姚祖培教授论治原发性高血压病之经验探讨

发布时间：2017-12-31 13:26

本文关键词：姚祖培教授论治原发性高血压病之经验探讨　出处：《南京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：观察姚祖培教授中西医结合治疗原发性高血压病的临床疗效,并总结出姚教授临证治疗经验,为临床治疗此病提供参考和借鉴。方法：跟师临床学习,收集南通市中医院门诊及住院原发性高血压患者共59例,记录导师的诊治经过,观察疗程为4周。治疗后对所有患者采用中医证候积分表观察评定患者中医证候疗效和总有效率,以及部分血压仍高者的临床降压总有效率。结合辨证分型和用药规律的分析,以及门诊跟师抄方、导师授课的心得体会,总结出姚教授辨治高血压病的临床经验。结果：59例患者治疗后中医证候积分较治疗前明显降低(P0.01),临床总有效率83.05%,45例血压控制欠佳者治疗后降压总有效率80.00%。治疗过程中患者均未发生不良反应事件。59例辨证分型统计结果显示肝气亢盛证最多,占总病例的64.41%(其中肝郁气滞占10.17%,肝气亢动占54.24%),同时各证型中兼有血瘀证的共42例,其构占比高达71.17%。统计药物分类排名前三的依次是平肝熄风药、清热药、活血化瘀药。导师常用中药为牛膝、白芍、夏枯草、钩藤、赤芍、天麻、葛根、石决明、郁金等,功效以清肝、平肝、活血为主。导师常用中药性味、归经统计结果表明性多寒,味苦、辛,多入肝经。结论：姚教授重视“双心”概念,临床治疗高血压病强调关注心理和血压本身两方面的关系,认为其病变脏腑与肝关系最为密切,气血失和是重要病机,临床上实多虚少,多表现为肝气亢盛、血脉瘀阻。在治疗方面姚教授主张从平调肝气、活血化瘀入手以调和气血,有利于血压下降,尤对临床症状改善明显,较好地发挥了中医药在治疗高血压方面多层次、多环节、多靶点的综合调理作用。
[Abstract]:Objective: to observe the clinical effect of Professor Yao Zupei's combination of traditional Chinese and western medicine in the treatment of essential hypertension, and summarize Professor Yao's clinical experience in the treatment of this disease, and provide reference for clinical treatment of this disease. Methods: follow the teacher's clinical study. A total of 59 patients with essential hypertension in outpatient and inpatients of Nantong traditional Chinese Medicine Hospital were collected and the diagnosis and treatment of their mentors were recorded. Observe the course of treatment for 4 weeks. After the treatment of all patients with TCM syndromes integral table observation and evaluation of TCM syndromes efficacy and total effective rate. And part of the blood pressure is still high clinical total effective rate of hypotension, combined with the analysis of syndrome differentiation and drug use law, as well as the outpatient with the teacher copy, the experience of teaching. Results the score of TCM syndrome in 59 cases of the patients after treatment was significantly lower than that before treatment, and the total clinical effective rate was 83.05%. The total effective rate of lowering blood pressure in 45 patients with poor blood pressure control was 80.00.All the patients did not have adverse events during the treatment. The statistical results of syndrome differentiation in 59 cases showed that the syndrome of hyperactivity of liver qi was the most. It accounted for 64.41% of the total cases (liver stagnation and qi stagnation accounted for 10.17 cases, hyperactivity of liver qi accounted for 54.24%), and there were 42 cases with blood stasis syndrome in all syndrome types. The proportion of its structure is as high as 71.17.The top three drugs in statistical classification are Pinggan Xifeng medicine, heat-clearing medicine, promoting blood circulation medicine. Instructors often use Chinese medicine for Achyranthes bidentata, Radix Paeoniae Alba, Prunella subtilis, Rhizoma Uncaria, Radix Paeoniae Alba, Gastrodia elata. Pueraria root, stone cassia, Yu Jin, efficacy to clear the liver, calming the liver, promoting blood circulation mainly. Tutors commonly used traditional Chinese medicine flavor, return to the statistical results show that the sex of cold, bitter, symplectic. Conclusion: professor Yao attaches importance to the concept of "double heart", and the clinical treatment of hypertension emphasizes the relationship between psychology and blood pressure itself, and considers that the relationship between the pathological organs and the liver is the most close. Qi and blood disharmony is an important pathogenesis, clinical practice more deficiency and less, more performance for hyperactivity of liver qi, blood stasis obstruction. In the treatment aspect, Professor Yao advocated from the level of regulating liver qi, activating blood circulation to reconcile qi and blood, conducive to the decline of blood pressure. Especially for the improvement of clinical symptoms, Chinese medicine in the treatment of hypertension in the multi-level, multi-link, multi-target comprehensive conditioning.
【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】：2016
【分类号】：R249;R259

【相似文献】