基于温补心肾、活血化瘀治疗缓慢性心律失常的临床研究

发布时间：2017-12-27 12:40

本文关键词：基于温补心肾、活血化瘀治疗缓慢性心律失常的临床研究　出处：《辽宁中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:观察基于温补心肾、活血化瘀法对缓慢性心律失常进行辨证治疗的临床疗效,并探讨中药在缓慢性心律失常起搏治疗术后应用的安全性及其对起搏治疗是否具有优化作用。材料与方法:招募120例确诊为心肾阳虚、血脉瘀阻型的缓慢性心律失常患者,其中植入起搏器者80例,未植入起搏器者40例,未植入起搏器患者接受“温补心肾、活血化瘀”的中医辨证治疗,植入起搏器的80例患者随机分成两组,一组不给于中药治疗,另一组接受“温补心肾、活血化瘀”的中医辨证治疗,进行治疗四周。观察治疗前后三组患者临床变化以及生活质量,并进行中医症状及生活质量评分。结果:心率疗效:参仙升脉组及联合组患者治疗后的平静心率及24h动态心电图各项心率指标均有显著提高(P0.05);起搏组前后变化无显著差异(P0.05);起搏组和联合组治疗后比较有显著性差异(△P0.05),说明参仙升脉+起搏器联合治疗提高心率的疗效优于单纯起搏器治疗。心电图疗效:参仙升脉组为82.50%,起搏器为90.00%,参仙升脉+起搏器组为95.00%,联合组疗效优于单纯起搏器组(P0.05)。中医症状总疗效:参仙升脉组为85.00%,起搏器组为90.00%,参仙升脉+起搏器组为92.50%,参仙升脉+起搏器组疗效优于起搏器组(P0.05)。单项证侯评分比较:各组患者治疗后中医证候均有改善。除对胸闷症状的疗效起搏组优于参仙升脉+起搏组(P0.05),其余各单项疗效参仙升脉+起搏组均优于起搏组(P0.05)。生活质量评分:起搏器组与联合组治疗前生活质量评估无差异,不具有统计学意义,两组具有可比性(P0.05)。参仙升脉组与联合组治疗后患者生活质量均明显提高,各项计分经计算后比较,均有统计学意义(P均0.05);起搏器组治疗前后生活质量评估无差异,不具有统计学意义(P0.05),说明其他干扰因素对生活质量的影响不具备统计学意义;起搏器组与联合组治疗后生活质量评估组间差异显著,具有统计学意义(P0.05),说明中药对起搏器术后患者生活质量有改善作用。各组治疗前后在肝、肾功能和血、尿、便常规方面均无明显异常(P0.05)。结论:基于温补心肾、活血化瘀法辨证治疗缓慢性心律失常疗效显著,能显著提高心率,并对患者的临床症状及生存质量有一定的改善,无任何明显毒副作用。联合组较单纯起搏组中医症状改变明显,进一步说明中药在缓慢性心律失常起搏治疗术后的应用对起搏治疗具有优化作用。
[Abstract]:Objective: To observe the clinical effect of warming and invigorating heart and kidney, promoting blood circulation and removing blood stasis on slow arrhythmia syndrome treatment, and explore the application of traditional Chinese medicine on slow arrhythmia pacing treatment after operation on the safety and pacing therapy whether had the effect of optimization. Materials and methods: the recruitment of 120 cases were diagnosed as deficiency of heart and kidney yang and blood stasis type of slow arrhythmia patients, including 80 cases of pacemaker implantation, 40 cases without pacemaker implantation, no pacemaker implantation patients received TCM treatment of warming and invigorating heart and kidney, promoting blood circulation and removing blood stasis ", implanted pacemaker randomly 80 cases divided into two groups, one group was not given to Chinese medicine treatment, another group received the TCM treatment of warming and invigorating heart and kidney, promoting blood circulation and removing blood stasis", for treatment. The clinical changes and quality of life were observed before and after the treatment of the three groups, and the symptoms and quality of life of the Chinese medicine were scored. Results: the curative effect of heart rate: Shenxian Shengmai group and combined group patients after the calm heart rate and 24h dynamic electrocardiogram of the heart rate increased significantly (P0.05); no significant difference before and after the change of pacing group (P0.05); pacing group and combined group after treatment had significant difference (P0.05), that. Xian Shengmai combined therapy + pacemaker pacemaker therapy improve curative effect is better than pure heart rate. The electrocardiogram effect: the Shen Xian Shengmai group was 82.50%, the pacemaker was 90%, the Shen Xian Shengmai + pacemaker group was 95%, and the combined group was better than the simple pacemaker group (P0.05). The total curative effect of TCM symptoms is: Shen Xian Sheng Mai group is 85%, pacemaker group is 90%, Shen Xian Sheng pulse + pacemaker group is 92.50%, the effect of Shen Xian Sheng Mai + pacemaker group is better than pacemaker group (P0.05). The comparison of the score of single syndrome: the TCM syndromes were improved after the treatment of the patients in each group. The pacing group was superior to the Shen Xian Shengmai + pacing group (P0.05) except for the symptoms of chest tightness. All the other curative effects of Shen Xian Shengmai + pacing group were better than that of the pacing group (P0.05). Quality of life score: there was no difference between the pacemaker group and the combined group before the treatment, and there was no statistical significance. The two groups were comparable (P0.05). Shenxian Shengmai group and combined treatment group were significantly improved after the quality of life of patients, after the score was calculated, were statistically significant (P < 0.05); the treatment group before and after pacemaker evaluation of quality of life of no difference was not statistically significant (P0.05), shows the influence of other factors on the quality of life does not have statistical significance pacemaker; group and combined treatment group after the assessment of the quality of life significantly, with statistical significance (P0.05), Chinese medicine has effect on improving the quality of life of patients after pacemaker implantation. There was no obvious abnormality in liver, kidney function, blood, urine and routine routine before and after treatment (P0.05). Conclusion: Based on the hearts and kidneys, promoting blood circulation and removing blood stasis syndrome differentiation and treatment of slow arrhythmia has obvious curative effect, can significantly improve the heart rate, and can improve the clinical symptoms and quality of life, without any obvious side effect. Compared with pacemaker group, the TCM symptoms of the combined group changed significantly, indicating that the application of Chinese medicine in pacing after bradyarrhythmia has an optimized effect on pacing therapy.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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