生脉散瘀汤对于气阴两虚型心绞痛患者疗效观察及对HRT的干预研究

发布时间：2018-07-15 17:03

【摘要】：目的:本研究是在中医理论指导下,通过观察生脉散瘀汤对气阴两虚型稳定型心绞痛患者的临床疗效以及其对心率震荡现象的干预,以达到寻求治疗心绞痛的新方法的目的。方法:将符合纳入标准的气阴两虚型稳定型心绞痛患者60例,按照随机分组方法分为对照组、观察组。对照组给予常规治疗:口服阿司匹林(拜阿斯匹灵)0.1g Qd,单硝酸异山梨酯片(欣康)20mg Bid,琥珀酸美托洛尔(倍他乐克)23.75mg Qd,观察组则在此基础上服用生脉散瘀汤(组成:党参30g丹参30g茯苓15g白术15g当归15g熟地黄30g五味子12g赤芍30g麦冬30g甘草6g)。以4周为一疗程,分别记录患者的,中医证候疗效积分,心绞痛疗效评价,动态心电图心率震荡指标(TO、TS),生活质量评价量表SF-36,利用“SPSS17.0”统计软件,进行组内、组间的统计学处理。结果:临床研究表明,治疗前后观察组和对照组进行组内比较,中医证候积分,中医证候疗效,心绞痛改善情况,动态心电图心率震荡指标(TO,TS),生活质量评价量表SF-36治疗后均有改善,有统计学意义(p0.05);治疗后两组组间比较显示,治疗组在改善中医证候积分,中医证候疗效,心率震荡指标(TO,TS),生活质量评价量表SF-36方面,观察组优于对照组(P0.05或者0.01);治疗前后两组安全指标比较,其差异无统计学意义(P0.05);观察组与治疗组治疗后在改善心绞痛疗效和躯体疼痛情况无明显差异,(P0.05)。结论:1.生脉散瘀汤可以改善气阴两虚型同时伴有室性早搏心绞痛患者的心率震荡现象,从而改善患者的心脏自主神经功能紊乱的情况;同时对其临床中医相关症候、生活质量均有明显改善。2.通过采用中西医相结合的方式治疗心绞痛,可以在保证西医的治疗基础之上的同时,明显改善患者的中医症候、生活质量,突出表现了西医与中医相结合治疗心绞痛的明显优势。3.应用中西医结合治疗的过程中,未见明显不良反应和不良事件,安全性可靠。
[Abstract]:Objective: under the guidance of TCM theory, this study observed the clinical effect of Shengmai Sanyu decoction on stable angina pectoris with deficiency of Qi and Yin and its intervention on the phenomenon of heart rate turbulence, in order to seek a new method for the treatment of angina pectoris. Methods: sixty cases of stable angina pectoris with deficiency of Qi and Yin were divided into control group and observation group. The control group was given routine treatment: oral aspirin (Bayaspirin) 0.1 g QD, Isosorbide mononitrate tablet (Xinkang) 20mg Bidd, metoprolol succinate (Betaloc) 23.75mg QD, observation group taking Shengmai Sanyu decoction (composition) on this basis. Dangshen 30g Salvia miltiorrhiza 30g Poria 15g Angelica sinensis 15g cooked Rehmannia glutinosa 30g Fructus Schisandrae 30g Radix Paeoniae Alba 30g Radix Ophiopogonis 30g Licorice 6g). A course of treatment of 4 weeks was used to record the curative effects of TCM syndromes, angina pectoris, heart rate turbulence index (TOOTS) of ambulatory electrocardiogram (ECG), quality of life evaluation scale (SF-36) and SPSS 17.0 statistical software. Statistical processing between groups. Results: the clinical study showed that the observation group and the control group were compared before and after treatment, the TCM syndromes integral, the curative effect of TCM syndromes, the improvement of angina pectoris, Dynamic ECG heart rate turbulence index (TOTTS), quality of life evaluation scale (SF-36) were improved after treatment, with statistical significance (p0.05). After treatment, the comparison between the two groups showed that the treatment group in the improvement of TCM syndromes integral, TCM syndromes curative effect, Heart rate turbulence index (TOOTS), quality of life evaluation scale (SF-36), the observation group was better than the control group (P0.05 or 0.01). The difference was not statistically significant (P0.05); there was no significant difference between the observation group and the treatment group in improving the effect of angina pectoris and somatic pain (P0.05). Conclusion 1. Shengmai Sanyu decoction can improve the phenomenon of heart rate turbulence in patients with deficiency of qi and yin and accompanied by ventricular premature beat angina pectoris, thereby improving the condition of cardiac autonomic nervous dysfunction in patients; at the same time, it can also improve the clinical syndromes related to traditional Chinese medicine. The quality of life was significantly improved. By treating angina pectoris with the combination of traditional Chinese and western medicine, we can obviously improve the TCM symptoms and the quality of life of patients on the basis of Western medicine treatment. Highlights the combination of Western medicine and Chinese medicine treatment of angina pectoris obvious advantage. 3. There were no obvious adverse reactions and adverse events in the course of application of integrated traditional Chinese and western medicine, so it was safe and reliable.
【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

【相似文献】