慢性心力衰竭与中医气虚血瘀病机相关性研究

发布时间：2018-02-27 04:26

本文关键词： 慢性心力衰竭益气化瘀冲剂临床研究　出处：《华北理工大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的通过本研究客观评价益气化瘀冲剂治疗慢性心力衰竭的临床疗效及安全性;证实LVEF降低性心衰和LVEF保留性心衰中医的共同病机是气虚血瘀所致的心气动力与脉道顺应性下降,而益气化瘀、活血通脉则是治疗LVEF降低性心衰和LVEF保留性心衰的基本方法,为中医药治疗慢性心力衰竭提供科学规范,临床行之有效的方法手段。方法将240例符合纳入标准的慢性心力衰竭患者随机分为试验组120例,对照组120例,两组中均有LVEF降低性心衰患者80例,LVEF保留性心衰患者40例,两组均在常规抗心力衰竭(贝那普利、酒石酸美托洛尔片等)西药治疗的基础上,试验组120例予益气化瘀冲剂,l剂/d;对照组120例予安慰剂(颗粒冲剂),l剂/d;两组冲剂均分早晚两次开水冲服。2月为一个疗程,一个疗程以后分别评估两组临床疗效及安全性。治疗前后分别设立的指标有:心功能、LVEF值、E/A检测、中医证候积分、下肢浮肿等观察指标及血尿便常规、肝功能肾功能等安全性指标,并通过统计学软件对数据进行统计学分析。结果本试验结束后,试验组中有115例患者完成此次试验,而对照组有112例。试验组与对照组LVEF降低性心衰患者在心功能、LVEF、下肢浮肿情况方面均有改善,试验组的改善情况明显优于对照组(P0.05),差异有统计学意义。试验组与对照组LVEF保留性心衰患者在心功能、E/A检测、下肢浮肿情况方面均有改善,试验组优于对照组(P0.05)。两组患者中医证候积分比较:试验组在单项中医证候除下肢浮肿方面(P=0.898)未有明显差异外,余心悸喘息、体倦乏力、舌象及脉象等证候改善均优于对照组(P0.05)。结论1益气化瘀冲剂可显著改善慢性心力衰竭患者心功能,LVEF值,E/A检测及中医气虚血瘀证候等指标。2益气化瘀冲剂治疗慢性心力衰竭具有安全性,值得临床应用及推广。3气虚血瘀所致的心气动力与脉道顺应性下降是慢性心力衰竭最基本的中医病机,益气化瘀、活血通脉为基本治疗法则。
[Abstract]:Objective to evaluate the efficacy and safety of Yiqi Huayu granule in the treatment of chronic heart failure. It is proved that the common pathogenesis of LVEF in reducing CHF and LVEF reserving CHF is the decrease of heart qi and vein compliance caused by deficiency of qi and blood stasis, while invigorating qi and removing blood stasis and activating blood circulation and Tongmai are the basic methods to treat LVEF and LVEF reserved CHF. Methods 240 patients with chronic heart failure were randomly divided into trial group (n = 120) and control group (n = 120). In both groups, there were 80 patients with low LVEF and 40 patients with reserved heart failure. Both groups were treated with western medicine (benazepril, metoprolol tartrate, etc.). The experimental group (120 cases) received Yiqi Huayu granule (Yiqi Huayu granule) and the control group (120 cases) received placebo (granule granule / L / d); the two groups of granules were divided into two times in the morning and evening. February was a course of treatment. After one course of treatment, the clinical efficacy and safety of the two groups were evaluated. The indexes before and after treatment were as follows: LVEF value of cardiac function and E / A test, TCM syndrome score, lower limb edema and hematuria routine. Safety indexes such as liver function and kidney function were analyzed statistically by statistical software. Results after this experiment, 115 patients in the trial group completed the test. There were 112 cases in the control group. The patients in the test group and the control group had improved in terms of heart function, lower limb edema, and lower limb effusion, both in the experimental group and in the control group. The improvement of the treatment group was significantly better than that of the control group (P 0.05), and the difference was statistically significant. Comparison of TCM syndromes between the two groups: there was no significant difference in the single TCM syndromes in the test group except for the swelling of the lower extremities (P < 0. 898), the palpitations remained gasping, and the body was tired and weak. Conclusion (1) Yiqi Huayu granule can significantly improve the heart function and LVEF value of patients with chronic heart failure, and the index of Qi-deficiency and blood-stasis syndrome of traditional Chinese medicine, such as Yiqi Huayu granule, in treating chronic heart failure, is better than the control group in improving the syndromes, such as tongue and pulse, etc. Conclusion 1 Yiqi Huayu granule can significantly improve the cardiac function of patients with chronic heart failure. Heart failure is safe, It is worthy of clinical application and popularizing the decline of heart and vein compliance caused by qi deficiency and blood stasis, which is the basic TCM pathogenesis of chronic heart failure.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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