化痰活血通脉汤治疗冠心病稳定型心绞痛（痰瘀互结型）的临床研究

发布时间：2018-03-25 05:41

本文选题：化痰活血通脉汤　切入点：冠心病　出处：《成都中医药大学》2016年硕士论文

【摘要】：目的：本研究旨在观察化痰活血通脉汤治疗冠心病稳定型心绞痛(痰瘀互结型)的临床疗效并探讨其作用机理。方法：纳入2015年3月至2016年2月成都中医药大学附属医院心血管内科门诊和住院部收集的70例西医符合冠心病稳定型心绞痛诊断、中医符合胸痹(痰瘀互结型)的患者,采用随机数字查表法将70例病人按1：1随机分为治疗组和对照组,每组35例。两组患者同时给予西药基础治疗(拜阿司匹林100mg口服一天一次,单硝酸异山梨酯缓释片60mg口服一天一次,美托洛尔缓释片23.75mg一天一次,阿托伐他汀钙片20mg晚上口服一天一次),治疗组在对照组西药治疗的基础上加服化痰活血通脉汤剂。4周后对两组患者在治疗前后的中医证候疗效、心绞痛程度、心电图疗效、血脂、炎症反应指标(CRP)、血液流变学等指标进行比较。结果：治疗组冠心病心绞痛的总有效率为97.1%,中医证候总有效率为94.3%,心电图疗效总有效率为85.7%；对照组冠心病心绞痛的总有效率为90.0%,中医证候总有效率为86.7%,心电图疗效总有效率为76.7%。两组治疗后均能改善或消除心绞痛表现及临床症状,减少中医证候积分,改善心电图ST段及T波异常情况,但比较两组差异无统计学意义(P0.05)。两组治疗后均能明显改善血液流变学各项指标,其中治疗组在改善全血粘度、红细胞聚集指数等方面优于对照组(P0.05)；同时,两组均可显著改善血脂代谢情况,在降低甘油三酯(TG)方面,治疗组明显优于对照组(P0.05)。提示：化痰活血通脉汤治疗冠心病稳定型心绞痛(痰瘀互结型)疗效优于对照组,观察期间两组均未发现明显不良反应。结论：临床观察示,化痰活血通脉汤治疗痰瘀互结型冠心病稳定型心绞痛有较好的疗效,未见明显不良反应。
[Abstract]:Objective: to observe the clinical effect of Huatan Huoxue Tongmai decoction (Huatan Huoxue Tongmai decoction) in the treatment of stable angina pectoris (phlegm and blood stasis type) of coronary heart disease. Methods: from March 2015 to February 2016, Chengdu University of traditional Chinese Medicine was included in the study. Seventy cases of western medicine collected from the outpatient and inpatient departments of the Department of Cardiovascular Medicine of affiliated Hospital were in accordance with the diagnosis of stable angina pectoris of coronary heart disease. In accordance with chest obstruction (phlegm and blood stasis), 70 patients were randomly divided into treatment group and control group by 1:1. 35 patients in each group were treated with basic western medicine (Aspirin 100mg once a day, isosorbide mononitrate sustained release tablet 60mg once a day, metoprolol sustained release tablet 23.75mg once a day. Atto vastatin calcium tablet 20mg was given orally once a day in the evening. The treatment group was treated with Huatan Huoxue Tongmai decoction for 4 weeks on the basis of western medicine in the control group. After the treatment, the TCM syndromes, the degree of angina pectoris, and the electrocardiogram of the two groups were treated. Blood lipid, Results: the total effective rate of angina pectoris of coronary heart disease in the treatment group was 97.1, the total effective rate of TCM syndrome was 94.3 and the total effective rate of electrocardiogram was 85.7 in the control group. The total effective rate was 90.0, the total effective rate of TCM syndrome was 86.7, the total effective rate of electrocardiogram was 76.70.After treatment, both groups could improve or eliminate the symptoms of angina pectoris and clinical symptoms. To reduce TCM syndromes integral and improve St segment and T wave abnormality of electrocardiogram, but there was no significant difference between the two groups (P 0.05). All the indexes of hemorheology were significantly improved in the treatment group, and the whole blood viscosity was improved in the treatment group. The erythrocyte aggregation index was better than that of the control group (P 0.05), and both groups could significantly improve the metabolism of blood lipids and reduce the TGs of triglyceride. The therapeutic effect of Huatan Huoxue Tongmai decoction in treating stable angina pectoris of coronary heart disease (phlegm and blood stasis type) was better than that in control group, and no obvious adverse reactions were found in both groups during the observation period. Conclusion: clinical observation shows that the therapeutic effect of Huatan Huoxue Tongmai decoction is better than that of control group. Huatan Huoxue Tongmai decoction (Huatan Huoxue Tongmai decoction) has good curative effect on stable angina pectoris of coronary heart disease.
【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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