芪附温阳汤治疗扩张型心肌病的临床疗效评价

发布时间：2018-06-14 12:04

本文选题：芪附温阳汤 + 扩张型心肌病　；参考：《山东中医药大学》2016年硕士论文

【摘要】：目的:本课题旨在探索芪附温阳汤配合常规西药治疗扩张型心肌病与单纯常规西药治疗相比较临床疗效有无差异,评价芪附温阳汤治疗扩张型心肌病的临床疗效并探索其作用机理,为其指导扩张型心肌病的诊疗提供一定的临床依据。方法:选取50例扩张型心肌病心肾阳虚证型患者,随机分为对照组和治疗组。对照组采取西药常规治疗,治疗组在西药常规治疗基础上配合芪附温阳汤。以8周为1个疗程,记录患者治疗前后的中医症候积分、心功能分级(NYHA分级法)、血清N末端脑钠尿肽原(NT-proBNP)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、明尼苏达心力衰竭患者生活质量评分,并应用“SPSS17.0”统计软件对其进行统计学分析。结果:(1)治疗组心功能分级疗效总有效率为88%,对照组总有效率60%,采用秩和检验对两组有效率进行比较,治疗组疗效优于对照组(P0.05)。(2)治疗后两组患者中医症候积分、NT-proBNP、LVEF、明尼苏达心力衰竭患者生活质量评分与治疗前比较均有显著性差异(P0.01),对两组进行组间比较,治疗组优于对照组(P0.05)。(3)治疗后两组患者LVEDD与治疗前比较有显著性差异(P0.01),对两组进行组间比较,治疗组与对照组无统计学差异(P0.05)。(4)两组患者治疗前后安全性指标均无明显异常变化(P0.05)。结论:芪附温阳汤对扩张型心肌病心肾阳虚型患者的中医症候积分、心功能分级、NT-proBNP、左心室射血分数、明尼苏达心力衰竭患者生活质量评分均具有明显改善作用;对肝肾功能无明显影响,安全性良好。
[Abstract]:Objective: to explore the clinical effect of Qifu Wenyang decoction combined with conventional western medicine in the treatment of dilated cardiomyopathy. To evaluate the clinical effect of Qifuwenyang decoction in the treatment of dilated cardiomyopathy and to explore its mechanism, and to provide some clinical basis for guiding the diagnosis and treatment of dilated cardiomyopathy. Methods: 50 cases of dilated cardiomyopathy with deficiency of heart and kidney yang were randomly divided into control group and treatment group. The control group was treated with routine western medicine, and the treatment group was treated with Qifu Wenyang decoction on the basis of routine western medicine treatment. Taking 8 weeks as a course of treatment, the scores of TCM symptoms before and after treatment were recorded. NYHA classification of cardiac function, NT-proBNPN, LVEDDD, LVEFN, LVEFV, and quality of life of patients with heart failure in Minnesota were analyzed with SPSS 17.0 statistical software. Results the total effective rate of heart function grading in the treatment group was 88 and that in the control group was 60. The effective rate of the two groups was compared by rank sum test. The curative effect of the treatment group was better than that of the control group (P 0.05, P 0.05, P < 0.05). After the treatment, the score of TCM symptom and the score of quality of life of the patients with Minnesota heart failure were significantly higher than those of the control group (P 0.01), and the difference between the two groups was also significant (P 0.01), and there were significant differences between the two groups in the score of quality of life of the patients with heart failure in Minnesota. There was significant difference in LVEDD between the two groups after treatment and before treatment. There was no significant difference between the treatment group and the control group in the safety indexes of the two groups before and after treatment. Conclusion: Qifuwenyang decoction can significantly improve the scores of TCM symptoms, cardiac function grading and NT-proBNPs, left ventricular ejection fraction (LVEF), and Minnesota heart failure patients' quality of life (QOL) in patients with heart and kidney yang deficiency of dilated cardiomyopathy. It has no obvious effect on liver and kidney function and is safe.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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