耳尖放血治疗阴虚阳亢型高血压病的即时疗效观察

发布时间：2017-12-28 13:16

本文关键词：耳尖放血治疗阴虚阳亢型高血压病的即时疗效观察　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：[目的]观察耳尖放血疗法的即时降压效果,验证其疗效并探讨其作用机制,为临床阴虚阳亢型高血压病的治疗及护理提供一种简便有效且副作用小的辅助中医治疗方法,也是为了提供更多的佐证支持传统中医治疗手段在临床中的推广。[方法]本研究采取临床交叉试验原则,选取在2015年10月至2016年6月期间江苏省中医院老年医学科收治的30例原发性阴虚阳亢型高血压患者,利用交叉试验方法,将其配对分为试验组及对照组,各30例,试验组用耳尖放血法治疗,对照组舌下含服卡托普利片治疗,比较治疗前后两组在一段时间内血压变化。[结果]耳尖放血干预阴虚阳亢型高血压即时疗效的观察结果:①将治疗前试验组和对照组的血压进行比较,发现其无统计学差异(P0.05),所以能够在组间进行试验研究。②将对照组和试验组治疗前及治疗后5分钟、10分钟、30分钟、60分钟、120分钟的收缩压值进行组间两两比较,经方差分析后结果显示:治疗后5分钟、10分钟试验组及对照组的收缩压值未见明显差异(P0.05);治疗后的30分钟、60分钟、120分钟试验组和对照组的收缩压值比较,两组值间有显著性差异(P＜0.05)。③将对照组和试验组治疗前及治疗后5分钟、10分钟、30分钟、60分钟、120分钟的舒张压值进行组间两两比较,经方差分析后结果显示:治疗后5分钟、10分钟试验组及对照组的舒张压值未见明显差异(P0.05);治疗后的30分钟、60分钟、120分钟试验组和对照组的舒张压值比较,两组值间有显著性差异(P＜0.05)。④对试验组与对照组各时间点收缩压进行组间均值比较,运用折线图分析,发现试验组收缩压在治疗后5分钟-60分钟,均呈下降趋势,至120分钟时,收缩压回升。⑤对试验组与对照组各时间点舒张压进行组间均值比较,运用折线图分析,发现试验组舒张压在治疗后5分钟-60分钟,均呈下降趋势,至120分钟时,舒张压回升。⑥组内比较两组患者各时间点的收缩压值,经方差分析后结果显示:对照组治疗前和治疗后各时间点收缩压值比较均有非常明显差异(P＜0.01),治疗后5分钟与治疗后10分钟、30分钟、60分钟、120分钟收缩压值比较,均有非常明显差异(P＜0.01),治疗后10分钟和治疗后30分钟、60分钟、120分钟收缩压值比较,均有非常明显差异(P0.01),治疗后30分钟和治疗后60分钟、120分钟收缩压值比较,均有非常明显差异(P00.01),治疗后60分钟和治疗后120分钟收缩压值比较,有非常明显差异(P＜0.01);试验组治疗前和治疗后各时间点收缩压值比较,均有非常明显差异(P0.01),治疗后5分钟和治疗后10分钟、30分钟、60分钟、120分钟收缩压值比较,均有非常明显差异(P0.01),治疗后10分钟和治疗后30分钟、60分钟收缩压值比较,均有非常明显差异(P0.01),但和治疗后120分钟收缩压值比较,未见明显差异(P0.05),治疗后30分钟和治疗后60分钟、120分钟收缩压值比较,均有非常明显差异(P＜0.01),治疗后60分钟和治疗后120分钟收缩压值比较,有非常明显差异(P＜0.01)。⑦组内比较两组患者各时间点的舒张压值,经方差分析后结果显示:对照组治疗前和治疗后各时间点舒张压值比较均有非常明显差异(P0.01),治疗后5分钟与治疗后10分钟、30分钟、60分钟、120分钟舒张压值比较,均有非常明显差异(P＜0.01),治疗后10分钟和治疗后30分钟、60分钟、120分钟舒张压值比较,均有非常明显差异(P0.01),治疗后30分钟和治疗后60分钟、120分钟舒张压值比较,均有非常明显差异(P0.01),治疗后60分钟和治疗后120分钟舒张压值比较,有非常明显差异(P＜0.01);试验组治疗前和治疗后各时间点舒张压值比较,均有非常明显差异(P＜0.01),治疗后5分钟和治疗后10分钟、30分钟、60分钟、120分钟舒张压值比较,均有非常明显差异(P0.01),治疗后10分钟和治疗后30分钟、60分钟舒张压值比较,均有非常明显差异(P0.01),但和治疗后120分钟舒张压值比较,未见明显差异(P0.05),治疗后30分钟和治疗后60分钟、120分钟舒张压值比较,均有非常明显差异(P0.01),治疗后60分钟和治疗后120分钟舒张压值比较,有非常明显差异(P＜0.01)。⑧在试验组和对照组治疗后60分钟时,检验干预效果,运用秩和检验后结果显示:Z=-0.359,P=0.720(P0.05),即试验组和对照组治疗后60分钟时干预效果无统计学差异。[结论]两组患者经治疗后,收缩压与舒张压均下降,治疗后10min、30min、60min的血压改善情况均比较显著(P0.05),而在60min时患者的血压改善情况最好,60min-120min之内,试验组降压效果不明显,对照组仍有降压效果。两组可改善中医证候,但疗效无明显差异(P0.05)。
[Abstract]:[Objective] to observe the antihypertensive effect of instant ear apex bloodletting therapy, verify its efficacy and to explore its mechanism, treatment and clinical nursing of Yinxu Yangkang provides a simple and effective auxiliary method of Chinese medicine treatment and the side effect is small, but also to provide more evidence to support the promotion of traditional Chinese medicine treatment in clinic the. [method] this study adopted clinical cross test principle, 30 cases of primary hypertension patients with hyperactivity were selected during the period from October 2015 to June 2016 in Jiangsu Province Traditional Chinese Medicine Hospital from the Department of Geriatrics, using cross test method, which were divided into experimental group and control group, 30 cases in each, the experimental group was treated with auricular apex bloodletting therapy. The control group of sublingual Captopril Tablets treatment, compared two groups before and after treatment for a period of time the change of blood pressure. [results] the effect of ear tip bloodletting intervention on hypertension of yin deficiency yang hyperactivity was observed: (1) comparing the blood pressure between the experimental group and the control group before treatment, it was found that there was no statistical difference (P0.05), so we could carry out an experimental study between the groups. The control group and the experimental group before and after treatment for 5 minutes, 10 minutes, 30 minutes, 60 minutes, 120 minutes of systolic blood pressure between the 22 groups were compared by analysis of variance results showed that: after treatment, 5 minutes, 10 minutes of the test group and control group, there was no obvious difference in systolic blood pressure (P0.05); contraction of 30 minutes and 60 minutes, 120 minutes of the test group and the control group after treatment, the pressure value comparison, two groups there was a significant difference between the values (P < 0.05). The control group and the experimental group before and after treatment for 5 minutes, 10 minutes, 30 minutes, 60 minutes, 120 minutes the diastolic blood pressure values were compared between the 22 groups, by the analysis of variance results showed that: the treatment after 5 minutes, 10 minutes of test group and control group, there was no obvious difference in diastolic blood pressure (P0.05); 30 minutes, 60 minutes, 120 minutes of the test group and the control group diastolic blood pressure values after treatment between the two groups, there was a significant difference between the values (P < 0.05). (4) comparing the mean value of systolic blood pressure between the experimental group and the control group at each time point, using the broken line chart analysis, we found that the systolic blood pressure of the experimental group decreased after 5 minutes and -60 minutes after treatment, and the systolic blood pressure increased after 120 minutes. (5) comparing the mean value of the diastolic blood pressure between the experimental group and the control group at each time point, using the broken line chart analysis, we found that the diastolic blood pressure of the experimental group decreased after 5 minutes -60 minutes after treatment, and the diastolic blood pressure increased again to 120 minutes. The group of two groups were compared at each time point of the value of systolic blood pressure, through the variance analysis results showed: the control group before and after treatment of each time point value of systolic blood pressure is relatively obvious differences (P < 0.01), 5 minutes after treatment and after treatment for 10 minutes, 30 minutes, 60 minutes, 120 minutes the systolic blood pressure value, have very significant difference (P < 0.01), 10 minutes after treatment and after treatment for 30 minutes, 60 minutes, 120 minutes, the systolic blood pressure value, have very significant difference (P0.01), 30 min after treatment and after treatment for 60 minutes, 120 minutes, the systolic blood pressure value, have very significant differences (P00.01) after treatment, 60 minutes and 120 minutes after treatment systolic blood pressure value, has a very significant difference (P < 0.01); the SBP values of experimental group before and after treatment, have very significant difference (P0.01), 5 minutes after treatment and after treatment for 10 minutes, 30 minutes, 60 minutes, 120 minutes, the systolic blood pressure value, have very significant difference (P0.01), 10 min after treatment and after treatment for 30 minutes, 60 minutes, the systolic blood pressure value, have very significant difference (P0.01), but compared with 120 minutes after treatment there was no significant difference between the value of systolic blood pressure (P0.05), after treatment 30 minutes and 60 minutes after 120 minutes treatment, systolic blood pressure, have very significant difference (P < 0.01), after treatment for 60 minutes and 120 minutes after treatment systolic blood pressure value, has a very significant difference (P < 0.01). The diastolic blood pressure values within groups were compared between the two groups at each time point, the variance analysis results showed: the control at each time point of the diastolic blood pressure values were very obvious differences between groups before and after treatment (P0.01), 5 min after treatment and after treatment for 10 minutes, 30 minutes, 60 minutes, 120 points Zhong Shuzhang pressure value comparison, have very significant differences (P < 0.01), 10 minutes after treatment and after treatment for 30 minutes, 60 minutes, 120 minutes the diastolic blood pressure value, have very significant difference (P0.01), 30 min after treatment and after treatment for 60 minutes, 120 minutes the diastolic blood pressure value, have very significant difference (P0.01), 60 minutes after treatment and after treatment 120 minutes the diastolic blood pressure value, has a very significant difference (P < 0.01); diastolic blood pressure values at each time point in experimental group before and after treatment, have very significant difference (P < 0.01), 5 minutes after treatment and after treatment for 10 minutes, 30 minutes, 6 0 minutes, 120 minutes the diastolic blood pressure value, have very significant difference (P0.01), 10 min after treatment and after treatment for 30 minutes, 60 minutes the diastolic blood pressure value, have very significant difference (P0.01), and 120 minutes after treatment but the diastolic blood pressure value, there is no significant difference (P0.05), after treatment 30 minutes and 60 minutes, 120 minutes after the treatment of diastolic blood pressure values, have very significant difference (P0.01), 60 min after treatment and after treatment 120 minutes the diastolic blood pressure value, has a very significant difference (P < 0.01). In the experimental group and control group after treatment for 60 minutes, test the effect of intervention, with rank test results showed: Z=-0.359, P=0.720 (P0.05), the experimental group and the control group after treatment for 60 minutes when the intervention had no significant difference. [Conclusion] the two groups of patients after treatment, systolic blood pressure and diastolic blood pressure were decreased after treatment, 10min, 30min, 60min were significantly improved blood pressure (P0.05), and the improvement of blood pressure in patients with 60min best, within 60min-120min, the hypotensive effect of experimental group is not obvious, there is still the antihypertensive effect of the control group. The two groups can improve the TCM syndrome, but there is no significant difference in the curative effect (P0.05).
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R248.1

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