生脉散加减治疗心肌梗死后心绞痛气阴两虚型的临床疗效评价

发布时间：2017-12-28 05:17

本文关键词：生脉散加减治疗心肌梗死后心绞痛气阴两虚型的临床疗效评价　出处：《山东中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:本试验旨在观察生脉散加减治疗气阴两虚型心肌梗死后心绞痛的临床疗效,评价其安全性,并初步探究其作用机理。方法:将笔者自2015年4月至2016年2月于山东中医药大学附属医院心内科门诊、病房及综合内科病房实习收集的60例病例,符合气阴两虚型心肌梗死后心绞痛的纳入排除标准,随机分为中药治疗组与对照组,每组30例,两组患者的一般情况无统计学差异。两组均给予西医常规综合治疗,中药治疗组在此基础上加服加减生脉散,日一剂,分早、晚两次饭后温服。试验为期4周,观察两组患者治疗前后的心绞痛发作情况(疼痛程度、发作频率及持续时间)、中医证候积分判定、心电图变化、硝酸甘油停减率、相关实验室检查,进行对比分析,评估其临床疗效及药物安全性。结果:4周后,对比中药治疗组及对照组的临床疗效,中药治疗组在改善心绞痛的发作情况(疼痛程度、发作频率、发作持续时间)方面疗效优于对照组,中医症状评分改善明显,在硝酸甘油停减率、心电图改变方面也展现了服用中药的优势,在肌钙蛋白I、CK-MB、TG、TC、LDL-C、CRP、纤维蛋白原、血流变等实验室检查指标方面,二者对比有统计学差异,显示中药治疗组较对照组有较好的临床疗效,在肝肾功能等安全性指标方面显示无统计学差异,应用安全。结论:结果显示生脉散加减联合西医常规治疗能显著提高气阴两虚型心肌梗死后心绞痛的临床疗效,对比单纯的西医常规治疗,中药治疗组在改善患者的临床症状体征以及相关实验室指标方面疗效显著。其相关机制可能为增加心肌细胞血供、抑制炎症反应、调脂稳定斑块、改善血管内皮功能、延缓动脉硬化进展等,并具有良好的耐受性及安全性,值得进一步应用及推广。
[Abstract]:Objective: To observe the clinical efficacy of Shengmai Powder in the treatment of angina pectoris after myocardial infarction, evaluate its safety and explore its mechanism. Methods: 60 cases of the author from April 2015 to February 2016 in the outpatient department of Cardiology, wards and comprehensive medical ward of Affiliated Hospital of Shandong University of Traditional Chinese Medicine internship collected, in accordance with the inclusion of angina pectoris of Qi Yin deficiency after myocardial infarction were excluded, were randomly divided into treatment group and control group, 30 cases in each group, no significant difference between the two groups in general. The two groups were given conventional western medicine treatment, Chinese medicine treatment group on the basis of Jiajian Shengmaisan, a agent, divided into early and late two after dinner. The experiment lasted for 4 weeks, two groups were observed before and after treatment in patients with angina pectoris (pain, seizure frequency and duration), TCM syndrome score determination, ECG, nitroglycerin withdrawal rate, laboratory examination, comparative analysis, to evaluate the clinical efficacy and safety of medicines. Results: after 4 weeks, the clinical curative effect of traditional Chinese medicine treatment group and control group, the onset of traditional Chinese medicine treatment group in improving angina pectoris (pain, seizure frequency and duration) has better effect than the control group, TCM symptom scores improved significantly, the decrease rate of nitroglycerin, ECG changes also show taking the advantages of traditional Chinese medicine, in CK-MB, TG, troponin I, TC, LDL-C, CRP, fibrinogen, blood rheology and other laboratory indexes, two compared with statistical difference, Chinese medicine treatment group has better clinical efficacy than the control, showed no significant difference in the liver and kidney function and other safety indicators, application safety. Conclusion: the results showed that Shengmai Decoction Combined with conventional western medicine therapy can significantly improve the clinical curative effect of Qi Yin deficiency myocardial infarction angina pectoris after the conventional treatment of Western medicine compared to pure Chinese medicine treatment group, significant improvement in patients with clinical symptoms and related laboratory index of curative effect. Its related mechanisms may increase myocardial blood supply, inhibit inflammatory reaction, regulate lipid, stabilize plaque, improve endothelial function and delay the progression of arteriosclerosis. It is well tolerated and safe, and is worthy of further application and promotion.
【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】：2016
【分类号】：R259

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