedipine (38 cases) were included in the study. Sixty patients were randomly divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated with Huoluo Lishui decoction on the basis of the standard hypotension of western medicine, and the control group was treated with a certain dose of diuretics for 6 weeks. The degree of edema, the changes of TCM syndrome score and other adverse events were observed and compared before and after treatment, and the data were statistically analyzed by SPSS19.0 software. Results: 1. Compared with the control group, there were 13 cases of edema, 15 cases of mild edema, 2 cases of still edema of foot, 4 cases of no edema, 6 cases of mild edema and 20 cases of still edema of foot in the treatment group and the control group after treatment with traditional Chinese medicine (TCM) treatment group (13 cases), 15 cases (15 cases), 2 cases (2 cases), 4 cases (4 cases), 6 cases (6 cases) and 20 cases (20 cases). After chi-square test, the treatment group had obvious advantages over the control group (P01). 2. The degree of foot back depression was 2.67 卤0.52 mm before treatment, 0.55 卤0.44 mm after treatment and 0.78 卤0.16 before treatment, and 2.58 卤0.55 mm before treatment, 1.51 卤0.76 mm after treatment and 0.43 卤0.25 mm after treatment in the control group, and there was significant difference between the two groups before and after treatment (P 0.01, P < 0.05), and the degree of foot back depression was 2.67 卤0.52 mm before and after treatment, 0.55 卤0.44 mm and 0.78 卤0.16 before and after treatment, and 2.58 卤0.55 mm before treatment, 1.51 卤0.76 mm after treatment and 0.43 卤0.25 mm after treatment. In the treatment group, 35.59 卤4.24 cm after leg eluting, 37.90 卤4.12 cm before treatment and 35.77 卤4.25 cm after treatment, the treatment range was 0.92 卤0.42, while that in the control group was 36.22 卤4.80 cm, 38.5 卤4.70 cm before and 37.53 卤4.64 cm after treatment, and the treatment range was 0.43 卤0.08 before and after treatment. In the treatment group, 25.53 卤3.55 cm after neck circumference eluting, 28.08 卤3.60 cm before treatment, 25.77 卤3.55 cm after treatment, and 0.90 卤0.03 cm after treatment. In the control group, 25.88 卤4.53 cm after foot neck eluting, 28.23 卤4.41 cm before treatment and 26.85 卤4.54 cm after treatment, the range of treatment was 0.41 卤0.07. There was significant difference between the two groups before and after treatment by t test (P 0.01). The treatment range of the two groups was significantly different by group t test, and the treatment group was significantly better than the control group. 5. After treatment, the total score of TCM syndromes in the treatment group and the control group was significantly lower than that in the control group (P 0.01), but the total score in the treatment group was significantly lower than that in the control group (P 0.01). The total effective rate of TCM syndrome in the treatment group was 100%, which was significantly higher than that in the control group (40.00%) (P 0.01). The total effective rate of each symptom in the treatment group was better than that in the control group, and the improvement of each symptom was significantly better than that in the control group (P 0.01). Conclusion: the treatment group is superior to the control group in improving the antiswelling effect and clinical symptoms of lower extremity edema caused by calcium antagonists.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R544.1

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