益气复脉方对老年人冠心病室性早搏的作用及对窦性心率震荡影响的研究

发布时间：2018-03-08 14:02

本文选题：益气复脉方　切入点：冠心病　出处：《河南中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:观察益气复脉方对老年人冠心病(Coronary heart disease,CHD)室性早搏(Ventricular premature contractions,VPCs)气血两虚证的临床疗效及对窦性心率震荡(Heart rate turbulence,HRT)的两个量化指标TO(Turbulence onset震荡初始)、TS(Turbulence slope震荡斜率)的影响,探讨其作用机理,为该方治疗冠心病室性早搏奠定一定的理论基础,并提供循证医学的依据。方法:将收集的60名符合气血两虚型冠心病室性早搏诊断的病人随机的分成治疗组30例、对照组30例,治疗组予益气复脉方治疗,对照组选用盐酸普罗帕酮片(心律平)治疗,两组疗程均为6周。观察比较治疗组与对照组治疗前后的中医证候积分、中医证候疗效、24小时室性早搏次数、室性早搏的心电图疗效、心率震荡以及用药前后安全性指标等的变化;通过统计软件包SPSS19.0建立数据库,并进行数据管理与分析,最终得出结果。结果:(1)用药6周之后观察两组患者的中医证候积分的变化:治疗组与对照组比较:(P0.05),有统计学意义;两个组的中医证候疗效进行比较,在总有效率方面,治疗组80%,对照组则为60%,比较具有统计学的差异(P0.05)。(2)用药6周以后观察两组24小时动态心电图的VPCs次数的变化:治疗组与对照组比较:(P0.05),差异无显著性,无统计学意义;治疗组VPCs心电图的总有效率66.67%,对照组则53.33%,两组比较差异无显著性(P0.05),两个组疗效相当。(3)用药6周后观察两组患者TO、TS的变化:治疗组与对照组TO比较:(P0.01),治疗组效更优;治疗组与对照组TS比较:(P0.01),有统计学的意义,治疗组效更优。结论:(1)在中医证候方面,益气复脉方能有效的改善老年人冠心病室性早搏气血两虚证患者的临床症状,如心悸、气短乏力、胸闷等。(2)在24小时动态心电图室性早搏次数与疗效方面,益气复脉方能够减少24小时动态心电图室性早搏的发生次数,并在VPCs的心电图疗效方面与盐酸普罗帕酮片相当。(3)益气复脉方能够使心率震荡的指标TO减小,TS增大,从而使HRT趋向平衡,由此使自主神经功能得到改善。(4)安全方面,益气复脉方无明显肝肾功能损害,未产生毒副作用,值得临床进一步推广运用。
[Abstract]:Objective: to observe the clinical effect of Yiqi Fumai recipe (YQFM) on the syndrome of qi and blood deficiency in elderly patients with coronary heart disease (CHD), and to observe the effect of Qi-blood deficiency syndrome of Ventricular premature contractitioners (VPCs) and the two quantitative indexes of TO(Turbulence onset concussion (TO(Turbulence onset concussion) on the slope turbulence slope of heart rate turbulence (HR), and to observe the clinical effect of Yiqi Fumai recipe (YQFM) on the Qi-blood deficiency syndrome in elderly patients with coronary heart disease (CHD). To explore the mechanism of its action, and to lay a theoretical foundation for the treatment of premature ventricular beats in coronary heart disease. Methods: 60 patients with CHD diagnosed by Qi-Xue deficiency syndrome were randomly divided into treatment group (n = 30) and control group (n = 30). The patients in the control group were treated with propafenone hydrochloride (propafenone hydrochloride) for 6 weeks. The changes of electrocardiogram effect, heart rate turbulence and safety indexes before and after treatment of ventricular premature beats were analyzed, and the database was established by statistical software package SPSS19.0, and the data was managed and analyzed. Results: after 6 weeks of medication, the changes of TCM syndromes in the two groups were observed: there was statistical significance in the treatment group compared with the control group (P 0.05); the curative effect of TCM syndrome in the two groups was compared with that in the control group, and in the total effective rate, The VPCs frequency of 24 hours ambulatory electrocardiogram in the treatment group and the control group was observed after 6 weeks. There was no significant difference between the treatment group and the control group, and there was no significant difference between the treatment group and the control group. The total effective rate of VPCs electrocardiogram in the treatment group was 66.67 and that in the control group was 53.33. There was no significant difference between the two groups. Compared with the control group TS, the treatment group has statistical significance, the effect of treatment group is better. Conclusion: in TCM syndromes, Yiqi Fumai prescription can effectively improve the clinical symptoms, such as palpitation, in elderly patients with ventricular premature beat qi and blood deficiency syndrome. Qi-short fatigue, chest tightness, etc.) in 24 hours ambulatory electrocardiogram ventricular premature beat times and curative effect, Yiqi Fumai prescription can reduce 24 hour ambulatory electrocardiogram ventricular premature beat occurrence times, The electrocardiographic efficacy of VPCs was similar to that of propafenone hydrochloride tablets.) Yiqi Fumai recipe could reduce the increase of to and increase TS of heart rate turbulence, thus make HRT tend to be balanced, and the autonomic nervous function could be improved. Yiqi Fumai recipe has no obvious damage of liver and kidney function and has no toxic side effects, so it is worth popularizing in clinic.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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