生脉散合炙甘草汤加减治疗室性早搏气阴两虚证的临床观察

发布时间：2018-05-27 06:36

本文选题：生脉散合炙甘草汤 + 室性早搏　；参考：《湖北中医药大学》2016年硕士论文

【摘要】：目的:观察生脉散合炙甘草加减治疗室性早搏患者的临床疗效及安全性,为临床治疗提供依据。方法:选取自2014年1月至2015年1月利川市中医院心血管内科住院部及门诊符合室性早搏诊断标准和中医心悸气阴两虚证患者60例。采用随机对照分组的方法将其分为治疗组和对照组,每组30例。治疗组:口服生脉散合炙甘草汤加减治疗,150ml/次,2次/日,早晚餐后各温服。对照组:口服酒石酸美托洛尔(倍他乐克)治疗,25mg/次,2次/日。疗程均为4周。治疗过程中根据各组患者心率、血压及症状来调节用量以及观察治疗前后两组患者中医症状,24小时动态心电图早搏次数,收集数据并进行统计学分析,判断两组治疗疗效及安全性。结果:1.证候积分方面:治疗组中医证候疗效显效率63.3%,有效率36.7%,无效率0%,总有效率100%;而对照组显效率20%,有效率66.7%,无效率4%,总有效率86.7%;经秩和检验分析P=0.000,P0.05,说明治疗组与对照组在证候积分方面存在明显差异,治疗组疗效优于对照组。2.早搏次数方面:治疗组动态心电图疗效显效率13.3%,有效率60%,无效率26.7%,总有效率73.33%;而对照组显效率3.3%,有效率16.7%,无效率80%,总有效率20%;经秩和检验分析P=0.000,P0.05,说明治疗组与对照组在早搏改善情况存在明显差异,治疗组疗效优于对照组。3.中医症状改善方面:治疗组及对照组都能有效改善早搏中医症状,但两组治疗前后有明显差异(P0.05),治疗组明显优于对照组。治疗组比对照组在心悸不宁、倦怠乏力、不寐多梦等症状改善更明显,两组在素体虚弱、面色苍白、耳鸣腰酸等症状改善方面无明显差异(P0.05)。4.安全性方面:两组患者在治疗前后安全性指标,如血常规、大便常规、尿常规、肝功能、肾功能均在正常范围之内,均未出现明显不良反应。结论:1.生脉散合炙甘草汤加减能显著改善中医证型属气阴两虚证室性早搏的症状,对心悸不宁、不寐多梦等症状改善尤为明显。2.生脉散合炙甘草汤加减能明显减少24小时动态心电图室性早搏次数。3.生脉散合炙甘草汤加减在治疗早搏过程中未出现明显不良反应,说明其安全有效。
[Abstract]:Objective: to observe the efficacy and safety of Shengmaisan combined with liquorice plus subtraction in the treatment of ventricular premature beats. Methods: from January 2014 to January 2015, 60 patients with Qi-Yin deficiency syndrome of heart palpitations and heart palpitations were selected from inpatient department and outpatient department of Department of Cardiovascular Medicine, Lichuan traditional Chinese Medicine Hospital, in accordance with the diagnostic criteria of ventricular premature beats and TCM palpitations. They were divided into treatment group and control group with 30 cases in each group. Treatment group: oral Shengmaisan combined with Radix Glycyrrhiza decoction for the treatment of 150 ml / time twice a day, morning and evening after the meal each warm. Control group: metoprolol tartrate (betaloc) was given orally for 25 mg / d. The course of treatment was 4 weeks. In the course of treatment, according to the heart rate, blood pressure and symptoms of the patients in each group, the dosage was adjusted and the 24 hour ambulatory electrocardiogram beat times of the two groups were observed before and after treatment, and the data were collected and analyzed statistically. The efficacy and safety of the two groups were evaluated. The result is 1: 1. Syndromes integral: in the treatment group, the effective rate of TCM syndromes was 63.3%, the effective rate was 36.7%, the effective rate was 0%, the total effective rate was 100; in the control group, the effective rate was 20%, the effective rate was 66.7%, the inefficiency rate was 4%, and the total effective rate was 86.7%; the rank sum test was used to analyze P0.000P0.05, indicating the treatment group and the control group. There were significant differences in syndromes integral between the two groups. The curative effect of the treatment group was better than that of the control group. In terms of the number of times of premature beats: in the treatment group, the markedly effective rate of ambulatory electrocardiogram was 13.3, the effective rate was 60, the effective rate was 26.7, the total effective rate was 73.33; in the control group, the markedly effective rate was 3.3, the effective rate was 16.7. the effective rate was 80 and the total effective rate was 20g; the rank sum test was used to analyze P0. 000 and P0. 05, indicating that the treatment group and the treatment group were correct. There was significant difference in the improvement of premature beats in the radiation group. The curative effect of the treatment group was better than that of the control group. The improvement of TCM symptoms: both the treatment group and the control group can effectively improve the TCM symptoms of premature beats, but there is a significant difference between the two groups before and after treatment, the treatment group is obviously better than the control group. Compared with the control group, the symptoms of palpitations, fatigue, insomnia and many dreams were improved more obviously in the treatment group than in the control group, but there was no significant difference between the two groups in the improvement of symptoms such as physical weakness, pale complexion, tinnitus, lumbar acid and so on. Safety: the two groups of patients before and after the treatment of safety indicators, such as blood routine, stool routine, urine routine, liver function, renal function are within the normal range, no significant adverse reactions. Conclusion 1. Shengmaisan combined with Radix Glycyrrhiza decoction can significantly improve the symptoms of ventricular premature beats of qi and yin deficiency syndrome in TCM syndrome, especially in the symptoms of heart palpitations, insomnia and many dreams. Shengmaisan combined with Radix Glycyrrhiza decoction can significantly reduce 24-hour ambulatory electrocardiogram ventricular premature beat times. 3. There was no obvious adverse reaction in the treatment of premature beats by Shengmaisan and ZhiLicao decoction, which indicated that it was safe and effective.
【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】：2016
【分类号】：R259

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