雷氏附姜温阳方治疗阳虚水泛型慢性心力衰竭的临床观察

发布时间：2018-03-04 01:01

本文选题：慢性心力衰竭　切入点：阳虚水泛　出处：《成都中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：观察雷氏附姜温阳方治疗阳虚水泛型慢性心力衰竭的临床疗效及安全性,以探讨雷氏附姜温阳方对慢性心力衰竭患者的作用,为临床使用提供一定的临床依据。方法：按照完全随机对照的原则,采用随机数字表法按照1：1的比例将符合中医阳虚水泛型诊断标准的64例慢性心力衰竭患者,分为对照组32例和治疗组32例。对照组采用西医标准治疗,治疗组在西医标准治疗的基础上加用雷氏附姜温阳方口服。用药两周后,比较两组患者的中医证候积分、心功能分级(NYHA分级法)、心衰积分(Lee氏计分法)、左室射血分数(LVEF)以及N末端脑钠肽前体(NT-proBNP)改善情况来评价雷氏附姜温阳方的疗效,并进行血、尿、便常规检查和肝、肾功能等检测,以此评价试验的安全性。结果：1、临床症状积分比较治疗两周后,对照组与治疗组均能显著改善患者中医证候积分和心衰积分(P0.01)；且治疗组积分下降幅度大于对照组(P0.05)。2、临床疗效比较治疗两周后,对照组与治疗组均能显著改善患者中医证候疗效、心功能疗效、心衰疗效和左室射血分数疗效(P0.01)；且治疗组临床疗效总有效率优于对照组。3、左室射血分数(LVEF)比较治疗两周后,对照组与治疗组均能显著提高患者左室射血分数(P0.01)；与对照组比较,治疗组在治疗两周后左室射血分数升高幅度较大,具有统计学意义(P0.05)。4、N末端脑钠肽前体(NT-proBNP)比较治疗两周后,对照组与治疗组均能显著降低患者N末端脑钠肽前体水平(P0.01)；与对照组比较,治疗组在治疗两周后N末端脑钠肽前体下降幅度较大,具有统计学意义(P0.05)。5、安全性比较在临床试验过程中,患者血、尿、便和肝、肾功能等均无显著异常(P0.05)。结论：温阳利水法治疗阳虚水泛型慢性心力衰竭患者有效。雷氏附姜温阳方可以改善慢性心力衰竭患者的临床症状,减少其中医证候积分、心衰积分,改善心功能分级,可增加左室射血分数,降低阳虚水泛型慢性心力衰竭患者的N末端脑钠肽前体(NT-proBNP)水平,是治疗阳虚水泛型慢性心力衰竭的有效方剂。本临床观察显示雷氏附姜温阳方安全性好,无毒副反应。
[Abstract]:Objective: To observe the clinical efficacy and safety of ginger decoction in the treatment of Warming Yang Lei Yang water generic chronic heart failure and to explore the role of ginger on Warming Yang Lei in patients with chronic heart failure, and provide clinical basis for the clinical use. Methods: according to random control principle, 64 cases of chronic heart failure were randomly according to 1:1 the proportion will meet the diagnostic criteria of TCM Yang water generic use, divided into 32 cases of the control group of 32 cases and treatment group. The control group was treated with standard treatment, treatment group on the basis of the western standard treatment combined with Ray's Party of ginger Warm Yang orally. After two weeks of treatment, compared two groups of patients with TCM syndrome integral, heart function classification (NYHA classification), heart failure score (Lee's score), left ventricular ejection fraction (LVEF) and N terminal pro brain natriuretic peptide (NT-proBNP) to evaluate the improvement of the party's Ginger Warm Yang Lei The curative effect, and blood, urine, stool routine examination and liver, renal function detection, safety evaluation to test. Results: 1. Clinical symptom scores after two weeks of treatment, the control group and the treatment groups can significantly improve the integral syndromes integral and heart failure (P0.01) and the treatment group; integral decreased than that of control group (P0.05.2), to compare the clinical efficacy after two weeks of treatment, the control group and the treatment groups can significantly improve the curative effect of TCM syndromes in patients with heart function, curative effect, curative effect and curative effect of left ventricular ejection fraction congestive heart failure (P0.01); the treatment group and the clinical curative effect of the total efficiency of.3 is better than the control group. The left ventricular ejection fraction (LVEF) comparison after two weeks of treatment, the control group and the treatment group was significantly increased in patients with left ventricular ejection fraction (P0.01); compared with the control group, the treatment group in two weeks after the treatment, left ventricular ejection fraction increased significantly, with statistical significance (P0.05).4, N at the end of Brain natriuretic peptide (NT-proBNP) comparison after two weeks of treatment, the control group and the treatment group were significantly lower in patients with N proBNP (P0.01); compared with the control group, the treatment group in two weeks after the treatment, N terminal brain natriuretic peptide decreased greatly, with statistical significance (P0.05.5), safety in clinical trials, patients with blood, urine, liver and kidney function, there were no significant abnormalities (P0.05). Conclusion: Warming Yang and diuretic therapy in patients with chronic heart failure Yang water generic. Reyes of ginger can improve warming Yang chronic heart failure in patients with clinical symptoms, reduce the the TCM syndrome score, heart failure score, improve heart function classification, can increase the left ventricular ejection fraction, decreased in patients with chronic heart failure Yang water generic N terminal brain natriuretic peptide (NT-proBNP) level, is effective in treating chronic heart failure Yang water generic. The clinical outlook Observe the safety of ginger Warm Yang Fang Lei display is good, non-toxic side effects.

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

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