生脉真武救心汤治疗慢性心衰的疗效观察

发布时间：2018-01-15 19:08

本文关键词：生脉真武救心汤治疗慢性心衰的疗效观察　出处：《广州中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：通过对慢性心力衰竭患者的生存质量量表评分,以及心功能分级改善情况的统计分析,探讨黄春林教授自拟方生脉真武救心汤在心肾阳虚、水瘀互结型慢性心力衰竭患者中的治疗作用,并为其临床疗效提供客观依据。方法：采用简单随机的方法将符合纳入及排除标准的,广东省中医院大德路总院住院部及门诊就诊的慢性心力衰竭患者,分为试验组和对照组,分别编号。建立相关数据记录表格,记录两组患者的性别、年龄、心功能分级、生存质量量表评分、来自门诊或住院部等基本信息。试验组予西药常规治疗药物加上生脉真武救心汤；对照组只予以西药治疗。观察病人的心衰情况,评估其心功能分级以及生存质量情况,并分别于治疗前和治疗后一周填写生存质量量表,同时记录心功能分级情况。最后,建立数据库,录入心功能分级改善情况及量表评分。并采用SPSS23.0版本将所得数据进行统计学处理与分析。结果：本研究中共纳入病例40例,分为试验组与对照组,每组分别20例。其中男性19例,女性21例；试验组中男性占8例,女性12例；对照组中男性共11例,女性9例。年龄最小37岁,最大87岁；其中试验组中年龄最小的为37岁,最大的为87岁,其均数加减标准差71.35±11.93；对照组年龄最小59岁,最大84岁,均数加减标准差为75.40±7.23。两组中各有13例患者来自门诊部,7例来自住院部。经过统计分析,试验组治疗前生存质量量表评分(102.89±18.78)与治疗后评分(34.95±10.56)差别具有统计学意义(P=0.00)；对照组病例在治疗前的生存质量量表评分(106.00±13.42)与治疗后的评分(51.05±12.59)之间的差别具有统计学意义(P=0.00)。试验组治疗前后得分的差值(67.95±15.26)与对照组治疗前后的得分的差值(54.95±5.24)之间的差别比较具有统计学意义(P=0.001)。在心功能改善方面,试验组治疗无效0人,有效2人,显效17人；对照组无效0人,有效4人,显效16人；两组的治疗在心功能改善方面有效率均为100%。对比两组心功能改善情况,统计结果显示P=0.106,P值大于0.05,无统计学意义,考虑两组治疗在心功能改善方面无明显差异。结论：本研究统计结果表明,生脉真武救心汤加常规西药与单纯西药在慢性心力衰竭的治疗中,无论是在患者的生存质量的改善方面,还是在心功能改善方面均有疗效。在生存质量改善方面,生脉真武救心汤加常规西药治疗的疗效优于单纯西药治疗；在心功能改善方面,二者无明显差异。对于辩证为心肾阳虚、水瘀互结的慢性心力衰竭患者,在常规西药治疗的基础上加用生脉真武救心汤,可提高患者生存质量。
[Abstract]:Objective: to evaluate the quality of life scale (QOL) of patients with chronic heart failure (CHF) and the improvement of cardiac function classification, and to explore Professor Huang Chunlin's self-designed decoction of "Fang Sheng Mai Zhenwu Jiu Xin Tang" for deficiency of heart and kidney yang. The therapeutic effect in patients with chronic heart failure with water stasis and blood stasis, and provide objective basis for its clinical efficacy. Methods: a simple and random method will be adopted to meet the inclusion and exclusion criteria. The patients with chronic heart failure (CHF) were divided into two groups: experimental group and control group. The related data record table was established to record the sex and age of the two groups. Cardiac function grading, quality of life scale score, from outpatient or inpatient departments and other basic information. The experimental group was given routine western medicine drugs plus Shengmai Zhenwu Jiuxin decoction; The patients in the control group were treated with western medicine only. The patients' heart failure was observed, cardiac function grading and quality of life were evaluated, and the quality of life scale was completed before treatment and one week after treatment. At the same time, the classification of cardiac function was recorded. Finally, the database was established. The improvement of cardiac function classification and the score of the scale were recorded. The data were statistically processed and analyzed by SPSS23.0 version. Results: 40 cases were included in this study. The patients were divided into experimental group and control group with 20 cases in each group, of which 19 cases were males and 21 cases were females. There were 8 males and 12 females in the trial group. There were 11 males and 9 females in the control group. The age was 37 years old and the oldest was 87 years old. In the test group, the youngest was 37 years old, the biggest was 87 years old, and the mean value was 71.35 卤11.93 years old. The control group was the youngest 59 years old, the oldest 84 years old, the average addition and subtractive standard deviation was 75.40 卤7.23.There were 13 patients from the outpatient department and 7 from the inpatient department in each group. The scores of QOL before treatment (102.89 卤18.78) and after treatment (34.95 卤10.56) in the trial group were significantly different from those in the control group (P < 0.001). The difference of QOL score before treatment (106.00 卤13.42) and after treatment (51.05 卤12.59) was statistically significant (P < 0.05). The difference of scores before and after treatment between the test group (67.95 卤15.26) and the control group (54.95 卤5.24). The difference was statistically significant in the improvement of cardiac function. In the experimental group, there were 0 ineffective, 2 effective and 17 effective. In the control group, 0 cases were ineffective, 4 cases were effective and 16 cases had remarkable effect. The effective rate of cardiac function improvement in the two groups was 100. Compared with the improvement of cardiac function in the two groups, the statistical results showed that the P value was greater than 0.05, there was no statistical significance. There was no significant difference between the two groups in the improvement of cardiac function. Conclusion: the statistical results of this study show that Shengmai Zhenwu jiuxin decoction conventional western medicine and simple western medicine in the treatment of chronic heart failure. Both in the improvement of patients' quality of life and in the improvement of cardiac function, the curative effect of Shengmai Zhenwu jiuxin decoction was better than that of western medicine alone. In the improvement of cardiac function, there is no significant difference between the two. For the patients with chronic heart failure who are dialectical of deficiency of heart and kidney yang and mutual formation of water and blood stasis, add Shengmai Zhenwu Jiuxin decoction on the basis of routine western medicine treatment. It can improve the quality of life of patients.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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