经方辨治慢性心力衰竭的文献研究

发布时间：2018-03-29 07:07

本文选题：经方　切入点：慢性心力衰竭　出处：《湖北中医药大学》2017年硕士论文

【摘要】：慢性心力衰竭是临床常见危重疾病,西医对其的研究颇深,治疗手段包括药物治疗和非药物治疗,近来随着中医对其认识加深,治疗方法逐步多样,包括经方治疗、验方治疗、中成药、中药注射液等不同方法,其中有关经方的使用的临床研究越来越多,本研究的目的:探讨经方在慢性心力衰竭中运用的辨证规律,分为两部分进行论述:第一部分通过研究理论文献,探讨慢性心力衰竭的中医学病名、病因病机、结合中医辨证理论及现代研究予以辨证分型研究。慢性心力衰竭病机为本虚标实、本虚为心气虚、阳气虚,标实为水饮、瘀血、痰浊。第二部分为临床文献研究,方法:通过收集近10年关于经方治疗慢性心力衰竭的临床研究,合格文献总计为116篇,通过excel建立表格,统计文献名、发表年代、病人例数、辨证分型、疗效判定标准等相关资料,对数据进行统计,结果显示:1、慢性心衰中不同经方使用频率依次为:真武汤、苓桂术甘汤、四逆汤、五苓散、木防己汤、葶苈大枣泻肺汤、瓜蒌薤白半夏汤、防己茯苓汤。2、慢性心衰以西医基础治疗联合经方治疗后患者平均有效率高低依次为:五苓散92.12%、真武汤91.67%、苓桂术甘汤90.9%、四逆汤90.86%、木防己汤85.3%。心衰中常见证型为:心肾阳虚型、阳虚水泛型、气虚血瘀型、痰瘀互阻型、阳气亏虚型。3、总结经方在治疗本病中涉及的诊断、治疗方法、疗效判定标准。根据总结临床研究文献,探讨经方使用的规律,包括运用规律和辨证规律;5、组方疗效对照研究显示:116篇文献中115篇均采用以西医药物治疗联合经方治疗进行临床观察,西医联合经方作为观察组,以单纯西医基础治疗作为对照组、观察组疗效均高于单纯组,说明经方在心力衰竭的治疗中起到积极作用,提高了临床疗效。6、探讨经方的功效;探索不同阶段心衰治疗经方选择的简单原则,包括早期的积极治疗原发病,中期的重在补虚扶正,后期的扶正驱邪并重。7、探索经方治疗慢性心力衰竭的辨证要点,包括辨病因、辨病位、辨病性、辨阴阳、辨虚实五个部分,并分别探究灵活运用经方的方法,以提高临床疗效。
[Abstract]:Chronic heart failure (CHF) is a common clinical critical disease. Western medicine has studied it very deeply. Treatment methods include drug therapy and non-drug therapy. Recently, with the deepening of the understanding of CHF, the treatment methods have gradually varied, including the treatment of Jing Fang and the treatment of prescription test. There are more and more clinical studies on the use of traditional Chinese medicine and traditional Chinese medicine injection. The purpose of this study is to explore the law of syndrome differentiation used by Jing Fang in chronic heart failure. It is divided into two parts: the first part discusses the name, etiology and pathogenesis of chronic heart failure by studying the theoretical literature. Combined with the theory of TCM syndrome differentiation and modern research, the pathogenesis of chronic heart failure (CHF) is based on deficiency, deficiency of heart qi, deficiency of yang qi, standard of water drink, blood stasis and turbid phlegm. The second part is clinical literature research. Methods: in the past 10 years, the clinical study on the treatment of chronic heart failure by Meridian prescription was carried out. There were 116 articles of qualified literature. The table was established by excel, the name of the documents was published, the number of patients was published, and the patients were classified according to syndrome differentiation. The result shows that the frequency of different prescriptions in chronic heart failure is Zhenwu Tang, Lingguizhugan decoction, Sini decoction, Wuling Powder, Mu Fang Ji Tang, Tingli Da Zao Xiefei decoction, etc. Guilou Xiebai Banxia decoction, Fangji Fuling decoction. 2. The average effective rate of chronic heart failure treated by western medicine combined with meridian prescription is: Wuling Powder 92.12, Zhenwu decoction 91.67, Lingguizhugan decoction 90.9, Sini decoction 90.86 and Mufangji decoction 85.3. The common syndromes in heart failure are heart and kidney yang deficiency. Yang deficiency and water generality, qi deficiency and blood stasis, phlegm and blood stasis mutual obstruction, Yang Qi deficiency and deficiency of yang. 3. The diagnosis, treatment method and curative effect judgment standard of Meridian prescription in the treatment of this disease are summarized. Including the use of the law and the law of syndrome differentiation. A comparative study of the efficacy of the group showed that 115 of the 116 articles were treated with western medicine combined with Jing Fang for clinical observation, and Western medicine combined with the classics as the observation group. The curative effect of the observation group was higher than that of the simple group, which showed that the Meridian prescription played a positive role in the treatment of heart failure, and improved the clinical efficacy. To explore the simple principles of treating heart failure in different stages, including the early active treatment of primary disease, the middle stage of the emphasis on tonifying deficiency and strengthening the spirit, and the later period of strengthening and dispelling evil spirits, and exploring the dialectical key points of Meridian prescription in treating chronic heart failure, including differentiation of etiology, In order to improve the clinical curative effect, the five parts of differentiating disease position, disease differentiation, yin and yang, and deficiency and reality are explored respectively in order to improve the clinical effect by using the method of meridian prescription.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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