温阳通络法治疗寒湿痹阻型系统性硬化的临床观察

发布时间：2018-05-22 11:47

本文选题：系统性硬化 + 寒湿痹阻型　；参考：《云南中医学院》2017年硕士论文

【摘要】：目的:探讨以附子桂枝合剂为代表方的温阳通络法治疗证属寒湿痹阻型系统性硬化的立论依据及临床疗效,采取随机对照分析研究,运用统计学方法,归纳、总结温阳通络法治疗系统性硬化的疗效及安全性。方法:采用随机对照试验,将符合纳入标准的60例寒湿痹阻型系统性硬化患者,随机分为治疗组30例和对照组30例。治疗组予口服附子桂枝合剂联合青霉胺片,对照组予口服青霉胺片。12周为一个疗程。观察两组患者治疗前、治疗后皮肤硬度、甲襞微循环检测结果、中医证候积分、血沉、C-反应蛋白等疗效性指标。并观察治疗前、治疗后两组患者血、尿、便常规化验、肝肾功能、心电图检查等安全性指标。结果:1.从中医病因病机出发探讨温阳通络法治疗系统性硬化(寒湿痹阻型)的立论依据及可行性;基于文献研究,提取有效治法方药,探讨附子桂枝合剂的主要组成药物、配伍规律及治疗系统性硬化的可行性。2.疗程结束后,两组中医证候比较,治疗组中医证候疗效总有效率为93.34%,对照组为80%,两组比较,差异有统计学意义(P0.05)。3.治疗组甲襞微循环检测结果有效率为90%,对照组为66.67%,两组比较,差异有统计学意义(P0.05)。4.疗程结束后,治疗组和对照组皮肤硬化分级比较,存在显著性差异(P0.05),治疗组明显优于对照组。5.疗程结束后,治疗组和对照组改善ESR、CRP比较,差异存在统计学意义(P0.05),治疗组优于对照组。6.研究过程中,两组患者血常规、肝肾功等均未出现明显异常。结论:1.以附子桂枝合剂为代表方的温阳通络法是治疗寒湿痹阻型系统性硬化安全有效的方法。2.附子桂枝合剂能明显改善寒湿痹阻型系统性硬化的临床症状,且未发现明显毒副作用,是安全有效的药物,值得临床应用及推广。
[Abstract]:Objective: to explore the theoretical basis and clinical effect of wenyang Tongluo method in treating systemic sclerosis of cold and dampness obstruction type with Fuzi Guizhi mixture as the representative prescription. To summarize the efficacy and safety of warming yang and clearing collaterals in the treatment of systemic sclerosis. Methods: 60 patients with systemic sclerosis of cold and dampness obstruction were randomly divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated with aconite Guizhi mixture combined with penicillamine tablet, and the control group was treated with penicillamine tablet for 12 weeks. The skin hardness, nailfold microcirculation, TCM syndromes score, erythrocyte sedimentation rate (ESR) and C-reactive protein were observed before and after treatment in the two groups. The safety indexes such as blood, urine, stool routine test, liver and kidney function, electrocardiogram were observed before and after treatment. The result is 1: 1. From the etiology and pathogenesis of traditional Chinese medicine, to discuss the theoretical basis and feasibility of warming Yang Tongluo method in treating systemic sclerosis (cold and dampness arthralgia obstruction type), based on the literature study, to extract effective prescription drugs, and to discuss the main components of Fuzi Guizhi mixture. Compatibility Law and the Feasibility of treating systemic sclerosis. After the end of the course of treatment, the two groups of TCM syndrome comparison, the treatment group TCM syndromes total effective rate of 93.34 and the control group is 80, the difference between the two groups, the difference was statistically significant (P 0.05). 3. The effective rate of nailfold microcirculation in the treatment group was 90 and that in the control group was 66.67. The difference between the two groups was statistically significant (P 0.05). After the course of treatment, there was a significant difference between the treatment group and the control group in skin sclerosis grade (P 0.05), and the treatment group was significantly better than the control group (P 0.05). After the course of treatment, the treatment group and the control group improved ESR-CRP, the difference was statistically significant (P 0.05), the treatment group was better than the control group. 6. In the course of the study, there were no significant abnormalities in blood routine, liver and kidney function in both groups. Conclusion 1. The Wenyang Tongluo method, which is represented by Fuzi Guizhi mixture, is a safe and effective method for the treatment of systemic sclerosis of cold and dampness obstruction type. Fuzi Guizhi mixture can obviously improve the clinical symptoms of systemic sclerosis of cold and dampness obstruction type, and no obvious toxic side effects have been found. It is a safe and effective drug and is worthy of clinical application and popularization.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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