血府逐瘀汤治疗冠心病左室舒张功能减退的临床研究

发布时间：2018-04-01 01:24

本文选题：冠心病(气滞血瘀型)　切入点：左室舒张功能不全　出处：《广州中医药大学》2016年硕士论文

【摘要】：目的：左室舒张功能减退,是冠心病早期心肌缺血的表现之一。降低左室舒张末期的压力,改善左室顺应性,可预防冠心病向终末期心力衰竭进一步发展。本研究旨在观察血府逐瘀汤治疗气滞血瘀型冠心病左室舒张功能减退的临床疗效,并观察血府逐瘀汤治疗气滞血瘀型冠心病前后超声心动图中反应左室舒张功能指标的改变。通过此研究,探索中西医结合在冠心病左室舒张功能减退患者中提供更好的治疗方法。方法：本研究采取前瞻性随机对照研究,选取广州市中医医院心病科住院诊断为冠心病左室舒张功能减退(气滞血瘀型)的患者60例,并按随机方法分为实验组30例和对照组30例。实验组运用血府逐瘀汤加冠心病常规西医治疗,对照组单运用冠心病常规西医治疗。治疗14天后观察两组临床疗效,并对照治疗前后患者超声心动图左室舒张功能指标(E、A、E/A)的改变。结果：1.治疗组与对照组的一般资料(包括年龄、性别),治疗前左室舒张功能指标E、A、E/A及中医症候积分比较,差异无统计学意义(P0.05)。2.左室舒张功能比较,治疗组在治疗后E、A、E/A比较,差异有统计学意义(P0.05)。对照组在治疗后A比较,差异无统计学意义(P0.05),而E、E/A比较,差异有统计学意义(P0.05)。两组在治疗后E、A、E/A比较,差异有统计学意义(P0.05)。3.中医证候积分比较,治疗前两组中医症候积分比较,差异无统计学意义(P0.05)。治疗前后两组中医症候积分分别比较,差异有统计学意义(P0.05)。治疗后两组中医症候积分比较,差异有统计学意义(P0.05)。4.两组中医症候疗效比较,差异有统计学意义(P0.05)。结论：1.两组患者性别构成、年龄比较均无显著性差异,具有可比性。2.两组患者治疗前后E、E/A比较均有显著性差异,表明两组治疗方案均能提高E峰、改善左室舒张功能。两组患者治疗后E、A、E/A比较均有显著性差异,表明治疗组比对照组在改善左室舒张功能不全方面效果更佳。3.两组患者治疗前后中医证候积分比较均有显著性差异,表明两组治疗方案均能减少中医证候积分。两组患者治疗后中医证候积分比较有显著性差异,表明治疗组比对照组更能减少中医症候积分。4.两组患者治疗后中医症候疗效比较有显著性差异,表明治疗组中医症候疗效优于对照组。
[Abstract]:Objective: left ventricular diastolic dysfunction is one of the manifestations of early myocardial ischemia in coronary heart disease. The aim of this study was to observe the clinical effect of Xuefu Zhuyu decoction on left ventricular diastolic dysfunction in patients with coronary heart disease with Qi stagnation and blood stasis. The changes of left ventricular diastolic function in echocardiography before and after Xuefu Zhuyu decoction were observed before and after treatment of coronary heart disease with Qi stagnation and blood stasis. To explore the better treatment of left ventricular diastolic dysfunction in patients with coronary heart disease by combining traditional Chinese and western medicine. Methods: a prospective randomized controlled study was conducted in this study. Sixty patients with coronary heart disease diagnosed as left ventricular diastolic dysfunction (Qi stagnation and blood stasis type) were selected from Department of Heart Disease, Guangzhou traditional Chinese Medicine Hospital. The experimental group was treated with routine western medicine for coronary heart disease with Xuefu Zhuyu decoction, while the control group was only treated with routine western medicine for coronary heart disease. After 14 days of treatment, the clinical effects of the two groups were observed. The changes of left ventricular diastolic function index were compared before and after treatment. Results: 1. The general data of the treatment group and the control group (including age, sex, left ventricular diastolic function index, EtA / A and TCM symptom score) were compared before and after treatment. There was no significant difference in left ventricular diastolic function between the two groups. There was significant difference between the treatment group and the control group after treatment. In the control group, there was no significant difference (P 0.05), but there was no significant difference between the two groups (P < 0.05), but the E / A ratio of the treatment group was higher than that of the control group (P < 0.05), but that of the control group was higher than that of the control group (P < 0.05). The difference was statistically significant (P 0.05). After treatment, the difference between the two groups was statistically significant (P 0.05). There was no significant difference between the two groups before and after treatment. The difference was statistically significant (P 0.05). After treatment, there was a significant difference in the scores of TCM symptoms between the two groups. There was no significant difference in the curative effect of TCM symptoms between the two groups (P 0.05). Conclusion: 1. There is no significant difference in sex composition and age comparison between the two groups. There were significant differences between the two groups before and after treatment, which indicated that both groups could improve E peak and left ventricular diastolic function, and there were significant differences between the two groups after treatment. The results showed that the treatment group was better than the control group in improving left ventricular diastolic dysfunction. There were significant differences between the two groups before and after treatment. The results show that the two treatment schemes can reduce the TCM syndromes integral, and there are significant differences between the two groups after the treatment of TCM syndromes integral. The results showed that the treatment group was more effective than the control group in reducing the TCM symptom score. 4. There was significant difference between the two groups after treatment, which indicated that the treatment group had better curative effect than the control group.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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