体外反搏对慢性心力衰竭（气阴两虚，心血瘀阻证）患者疗效的临床观察

发布时间：2018-01-30 18:34

本文关键词： 体外反搏气阴两虚心血瘀阻证慢性心衰生活质量　出处：《长春中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:本课题主要通过对慢性心力衰竭患者辅助体外反搏的临床疗效进行评价,为慢性心力衰竭患者的非药物治疗提供证据。方法:选取72例长春中医药大学附属医院心功能II、III级,中医证型为气阴两虚,心血瘀阻证型的患者为研究对象,将入组患者按1:1比例分为治疗组和对照组,每组36例,进行临床观察。对照组给予慢性心衰常规药物治疗,治疗组在常规药物治疗的基础上加用体外反搏。在治疗前采集患者性别、年龄、病程、合并疾病分布情况、心功能分级、以及中医症状、体征,进行辨证分型,并填写明尼苏达生活质量表进行评分。治疗后6个月通过回访了解心血管不良事件发生情况,中医证候情况以及明尼苏达生活质量表评分。结果:两组患者心血管不良事件治疗前后比较,治疗组患者再住院占3%;对照组患者再住院占23%;在再住院项上P0.05,提示两组患者有显著差异。在心肌梗死、死亡两项上P0.05,提示两组比较无显著差异;经t检验,两组患者治疗前后中医症状疗效比较,在心悸、气短,疲乏、下肢浮肿、面色、头晕、胁下痞块、汗出、口干、舌质、舌苔、脉象中医症状方面均有显著差异(P0.05),具有可比性,治疗组明显优于对照组。两组患者治疗前后中医证候总疗效比较,治疗组总有效率85.7%,对照组总有效率65.7%,两组中医证候总疗效比较有显著差异,有统计学意义(P0.05),说明治疗组中医证候总疗效优于对照组;两组患者治疗前后心功能疗效比较,治疗组总有效率85.7%,对照组总有效率77.1%,两组患者心功能疗效比较方面有显著差异,有统计学意义(P0.05);两组患者治疗前后6分钟步行试验比较(P0.05),有统计学意义,治疗组优于对照组;两组治疗前后LVEF值比较(P0.05),具有统计学意义,治疗组治疗效果优于对照组;两组患者治疗前后明尼苏达生活质量表评分,有统计学意义(P0.05),说明体外反搏疗法对患者的生命质量有明确的改善作用,在慢性心力衰竭患者中的应用研究具有重要意义。结论:体外反搏疗法可以改善慢性心力衰竭(气阴两虚,心血瘀阻证)心血管不良事件的发生,改善患者的心功能,中医症状以及提高生活质量及运动耐量。
[Abstract]:Objective: This paper mainly through the evaluation of clinical efficacy in patients with chronic heart failure secondary external counterpulsation, provide evidence for non drug treatment in patients with chronic heart failure. Methods: 72 cases of cardiac function in Affiliated Hospital of Changchun University of Traditional Chinese Medicine, II, III, TCM syndrome type of Qi and yin deficiency, syndrome of heart blood stasis patients as the research object, the the patients according to the proportion of 1:1 divided into treatment group and control group, each group of 36 cases for clinical observation. The control group was given routine drug treatment of chronic heart failure, treatment group on the basis of routine therapy combined with external counterpulsation. Before treatment were collected in gender, age, disease duration, disease distribution, heart function classification and TCM symptoms, signs, syndromes, and fill out the Minnesota quality of life table score. 6 months after the treatment by a return visit to understand the incidence of adverse cardiovascular events, Chinese Medicine The syndrome and quality of life scale in Minnesota. Results: two groups of patients before and after treatment of cardiovascular adverse events compared with patients in the treatment group hospitalization accounted for 3%; the patients in the control group re hospitalization accounted for 23%; in hospitalization on P0.05, suggesting that patients in the two groups had significant difference. In myocardial infarction, death two P0.05 tips the two groups had no significant difference; by t test, two groups of patients before and after treatment of TCM symptoms in comparison, palpitations, shortness of breath, fatigue, edema of lower limbs, complexion, dizziness, breast lump, sweating, dry mouth, tongue, tongue, pulse and symptoms were significant differences (P0.05), were comparable, the treatment group was significantly better than the control group. Compare the total effect of Chinese medicine syndromes of two groups of patients before and after treatment, the total effective rate of treatment group 85.7%, control group total effectiveness 65.7%, two groups of TCM syndrome curative effect more significant differences, with statistical significance (P0.05), indicating that the treatment group TCM syndrome total effect is better than the control group; comparison of curative effect on cardiac function in two groups before and after treatment, the total effective rate of treatment group 85.7%, control group total efficiency of 77.1%, there is significant difference between the efficacy of cardiac function in patients with two groups was statistically significant (P0.05); two groups of patients before and after the 6 minute walk test comparison (P0.05), was statistically significant, the treatment group than the control group; the two groups before and after treatment LVEF value (P0.05), was statistically significant, the treatment group better than the control group; two groups of patients before and after treatment of Minnesota quality of life score, with statistical significance (P0.05), that the external counterpulsation therapy is effective to clear the quality of life of patients, has important significance to research the application in patients with chronic heart failure. Conclusion: external counterpulsation therapy can improve chronic heart failure (yin deficiency, blood stasis syndrome) the adverse cardiovascular events To improve the heart function of the patients, the symptoms of traditional Chinese medicine and the improvement of the quality of life and the endurance of exercise.

【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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