山药补肺元汤合熊胆散治疗太阴人冠心病心绞痛的临床研究

发布时间：2018-06-01 19:54

  本文选题：冠心病 + 太阴人　； 参考：《延边大学》2017年硕士论文

【摘要】：目的通过观察山药补肺元汤合熊胆散治疗太阴人冠心病心绞痛的临床研究,探讨山药补肺元汤合熊胆散治疗冠心病心绞痛的有效性、安全性,为朝医药在临床治疗冠心病提供更为有效的治疗依据。方法将50例太阴人冠心病稳定型心绞痛患者,按其就诊顺序随机分为两组,即治疗组、对照组,其中25例治疗组服用山药补肺元汤合熊胆散,其余25例对照组服用瑞舒伐他汀钙片。所有患者每日给予5%葡萄糖(250草仙)250ml+丹红注射液40ml,治疗组在丹红注射液基础上给予山药补肺元汤合(组成:麦门冬15g、山药10g、桔梗10g、莱菔子10g、五味子5g、薏苡仁10g。)按每剂600ml水泡半小时,水煎300ml或按院内常规煎服,每日一剂,早晚各一次分服。熊胆散2g(熊胆散每0.5g装入1个胶囊管中),每晚一次口服,4周为一个疗程;对照组给予瑞舒伐他汀钙片20mg(瑞脂:5mg×14片)每晚顿服,4周为一个疗程。结果1.经统计分析后对照组和治疗组在性别、病程、年龄及体重指数这几个方面比较均无统计学意义(P0.05),说明可以进行比较。2.综合疗效:对照组总有效例数为17例、总有效率为68%,治疗组总有效例数为21例、总有效率为84%,山药补肺元汤合熊胆散治疗太阴人冠心病稳定型心绞痛总体有效率与对照组没有统计学差异(P0.05)。3.中医临床症状记分:治疗组与对照组用药前的证候记分相比,无统计学差异(P0.05),说明可以进行比较;用药后熊胆组患者的记分明显下降,说明山药补肺元汤合熊胆散能够有效的改善冠心病稳定型心绞痛患者的临床症状;同时说明了在改善中医症状方面,山药补肺元汤组的疗效明显优于对照组。4.心绞痛记分:治疗组与对照组在治疗前的心绞痛记分比较,无统计学差异(P0.05),说明两组数据具有比较性;用药后治疗组患者心绞痛记分有显著降低,这点可以说明运用山药补肺元汤合熊胆散可明显改善患者心绞痛症状,同时治疗后治疗组心绞痛记分明显低于对照组,进一步说明山药补肺元汤合熊胆散在改善心绞痛症状方面更优于瑞舒伐他汀钙片的治疗。5.心电图疗效:对照组共有21例患者心电图异常,用药后15例患者的心电图异常导联得到有效恢复,总有效率为71%;治疗组共有21例患者心电图异常,用药后18例患者的心电图异常导联得到有效恢复,总有效率为85%。6.血脂TC、HDL、LDL变化:经过治疗后对照组和治疗组患者体内血脂含量均有明显改变,说明山药补肺元汤合熊胆散可以明显降低TC、LDL并增加HDL在患者体内的含量。7.所有患者的生命体征、血常规、尿常规、肝功能、肾功能、心肌酶、出凝血时间等均未出现明显异常。结论1.采用山药补肺元汤合熊胆散治疗太阴人冠心病稳定型心绞痛未见毒副反应或其他药源性不良反应的发生,肾功能等未出现明显异常,治疗过程中未发生任何心血管意外等不良情况,且治疗组对山药补肺元汤合熊胆散的耐受性总体良好。2.临床上应用山药补肺元汤合熊胆散具有能够有效改善太阴人冠心病心绞痛患者胸闷、心前区及上臂、下颌的阵发性、压榨性疼痛等临床症状。3.临床上应用山药补肺元汤合熊胆散治疗太阴人冠心病心绞痛患者可使心绞痛的疼痛程度、发作频率、持续时间有效降低。4.临床上应用山药补肺元汤合熊胆散能够有效恢复太阴人冠心病心绞痛患者心电图各异常导联的改变。5.太阴人冠心病心绞痛患者经山药补肺元汤合熊胆散治疗后体内TC、LDL含量明显降低,HDL含量有所增加。
[Abstract]:Objective To observe the clinical study of yam tonifying Yuan Tang and bear Dall powder in treating coronary heart disease and angina pectoris in the Tai Yin people, and to explore the effectiveness and safety of yam tonifying Yuan Tang and bear Dall powder in treating coronary heart disease and angina pectoris. In order to provide more effective treatment basis for the treatment of coronary heart disease in the clinic, 50 cases of stable heart disease of coronary heart disease in the Tai Yin people are taken. The pain patients were randomly divided into two groups according to the order of their treatment, that is, the treatment group and the control group, of which 25 cases were treated with yam, tonifying lung yuan soup and bear gall powder, and the rest 25 cases of the control group were taken Rosuvastatin Calcium Tablets. All the patients were given 5% glucose (250 grass immortals) 250ml+ Danhong injection 40ml daily, and the treatment group was supplementing the Danhong Injection on the basis of Danhong injection. Lung Yuan Tang (composition: 15g, 10g, 10g, semen semen 10g, sulforaphane 10g, Schisandra 5g, coix 10g.) for half an hour per dose of 600ml blisters, decoction of 300ml or regular decocting in hospital, one dose per day, every morning and evening. Bear gall powder 2g (bear bile powder per 0.5g loaded in 1 capsules), once a night and 4 weeks as a course of treatment; the control group is given a course of treatment; control group given. Rosuvastatin Calcium Tablets 20mg (Rayleigh: 5mg x 14 tablets) was taken every night and 4 weeks as a course of treatment. Results there was no significant difference between the control group and the treatment group on the gender, course of disease, age and body mass index (P0.05) after statistical analysis (P0.05), which showed that the total effective rate of the control group was 17 cases and the total effective rate was effective. For 68%, the total number of effective cases in the treatment group was 21 cases, the total effective rate was 84%. The total effective rate of yam tonifying lung Yuan Tang and bear gall powder in treating stable angina pectoris of the Tai Yin people was not statistically significant (P0.05).3. clinical symptom score of TCM: there was no statistical difference between the treatment group and the control group before the score of the syndrome (P0.05). It can be compared, after drug use, the score of the bear bile group is obviously decreased. It shows that the yam tonifying Yuan Tang and bear Dall powder can effectively improve the clinical symptoms of the patients with stable angina pectoris. At the same time, the curative effect of the yam Decoction group is better than the control group.4. angina pectoris score: the treatment group and the treatment group are better than the control group. The score of angina pectoris before treatment was not statistically different (P0.05), indicating that the data of two groups were comparative, and the score of angina pectoris in the treatment group was significantly lower after drug use, which could indicate that the use of yam tonifying lung Yuan Tang and bear Dall powder could obviously improve the symptoms of angina pectoris in patients, and the score of angina pectoris in the treatment group was obviously lower. In the control group, it was further explained that yamchi tonifying lung Yuan Tang and bear Dall powder were better than Rosuvastatin Calcium Tablets in the treatment of angina pectoris in the treatment of.5. electrocardiogram. There were 21 patients in the control group with abnormal electrocardiogram, 15 patients with abnormal lead in electrocardiogram were effectively restored, the total effective rate was 71%, and the treatment group had 21 patients' heart. Abnormal electrocardiogram of 18 patients after drug use was effectively recovered, the total effective rate was 85%.6. blood lipid TC, HDL, LDL changes: after treatment, the blood lipid content in the control group and the treatment group were obviously changed, indicating that the yam tonifying lung Yuan Tang and bear gall powder can obviously reduce TC, LDL and increase the HDL content.7. in the patient's body. There was no obvious abnormality in all patients' vital signs, blood routine, urine routine, liver function, renal function, myocardial enzyme, and coagulation time. Conclusion 1. the treatment of stable angina pectoris of coronary heart disease of the Tai Yin people with yam tonifying lung Yuan Tang and bear gall powder has no toxic side reaction or other drug induced adverse reactions, and there are no obvious abnormalities in renal function. No adverse events such as cardiovascular accidents occurred during the treatment, and the treatment group had a good overall tolerance to yam tonifying lung Yuan Tang and bear gall powder in the treatment group. The clinical application of yam tonifying lung Yuan Tang and bear gall powder could effectively improve chest tightness in patients with coronary heart disease, precardiac region and upper arm, paroxysmal paroxysmal and squeezed pain in the.2.. Clinical application of clinical symptom.3. to treat patients with angina pectoris in the treatment of angina pectoris in patients with angina pectoris in the treatment of angina pectoris by yam tonifying lung Yuan Tang and bear gall powder. The clinical application of.4. in the clinical application of yam tonifying lung Yuan Tang and bear gall powder can effectively restore the changes of ECG abnormality lead in patients with angina pectoris of the Tai Yin people .5. the TC and LDL contents in the body of patients with coronary heart disease and angina pectoris were significantly reduced after treatment by yam, Bu Fei Tang and bear gall powder. The content of HDL increased.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259
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本文编号：1965428