益脉颗粒对老年气虚血瘀型稳定性心绞痛患者生活质量影响的研究
发布时间：2018-08-02 18:03
【摘要】：目的:观察益脉颗粒治疗老年气虚血瘀型稳定性心绞痛的临床疗效及对患者生活质量的影响,并探讨作用机制,为今后临床用药提供依据。方法:选取符合纳入标准的60例患者作为研究对象,将60例患者随机分为两组:观察组和对照组,每组各30例。观察组在常规西药治疗的基础上给予中药制剂益脉颗粒,对照组仅给予常规西药治疗,4个疗程后,对比两组患者治疗前后心电图疗效、中医症候积分、中医症候疗效、血脂、血浆纤维蛋白原、左心射血分数、运动耐量、生活质量及安全性指标的变化并进行统计学分析。结果:1.心电图疗效:治疗后两组间比较,观察组心电图总有效率高于对照组,差异具有统计学意义(P0.05)。2.中医症候积分:治疗前两组患者中医症候积分比较无明显差异(P0.05),治疗后两组患者中医症候积分较治疗前均显著降低(P0.01),且观察组中医症候积分降低明显优于对照组(P0.01)。3.中医症候疗效:治疗后两组间比较,观察组中医症状改善总有效率高于对照组(P0.05)。4.血脂:治疗前两组患者甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)之间比较无明显差异(P0.05),治疗后两组患者TG、TC、LDL较治疗前均显著降低(P0.01),HDL较治疗前显著升高(P0.01),治疗后观察组TG、TC、LDL、HDL改善均优于对照组(P0.05)。5.血浆纤维蛋白原:治疗前两组患者血浆纤维蛋白原(FIB)比较无明显差异(P0.05),治疗后两组患者FIB较治疗前均显著降低(P0.01),且观察组降低程度优于对照组(P0.05)。6.左心射血分数(LVEF):治疗前两组患者LVEF比较无明显差异(P0.05),治疗后两组患者LVEF较治疗前均显著升高(P0.01),且观察组升高程度明显优于对照组(P0.01)。7.运动耐量:治疗前两组患者6分钟步行距离及心肌耗氧量比较无明显差异(P0.05),治疗后两组患者6分钟步行距离较治疗前显著增加(P0.01),心肌耗氧量较治疗前明显降低(P0.01),治疗后两组间比较,观察组6分钟步行距离及心肌耗氧量改善均优于对照组(P0.05)。8.生活质量:治疗前西雅图心绞痛量表(SAQ)评分表明治疗前两组患者在躯体活动受限度(PL)、心绞痛稳定状态(AS)、心绞痛发作情况(AF)、治疗满意程度(TS)及疾病认识程度(DP)等方面比较无明显差异(P0.05),治疗后两组患者在PL、AS、AF、TS、DP方面评分均较治疗前显著提高(P0.01),且观察组在PL、AS、AF、TS、DP改善均明显优于对照组(P0.01)。9.安全性指标:两组患者治疗过程中均未发生严重不良反应,三大常规、肝、肾功能未见明显异常。结论:本研究证明益脉颗粒能够改善老年气虚血瘀型稳定性心绞痛患者的心电图及中医症候疗效,调节血脂,降低血浆FIB含量,改善左心射血功能,提高运动耐量,提高生活质量,并且该药在实验过程中并未出现不良反应,具有较好的安全性。
[Abstract]:Objective: to observe the clinical effect of Yimai granule in treating senile stable angina pectoris with deficiency of qi and blood stasis and its effect on the quality of life, and to explore the mechanism of action. Methods: 60 patients were randomly divided into two groups: observation group (n = 30) and control group (n = 30). The observation group was given traditional Chinese medicine Yimai granule on the basis of routine western medicine treatment, while the control group was only given routine western medicine treatment. After 4 courses of treatment, the electrocardiogram effect, TCM symptom integral, TCM symptom curative effect and blood lipid were compared between the two groups. The changes of plasma fibrinogen, left ventricular ejection fraction, exercise tolerance, quality of life and safety were analyzed statistically. The result is 1: 1. Electrocardiogram efficacy: after treatment between the two groups, the observation group electrocardiogram total effective rate was higher than the control group, the difference was statistically significant (P0.05). 2. TCM symptom integral: there was no significant difference between the two groups before treatment (P0.05). After treatment, the TCM symptom score of the two groups was significantly lower than that before treatment (P0.01), and the TCM symptom integral of the observation group was significantly lower than that of the control group (P0.01). 3. Curative effect of TCM symptom: compared with two groups after treatment, the total effective rate of TCM symptom improvement in observation group was higher than that in control group (P0.05). 4. Serum lipids: there was no significant difference in triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) between the two groups before treatment (P0.05). (P0.01), after treatment, the improvement of TGN TCL HDL in the observation group was better than that in the control group (P0.05). Plasma fibrinogen: there was no significant difference in plasma fibrinogen (FIB) between the two groups before treatment (P0.05). After treatment, the FIB of the two groups was significantly lower than that before treatment (P0.01), and the degree of decrease in the observation group was better than that in the control group (P0.05). 6. Left ventricular ejection fraction (LVEF): there was no significant difference in LVEF between the two groups before treatment (P0.05). After treatment, LVEF in both groups was significantly higher than that before treatment (P0.01), and the degree of increase in the observation group was significantly higher than that in the control group (P0.01) .7. Exercise tolerance: there was no significant difference in 6-minute walking distance and myocardial oxygen consumption between the two groups before treatment (P0.05). After treatment, the 6-minute walking distance was significantly increased (P0.01), and myocardial oxygen consumption was significantly decreased (P0.01). Comparison between the two groups after treatment, The improvement of 6-minute walking distance and myocardial oxygen consumption in the observation group was better than that in the control group (P0.05). Quality of life: before treatment, the (SAQ) score of Seattle angina scale indicated that before treatment, the two groups had satisfactory degree of (TS) and degree of understanding of disease, (DP), etc., in the stable state of (PL), angina pectoris with restricted somatic activity, (AF), treatment of stable state of angina pectoris, etc. There was no significant difference between the two groups (P0.05). After treatment, the scores of the two groups were significantly higher than those before treatment (P0.01), and the improvement of TSDP in the observation group was significantly better than that in the control group (P0.01). Safety index: there were no serious adverse reactions in both groups, and there were no obvious abnormalities in liver and kidney function. Conclusion: this study proves that Yimai granule can improve the effect of electrocardiogram and TCM syndrome in elderly patients with stable angina pectoris of Qi deficiency and blood stasis type, regulate blood lipid, decrease plasma FIB content, improve left ventricular ejection function and improve exercise tolerance. Improve the quality of life, and the drug did not appear in the experimental process of adverse reactions, with good safety.
【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
本文编号：2160239
[Abstract]:Objective: to observe the clinical effect of Yimai granule in treating senile stable angina pectoris with deficiency of qi and blood stasis and its effect on the quality of life, and to explore the mechanism of action. Methods: 60 patients were randomly divided into two groups: observation group (n = 30) and control group (n = 30). The observation group was given traditional Chinese medicine Yimai granule on the basis of routine western medicine treatment, while the control group was only given routine western medicine treatment. After 4 courses of treatment, the electrocardiogram effect, TCM symptom integral, TCM symptom curative effect and blood lipid were compared between the two groups. The changes of plasma fibrinogen, left ventricular ejection fraction, exercise tolerance, quality of life and safety were analyzed statistically. The result is 1: 1. Electrocardiogram efficacy: after treatment between the two groups, the observation group electrocardiogram total effective rate was higher than the control group, the difference was statistically significant (P0.05). 2. TCM symptom integral: there was no significant difference between the two groups before treatment (P0.05). After treatment, the TCM symptom score of the two groups was significantly lower than that before treatment (P0.01), and the TCM symptom integral of the observation group was significantly lower than that of the control group (P0.01). 3. Curative effect of TCM symptom: compared with two groups after treatment, the total effective rate of TCM symptom improvement in observation group was higher than that in control group (P0.05). 4. Serum lipids: there was no significant difference in triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) between the two groups before treatment (P0.05). (P0.01), after treatment, the improvement of TGN TCL HDL in the observation group was better than that in the control group (P0.05). Plasma fibrinogen: there was no significant difference in plasma fibrinogen (FIB) between the two groups before treatment (P0.05). After treatment, the FIB of the two groups was significantly lower than that before treatment (P0.01), and the degree of decrease in the observation group was better than that in the control group (P0.05). 6. Left ventricular ejection fraction (LVEF): there was no significant difference in LVEF between the two groups before treatment (P0.05). After treatment, LVEF in both groups was significantly higher than that before treatment (P0.01), and the degree of increase in the observation group was significantly higher than that in the control group (P0.01) .7. Exercise tolerance: there was no significant difference in 6-minute walking distance and myocardial oxygen consumption between the two groups before treatment (P0.05). After treatment, the 6-minute walking distance was significantly increased (P0.01), and myocardial oxygen consumption was significantly decreased (P0.01). Comparison between the two groups after treatment, The improvement of 6-minute walking distance and myocardial oxygen consumption in the observation group was better than that in the control group (P0.05). Quality of life: before treatment, the (SAQ) score of Seattle angina scale indicated that before treatment, the two groups had satisfactory degree of (TS) and degree of understanding of disease, (DP), etc., in the stable state of (PL), angina pectoris with restricted somatic activity, (AF), treatment of stable state of angina pectoris, etc. There was no significant difference between the two groups (P0.05). After treatment, the scores of the two groups were significantly higher than those before treatment (P0.01), and the improvement of TSDP in the observation group was significantly better than that in the control group (P0.01). Safety index: there were no serious adverse reactions in both groups, and there were no obvious abnormalities in liver and kidney function. Conclusion: this study proves that Yimai granule can improve the effect of electrocardiogram and TCM syndrome in elderly patients with stable angina pectoris of Qi deficiency and blood stasis type, regulate blood lipid, decrease plasma FIB content, improve left ventricular ejection function and improve exercise tolerance. Improve the quality of life, and the drug did not appear in the experimental process of adverse reactions, with good safety.
【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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