温阳利水法治疗慢性收缩性心力衰竭临床疗效的系统评价及用药规律

发布时间：2018-06-25 01:22

本文选题：温阳利水 + 慢性收缩性心力衰竭　；参考：《山东中医药大学》2016年硕士论文

【摘要】：目的:1.运用系统评价中Meta分析对温阳利水法治疗慢性收缩性心力衰竭的临床疗效和安全性进行评估;2.借助中医传承辅助系统,挖掘温阳利水法治疗慢性收缩性心力衰竭的用药及组方规律。方法:1.检索近20年来已发表在国内外医学期刊上采用温阳利水法治疗慢性收缩性心力衰竭的随机对照试验研究,利用RevMan5.3软件对符合标准的研究进行异质性检验、Meta分析、倒漏斗图与敏感性分析等;2.借助中医传承辅助系统对文献和临床资料中采用温阳利水法治疗慢性收缩性心力衰竭的处方进行筛选、录入,进行相关性数据分析,从中得出温阳利水法治疗慢性收缩性心力衰竭的方剂配伍规律。结果:1.本研究共35项随机对照临床试验符合标准,患者共3252例。(1)对9个研究结果的总体效应进行Meta分析结果为:研究结果指标的相对合并效应量OR值均不等于1或MD值均不等于0,且合并后的总体P值均小于0.05,说明配合温阳利水法治疗慢性收缩性心力衰竭与单纯西药治疗比较均有统计学意义;(2)5个研究结果指标(心功能疗效、中医证候疗效、Lee氏心衰积分评价心衰的有效率,6MWT,LVEF)经治疗后治疗组的改善明显优于对照组;4个研究结果指标(中医证候积分、BNP、LVEDD、生活质量评分)经治疗后治疗组变化明显低于对照组。2.借助中医传统辅助平台系统(V2.5),对符合的111个处方进行相关分析,确定使用频次较高的药物、核心组合28对,候选新方6首,揭示其用药的规律。结论:1.温阳利水法治疗慢性收缩性心力衰竭良好的临床疗效和安全性得到证实;2.对符合的处方进行统计分析,得出常用药物核心组合,候选新方,对临床辨证指导选药具有深远意义。
[Abstract]:Purpose 1. To evaluate the clinical efficacy and safety of Wenyangli water therapy in the treatment of chronic systolic heart failure (CHF) by meta-analysis in systematic evaluation. With the aid of traditional Chinese Medicine (TCM) inheriting auxiliary system, we excavate the law of treatment of chronic systolic heart failure by warming yang and water therapy. Method 1: 1. A randomized controlled trial study on the treatment of chronic systolic heart failure (CHF) with wenyangli method in medical journals at home and abroad in the past 20 years was searched. A meta-analysis of heterogeneity test was performed using RevMan5.3 software. Inverted funnel diagram and sensitivity analysis. With the help of traditional Chinese Medicine (TCM) inheritance Assistant system, the prescriptions for the treatment of chronic systolic heart failure (CHF) were screened, inputted and analyzed by using WYLW in the literature and clinical data. From the conclusion of Wenyang-Lishui method for the treatment of chronic systolic heart failure prescription compatibility rule. The result is 1: 1. A total of 35 randomized controlled clinical trials were conducted in this study. There were 3252 patients. (1) the results of meta-analysis of the total effects of 9 study results were as follows: the OR value of the relative combined effect was not equal to 1 or the MD value was not equal to 0, and the total P value of the combined study was less than 0.05, said. There was significant difference between the treatment of chronic systolic heart failure and that of western medicine alone. The curative effect of TCM Syndrome and the effective rate of evaluating Heart failure by Lee's Heart failure score) after treatment, the improvement of the treatment group is obviously better than that of the control group, and the changes of the treatment group after treatment with four indexes (TCM syndrome integral and BNPLVEDD-quality of life score) are obviously better than those in the control group. It was significantly lower than that of control group. With the help of traditional Chinese Medicine assisted platform system (V2.5), 111 prescriptions in accordance with the relevant analysis, the use of high-frequency drugs, core combination of 28 pairs, 6 candidates, to reveal the law of its drug use. Conclusion 1. The clinical efficacy and safety of warming yang and water therapy in the treatment of chronic systolic heart failure have been proved to be 2. 2%. According to the statistical analysis of prescriptions, the core combination of commonly used drugs and the candidates for new prescriptions are obtained, which is of far-reaching significance to the clinical guidance of drug selection based on syndrome differentiation.
【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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