归脾汤合生脉饮加减治疗心脾两虚型室性早搏的疗效观察

发布时间：2018-05-11 17:11

本文选题：归脾汤合生脉饮 + 室性早搏　；参考：《湖北中医药大学》2017年硕士论文

【摘要】：目的观察归脾汤合生脉饮加减对心脾两虚证室性早搏患者的临床疗效及安全性,初步探索和分析其作用机制,为其临床应用提供科学依据,为室性早搏的中医治疗提供安全有效的方药,从而更好地服务于临床。方法选取自2015年9月至2017年2月湖北省中医院光谷院区心血管内科住院部及门诊符合西医室性早搏诊断标准同时中医辨证为心脾两虚证患者50例。按照随机分组的方法分为治疗组25例和对照组25例。治疗组:口服中药汤剂归脾汤合生脉饮加减治疗,2次/日,早中餐后各温服。对照组:口服西药琥珀酸美托洛尔缓释片(倍他乐克)[阿斯利康制药有限公司]规格:47.5mg*7片,起始量为23.75mg,每天一次,根据血压、心率变化,逐步调整剂量,疗程均为4周。观察治疗前后中医证侯及舌脉、中医证侯积分及24小时动态心电图早搏次数的变化,收集相关数据并进行统计学分析。结果1.室性早搏次数方面:两组治疗后室早总数均明显减少,但治疗后组间比较无统计学意义(P0.05);2.室早总疗效方面:治疗组治疗后总有效率为76%,对照组总有效率为80%,组间比较无统计学意义(P0.05),说明治疗后两组无明显差异;3.中医证侯方面:治疗组及对照组都能有效改善早搏中医症状,但治疗组明显优于对照组(P0.05),以心悸气短、神疲乏力、纳呆食少、面色无华改善更明显,两组在头晕目眩、少寐多梦、腹胀便溏改善方面无明显差异(P0.05);4.中医证侯积分总疗效方面:治疗后治疗组显效率60%,有效率28%,总有效率88%,对照组显效率28%,有效率36%,总有效率为64%,两组相比,治疗组优于对照组(P0.05);5.安全性方面:治疗组在服用中药过程中,患者未出现严重不良反应,全程定期监测血尿粪三大常规、肝肾功能、凝血功能等安全性指标,无明显变化。结论1.归脾汤合生脉饮加减能明显改善心脾两虚证室性早搏患者的中医证侯,其中以心悸气短、神疲乏力、纳呆食少、面色无华改善更明显;2.归脾汤合生脉饮加减能明显减少室性早搏患者的早搏次数;3.归脾汤合生脉饮加减在治疗室性早搏过程中未发现明显不良反应和毒副作用,说明了其安全性和有效性。
[Abstract]:Objective To observe the clinical efficacy and safety of GUI PI decoction combined with Shengmai drink on ventricular premature beat of two deficiency syndrome of heart and spleen, preliminary exploration and analysis of its mechanism of action, provide scientific basis for its clinical application, provide a safe and effective prescription for the treatment of ventricular premature beat, so as to better serve the clinic. Methods from September 2015 to 2017 are selected. In February, the hospitalization department and outpatient department of the Department of cardiovascular medicine in Optics Valley Hospital of Hubei Provincial Traditional Chinese Medical Hospital were in accordance with the diagnostic criteria of Western medicine ventricular premature beat. At the same time, the TCM syndrome was divided into 50 patients with two deficiency syndrome of heart and spleen. The treatment group was divided into 25 cases and 25 cases in the control group. The treatment group was treated with Decoction of Chinese medicine and decoction of Chinese medicine, combined with Shengmai Decoction, 2 times / day, and early Chinese meal. The control group: the control group: oral western medicine Metoprolol Succinate Sustained-release Tablets (Betaloc) [AstraZeneca Pharmaceutical Co., Ltd.] specifications: 47.5mg*7 tablets, the initial amount of 23.75mg, once a day, according to the blood pressure, heart rate changes, gradually adjust the dose, the course is 4 weeks. Observe and treatment of TCM syndrome and tongue vein, TCM syndrome score and 24 hour movement The changes in the frequency of premature beat of the electrocardiogram were collected and analyzed statistically. Results the number of 1. ventricular premature beats decreased significantly in the two groups after treatment, but there was no significant difference between the groups after treatment (P0.05); the total effective rate in the 2. compartment was 76% after treatment and the total effective rate of the control group was 80%. The total effective rate of the control group was 80%. There was no statistical significance (P0.05), indicating that there was no significant difference between the two groups after the treatment. 3. the treatment group and the control group could effectively improve the symptoms of traditional Chinese medicine, but the treatment group was significantly better than the control group (P0.05), with palpitation shortness of breath, the weakness of God, the lack of food, the improvement of the color without China, and the two groups in dizziness, insomnia and many dreams, and abdomen. There was no significant difference in swelling and loose stool improvement (P0.05); 4. the total curative effect of TCM syndrome score: after treatment, the effective rate was 60%, the effective rate was 28%, the total effective rate was 88%, the control group was 28%, the effective rate was 36%, the total effective rate was 64%, the treatment group was superior to the control group (P0.05) compared with the control group (5.); 5. safety aspects: the treatment group was taking Chinese traditional medicine process, patients There was no serious adverse reaction. There was no obvious change in the safety indexes of three major routine hematuria excrement, liver and kidney function, blood coagulation function and so on. Conclusion 1. guanpi decoction combined with Shengmai drink can obviously improve the TCM syndrome of the patients with ventricular premature beat of two deficiency syndrome of heart and spleen. 2. PWM and Shengmai Decoction can significantly reduce the number of premature beat in the patients with premature ventricular contractions, and the addition and subtraction of Shengmai Decoction and Shengmai Decoction in the therapeutic room have not found obvious adverse reactions and side effects in the process of sexual premature beat in the therapeutic room, indicating its safety and effectiveness.

【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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