调脾护心方治疗心脾两虚型室性早搏的临床观察

发布时间：2018-02-27 03:37

本文关键词： 调脾护心方心脾两虚室性早搏临床观察　出处：《安徽中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:运用中药复方汤剂(调脾护心方)治疗室性早搏患者,观察其对室性早搏患者临床症状的控制及其安全性。通过对其选用的相关指标的剖析,联合观察室性早搏患者的中医症状表现,综合辨病及辨证分析,探讨调脾护心方中医临床诊治的有效性及安全性。方法:选取2014年11月至2015年11月期间就诊于安徽中医药大学第一附属医院心内科门诊或住院部,西医诊断为室性早搏,同时传统医学辨证属心脾两虚证型的60例患者,随机分成2组:中西药治疗组30例,西药对照组30例。治疗组:口服美托洛尔47.5mg(原研),每次23.75-47.5mg,每日1次。同时口服调脾护心方中药颗粒剂冲服,每日一帖,分两次服用。对照组:口服美托洛尔47.5mg(原研),每次23.75-47.5mg,每日1次。两组疗程均为4周,实验期间原则上停用影响临床疗效的相关药物,生活方式基本不变。观察两组及组间治疗前后中医证候积分、中医证候疗效和24h小时动态心电图室性早搏次数的及疗效变化情况。结果:(1)疗效性评价:(1)观察指标在治疗后疗效的比较:治疗组治疗后总有效率为86.67%;对照组总有效率为83.33%,组间比较,计算P0.05,治疗后两组无明显差异;(2)室性早搏治疗前后总数的比较:两组治疗后室早总数明显减少,治疗后组间比较无统计学意义(P0.05);(3)中医证候及单项症状疗效的比较:治疗组中医证候总有效率达96.67%,对照组中医证候总有效率是70.00%,组间比较差异显著(P0.05);中医单项症状改善方面治疗组优于对照组(P0.05)。(2)临床安全性指标:本课题进行期间,治疗组30例患者中,仅1人出现偶有反酸表现,经护胃治疗后,症状好转,完成临床观察,其余均无明显不适反应,两组治疗前后血常规、小便常规、大便常规以及肝肾功能结果无明显改变,未出现不良反应。结论如下:(1)调脾护心方联合琥珀酸美托洛尔治疗室性早搏总有效率达86.67%。临床治疗室性早搏疗效确切,方案可行。(2)通过健脾益气、养心安神为原则组方的调脾护心方紧扣病机,对于心脾两虚型室性早搏患者,治疗后中医证候积分明显降低,总有效率高达96.67%,优于对照组,说明调脾护心方能明显改善中医证候,改善患者临床症状。(3)调脾护心方在改善患者心悸、胸闷、乏力、失眠等方面有很大优势,且无明显不良发应,未发现毒副作用,为室早的诊治增添了可靠的中医特色方剂。
[Abstract]:Objective: to observe the clinical symptom control and safety of the patients with ventricular premature beats treated with traditional Chinese medicine compound decoction (Tiaopi Huxin recipe). To observe the symptoms of the patients with ventricular premature beat, and to analyze the syndrome differentiation and syndrome differentiation of the patients with ventricular premature beat. To explore the efficacy and safety of Tiaopi Huxin recipe in the clinical diagnosis and treatment of ventricular premature beat (VPB). Methods: from November 2014 to November 2015, the patients were admitted to the Department of Cardiology of the first affiliated Hospital of Anhui University of traditional Chinese Medicine, and the patients were diagnosed as ventricular premature beats by Western medicine. At the same time, 60 patients with syndrome differentiation of deficiency of heart and spleen were randomly divided into two groups: 30 cases in Chinese and western medicine treatment group, 30 cases in traditional Chinese medicine treatment group, 30 cases in western medicine treatment group, Treatment group: oral metoprolol 47.5 mg per time, once a day, while oral administration of Tiaopihuxin prescription Chinese medicine granules, one tablet per day, the treatment group was treated with metoprolol 47.5 mg / day, the control group was treated with metoprolol 47.5 mg / day. The control group was given metoprolol 47.5 mg orally once a day, 23.75-47.5 mg per day. The course of treatment in both groups was 4 weeks. In principle, the related drugs affecting the clinical efficacy were stopped during the experiment. The life style was basically unchanged. Observe the integral of TCM syndromes before and after treatment between the two groups, The curative effect of TCM syndromes, the times of ventricular premature beat in 24 h ambulatory electrocardiogram and the change of curative effect. Results: the comparison of curative effect after treatment with observation index: the total effective rate of treatment group was 86.67; the control group was 86.67; the control group was 86.67; the control group was 86.67; the control group was 86.67; the control group was 86.67. The efficiency was 83.33. After treatment, there was no significant difference between the two groups in the total number of ventricular premature beats before and after treatment: the total number of ventricular premature beats in the two groups decreased significantly after treatment. Comparison of TCM syndromes and single symptoms after treatment: the total effective rate of TCM syndromes in the treatment group was 96.67g, the total effective rate of the TCM syndrome in the control group was 70.000.The difference between the two groups was significant (P 0.05); The treatment group was superior to the control group (P0.05P0.05. 2) the clinical safety index: during the course of this project, the treatment group was better than the control group. Of 30 patients in the treatment group, only 1 had occasional regurgitation. After gastric care, symptoms improved and clinical observation was completed. There was no obvious discomfort between the two groups. Blood routine and urine routine before and after treatment were observed in both groups. There were no obvious changes in stool routine and liver and kidney function, and no adverse reactions. Conclusion the total effective rate of Tiaopihuxin decoction combined with metoprolol succinate in the treatment of ventricular premature beats is 86.67.The curative effect of clinical treatment on ventricular premature beats is definite. The scheme is feasible. (2) through the principle of invigorating spleen and invigorating qi, nourishing the heart and soothing the mind, the formula of regulating spleen and protecting the heart is closely related to the pathogenesis. For the patients with ventricular premature beats with deficiency of both heart and spleen, the score of TCM syndromes is obviously reduced after treatment, and the total effective rate is up to 96.67, which is superior to that of the control group. It shows that Tiaopi Huxin prescription can obviously improve TCM syndromes and improve the clinical symptoms of patients. It has great advantages in improving palpitation, chest tightness, fatigue, insomnia and so on, and has no obvious adverse reaction and no toxic side effects. For the room early diagnosis and treatment to add reliable traditional Chinese medicine characteristic prescription.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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