升陷汤加减治疗气虚证患者的临床疗效观察

发布时间：2018-02-25 15:47

本文关键词： 气虚证升陷汤临床观察　出处：《北京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：背景:气虚证广泛见于各种疾病的不同阶段或亚健康人群,表现为乏力、自汗、气短、神疲、懒言、脉虚、舌淡等一系列症候群,中医治疗气虚证有独特的优势。临床上遇气虚证患者,多数中医工作者辨证用药习惯从传统的调整阴阳、调理脏腑之气、营卫之气入手,我们基于宗气在人体的独特地位试从调补宗气入手治疗气虚证。历代医家认为宗气能统摄全身诸气,是诸气的纲领,具有"贯心脉、行呼吸,总行气血,撑持全身、振作精神,维持神思脑力,温养四肢官骸'"等功能[1]。宗气亏虚推动无力,气血斡旋失畅,全身诸气均受影响,表现为营卫之气、脏腑之气、经络之气不能正常运行,脏腑功能得不到正常的发挥。所以运用升陷汤益气升提、调补宗气,可以作为治疗气虚证的一个思路。研究目的:通过观察升陷汤加减治疗气虚证患者的中医症状改善情况,综合评价升陷汤加减治疗气虚证的临床疗效,为进一步扩大升陷汤的适应范围,为使升陷汤被更多中医工作者重视和认识尽一份力。研究方法:本临床研究采用自身前后对照的方法,根据气虚证诊断标准、纳入标准、排除标准,共纳入气虚证患者89例,脱落5例。84例气虚证患者按照疾病种类分为6组:糖尿病、心血管疾病、甲状腺疾病、肾系病、慢性疲劳综合征、其他疾病组。对符合纳入标准的患者予升陷汤加减治疗。观察周期为4周,分别于治疗前0天和治疗后第28天进行证候学记录,根据中医证候积分来评价症状的改善情况。采用SPSS21.0统计分析软件进行统计学处理。研究结果:①经过治疗后,84例气虚证患者的临床疗效显示:痊愈0例,显效10例,有效74例,无效0例,总有效率100%。结果:说明在临床应用升陷汤加减治疗气虚证患者有显著的疗效。②84例患者分病种治疗前后差值进行组间比较,P值0.05,比较差异有统计学意义,组间差值大小顺序为:甲状腺疾病慢性疲劳综合征其他疾病肾系疾病心血管疾病糖尿病。结果:说明升陷汤加减对甲状腺疾病的治疗有较好的疗效。③将84例气虚证患者的兼夹证按照中医证候分型分为血瘀证、血虚证、阴虚证、阳虚证、湿浊证、湿热证、肝郁证,比较各证证候积分治疗前后的差异均有统计学意义。结果:表明升陷汤加减治疗上述各兼夹证均有效。④对各证的症状改善情况分析,其中神疲、乏力、气短、自汗、肢体麻木、胸闷、心悸、咽干口渴、手足心热、潮热、头晕眼花、潮热、肢体困重、便溏不爽、苔黄腻、善太息、烦躁易怒等症状治疗前后积分比较,P值0.05,比较差异有统计学意义。结果:说明升陷汤加减能明显改善患者的上述临床症状,提高患者生活质量。⑤所有患者治疗前后无不良反应。结论:升陷汤加减治疗气虚证患者在改善中医症状方面有显著的疗效,能缓解患者的临床症状,且未出现不良反应,安全有效,值得临床推广应用。
[Abstract]:Background: different stages of qi deficiency syndrome is common in a variety of diseases or sub-health, manifested as fatigue, sweating, shortness of breath, lassitude, lazy words, weak pulse, pale tongue and a series of TCM syndrome, Qi deficiency syndrome has a unique advantage. The clinical syndrome of Qi in TCM syndrome patients, most workers from drug habits the adjustment of the traditional conditioning organs of yin and Yang, Qi, Ying and Wei Qi of our gas tries to tune up the gas in the treatment of qi deficiency in the unique position of human body. Based on the ancient physicians that can control all the cases of gas gas, the gas is the program, with "through the heart pulse, respiratory, blood bank support, body, spirits, maintain spiritual mental, warm and nourish the limbs' function of [1]., the skeleton of Zong Qi deficiency promote weakness, blood mediated loss of smooth body of the gas are affected, manifested as Ying and Wei Qi, viscera Qi, Qi of meridians can not operate normally, viscera function is not positive Often play. So the use of Shengxian Decoction Yiqi Shengti, Tiaobu cases of gas, can be used as a way of treating qi deficiency. Objective: through the observation of TCM symptoms in Sheng Decoction in the treatment of qi deficiency syndrome patients to improve the clinical curative effect, comprehensive evaluation of Shengxian Decoction in the treatment of Qi deficiency, in order to further expand Shengxian Decoction range for Shengxian Decoction by more and more Chinese workers, attention and awareness as a force. Methods: This clinical study using self-control method, according to the standard, Qi deficiency syndrome diagnosis and inclusion criteria, exclusion criteria, a total of 89 cases of patients with Qi deficiency syndrome, 5 cases of.84 patients with syndrome of Qi off according to the types of diseases were divided into 6 groups: diabetes mellitus, cardiovascular disease, thyroid disease, kidney disease, chronic fatigue syndrome and other diseases. The patients who met the inclusion criteria for Shengxian decoction treatment. The observation period was 4 weeks, respectively before treatment 0 days and twenty-eighth days after treatment of TCM syndrome, the symptoms evaluation according to TCM syndrome integral. Using SPSS21.0 statistical analysis software was used for statistical analysis. Results: after treatment, the clinical curative effect of 84 cases showed Qi deficiency syndrome patients: 0 cases were cured, 10 cases markedly effective, effective in 74 cases, 0 cases were invalid, the total efficiency of 100%. results: in the clinical application of L has obvious curative effect in decoction treating qi deficiency patients. The 84 patients were divided into disease difference between before and after treatment were compared between the two groups, the P value is 0.05, the difference was statistically significant, the difference between the groups value order: chronic fatigue of thyroid diseases the other kidney disease syndrome disease cardiovascular disease diabetes. Results: Shenxian Decoction on the treatment of thyroid disease has good curative effect. The 84 cases of patients with Qi deficiency syndrome and syndrome according to TCM syndrome type is divided into blood stasis syndrome, blood deficiency syndrome , yin deficiency, Yang deficiency, turbid dampness, damp heat syndrome, liver stagnation syndrome, the syndrome integral comparison before and after treatment were statistically significant. Results: the results showed that Shengxian Decoction in the treatment of the complicated syndromes are effective. The analysis of improvement of symptoms to the card, the lassitude, weakness shortness of breath, sweating, numbness, palpitations, chest tightness, dry throat, thirst, hot feeling, fever, dizziness, fever, body, loose stool, yellow greasy, deep sigh, irritability and other symptoms integral comparison before and after treatment, the P value is 0.05, the difference was statistically significant. Results: the clinical symptoms Shengxian decoction can significantly improve the patients, improve the quality of life of patients. All patients with adverse reactions before and after treatment. Conclusion: Shengxian Decoction Treatment of qi deficiency syndrome patients had significant therapeutic effects in improvement of TCM symptoms, can alleviate the clinical symptoms of the patients, and no adverse reaction It is safe and effective and is worthy of clinical application.

【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R255

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