益气活血通络法治疗稳定型心绞痛气虚血瘀证临床研究

发布时间：2018-04-24 15:52

本文选题：中医膏方 + 益气活血通络法　；参考：《安徽中医药大学》2016年硕士论文

【摘要】：目的:本研究从气血同治理论入手,观察益气活血通络法膏方在冠心病稳定型心绞痛气虚血瘀证患者临床应用,评价此膏方对冠心病稳定型心绞痛气虚血瘀证患者的临床疗效及安全性,并探讨相关作用机制,为临床推广该膏方提供理论及实践基础。方法:选择辨证为气虚血瘀证的冠心病稳定型心绞痛患者60例,采用随机数字表法分为对照组和治疗组。对照组以抗冠心病高危因素治疗为基础,降压、降糖、调脂及抗血小板聚集。治疗组在常规抗冠心病危险因素治疗的基础上加用益气活血通络膏方,每日2次,每次15g(开水冲服),疗程为28天。结果:1.心绞痛疗效、心绞痛积分方面:治疗组心绞痛疗效总有效率为93.3%,对照组心绞痛疗效总有效率为83.3%,P0.01,差异具有统计学意义。与对照组相比,治疗组治疗后的心绞痛积分下降更明显,P0.01,说明在改善心绞痛积分方面,治疗组优于对照组,差异具有统计学意义。2.中医证候疗效方面:治疗组总有效率为90%,对照组总有效率为83.3%,治疗组优于对照组,差异有统计学意义。在改善患者胸闷、胸痛、乏力、气短、自汗等方面,治疗组也是优于对照组,P0.05,差异具有统计学意义。在改善心悸方面,两组差异无统计学意义。3.心电图疗效方面:治疗组心电图疗效总有效率73.3%,对照组心电图总有效率53.3%,P0.05,差异有统计学意义。4.血脂方面比较:治疗组在改善甘油三酯(TG)和胆固醇(TC)方面优于对照组,P0.05,差异具有统计学意义。治疗后治疗组与对照组在低密度脂蛋白(LDL)方面比较,P0.05,差异无统计学意义。5.hs-CRP、NO、Hcy方面比较:对hs-CRP、Hcy改善,治疗组优于对照组,P0.05,差异有统计学意义;对NO改善方面,P0.05,差异不具有统计学意义。6.安全性评价:治疗组和对照组60例患者治疗前后均进行了血常规、尿常规、大便常规、凝血常规、肝功能(ALT、AST)、肾功能(Cr、Bun)检测,检测结果均波动在医学参考值范围之内,治疗前后无明显变化,说明益气活血通络膏方无明显毒副作用,应用安全。结论:益气活血通络膏方对气虚血瘀证胸痹心痛患者临床疗效较好,可显著改善患者的心绞痛症状,减少发作次数,改善中医症状,改善心电图疗效,降低血脂,且临床应用安全性良好,无不良反应。
[Abstract]:Objective: to observe the clinical application of Yiqi Huoxue Tongluo ointment in stable angina pectoris of coronary heart disease. To evaluate the clinical efficacy and safety of this ointment on stable angina pectoris of coronary heart disease patients with Qi deficiency and blood stasis syndrome, and to explore the related mechanism, and to provide a theoretical and practical basis for clinical popularization of the ointment prescription. Methods: sixty patients with stable angina pectoris of coronary heart disease with syndrome differentiation of qi deficiency and blood stasis were randomly divided into control group and treatment group. The control group was based on high risk factors of anti-coronary heart disease, including hypotension, blood glucose, lipid regulation and platelet aggregation. The treatment group was treated with Yiqi Huoxue Tongluo ointment on the basis of routine anti-coronary heart disease risk factors. The result is 1: 1. The total effective rate of angina pectoris in treatment group was 93.30.The total effective rate of angina pectoris in control group was 83.3% (P 0.01), the difference was statistically significant. Compared with the control group, the angina pectoris score in the treatment group decreased more obviously than that in the control group, indicating that the treatment group was better than the control group in improving angina pectoris score, the difference was statistically significant. The curative effect of TCM syndrome: the total effective rate of the treatment group is 90%, the total effective rate of the control group is 83.3%, the treatment group is better than the control group, the difference is statistically significant. In improving chest tightness, chest pain, fatigue, shortness of breath, self-sweating, the treatment group is also better than the control group P0.05, the difference is statistically significant. In improving palpitation, there was no significant difference between the two groups. The total effective rate of electrocardiogram in the treatment group was 73.3%, while that in the control group was 53.3% (P0.05), the difference was statistically significant. Comparison of blood lipids: the treatment group was better than the control group in improving triglyceride (TG) and cholesterol (TCC), the difference was statistically significant. After treatment, there was no significant difference between the treatment group and the control group in low density lipoprotein (LDL) (P 0.05). There was no significant difference between the treatment group and the control group (P 0.05). There was no significant difference between the treatment group and the control group in the improvement of hs-CRPU Hcy, and the difference was statistically significant in the treatment group than in the control group (P 0.05). There was no significant difference in the improvement of no (P 0.05). Safety evaluation: blood routine, urine routine, stool routine, coagulation routine, liver function test and renal function test were performed in 60 patients of treatment group and control group before and after treatment. The results were all fluctuated within the range of medical reference value. There was no obvious change before and after treatment, indicating that Yiqi Huoxue Tongluo ointment had no obvious side effects and was safe to use. Conclusion: Yiqi Huoxue Tongluo ointment has a good clinical effect on patients with chest obstruction and heart pain due to qi deficiency and blood stasis syndrome. It can significantly improve the symptoms of angina pectoris, reduce the number of attacks, improve the symptoms of traditional Chinese medicine, improve the curative effect of electrocardiogram, and reduce blood lipid. The safety of clinical application is good and there is no adverse reaction.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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