葶苈大枣泻肺汤合真武汤治疗慢性心力衰竭心肾阳虚型临床观察

发布时间：2018-06-17 12:12

本文选题：葶苈大枣泻肺汤 + 真武汤　；参考：《黑龙江省中医药科学院》2016年硕士论文

【摘要】：目的观察葶苈大枣泻肺汤合真武汤治疗心肾阳虚型慢性心力衰竭的疗效及安全性,旨在为临床上治疗心力衰竭提供实用而有价值的治疗方案。方法根据纳入标准与排除标准,于黑龙江省中医医院心内科门诊患者中选取60例,采用随机对照研究,将试验对象分为试验组与对照组。两组患者的一般资料无统计学差异。对照组予芪苈强心胶囊治疗,每日3次,一次8粒;试验组采用葶苈大枣泻肺汤合真武汤治疗,每日一剂,一日两次,早晚餐后半小时温服。28天后进行临床疗效评定。系统观察并比较治疗前、后两组患者之间及试验组组内的中医证候积分、血清C-反应蛋白(CRP)、心功能分级、左室射血分数(LVEF)、血清NT-proBNPN(端脑纳肽前体)的检测结果。密切观察两组患者治疗前后肝肾功能以及血、尿、便常规的变化。结果经过28天的治疗,临床研究表明在中医证候疗效方面试验组优于对照组(P0.05),其中试验组舌象、脉象方面的改善情况明显优于对照组(P0.05);试验组左室射血分数(LVEF)的增加幅度明显优于对照组(P0.05);两组血检CRP数值均降低,治疗组较对照组降低更明显(P0.05);试验组血清NT-proBNP(N端脑纳肽前体)值的降低幅度明显优于对照组(P0.05)。试验组及对照组疗前疗后肝、肾功能、血、尿、便常规均无明显变化(P0.05)?结论葶苈大枣泻肺汤合真武汤能改善CHF患者的临床症状和体征,提高患者生命质量,并通过降低NT-proBNP及C反应蛋白,增加LVEF等方面增强心脏功能,且具有良好的安全性、无不良反应?
[Abstract]:Objective to observe the efficacy and safety of Tinglida Zao Xiefei decoction combined with Zhenwu decoction in the treatment of chronic heart failure with deficiency of heart and kidney yang in order to provide a practical and valuable therapeutic scheme for the treatment of heart failure. Methods according to the criteria of inclusion and exclusion, 60 outpatients in Department of Cardiology, Heilongjiang Province traditional Chinese Medicine Hospital, were selected and randomly controlled. The subjects were divided into two groups: the experimental group and the control group. There was no statistical difference in general data between the two groups. The control group was treated with Qiliqiangxin capsule, 3 times a day, 8 capsules once a day, and the experimental group was treated with Tinglida Zao Xiefei decoction and Zhenwu decoction, once a day, twice a day, and half an hour after the morning and evening meal. The scores of TCM syndromes, serum C-reactive protein (CRP), cardiac function grade, left ventricular ejection fraction (LVEF) and serum NT-proBNPN (terminal brain natriuretic peptide precursor) were observed and compared before and after treatment. Observe the changes of liver and kidney function, blood and urine before and after treatment. Results after 28 days of treatment, the clinical study showed that the experimental group was superior to the control group in the curative effect of TCM syndromes, and the tongue picture of the experimental group was better than that of the control group. The improvement of pulse was better than that of control group (P 0.05), the increase of left ventricular ejection fraction (LVEF) was better than that of control group (P 0.05). Compared with the control group, the serum NT-proBNPN N-terminal nalapeptide precursor in the treatment group was significantly lower than that in the control group (P 0.05), and the serum NT-proBNPN N-terminal nalapeptide precursor in the treatment group was significantly lower than that in the control group. There were no significant changes in liver, kidney function, blood, urine and stool routine after treatment in the experimental group and the control group before and after treatment. Conclusion Tinglida Zao Xiefei decoction combined with Zhenwu decoction can improve the clinical symptoms and signs of CHF patients, improve the quality of life of CHF patients, enhance heart function by reducing NT-proBNP and C-reactive protein, increase LVEF and so on, and have good safety. No adverse reactions?
【学位授予单位】：黑龙江省中医药科学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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