中药复方对缓慢性心律失常患者血流动力学影响及生活质量评价
发布时间：2018-10-08 08:57
【摘要】：目的:通过前瞻性队列研究的方法,基于温补心肾、活血化瘀治疗缓慢性心律失常,对中药复方治疗缓慢性心律失常的效疗进行观察分析,探讨其疗效,及应用超声评价口服中药复方后血流动力学的改变,应用简明健康状况调查问卷(SF-36量表)评价其生活疗量的改变。材料与方法:于2015年12月至2016年02月期间通过医院招募受试者,其中缓慢性心律失常(未接受治疗)患者40例(队列一),起搏器植入术后患者80例,随机分成两组,每组40例(队列二、队列三)。其中队列一与队列三给予参仙升脉口服液,疗程为4周。三组均需记录患者的年龄、性别及是否伴有脑血管病、冠心病、糖尿病等基线水平。通过简明健康状况调查问卷(SF-36量表)问卷对生活质量改善评分。测定治疗前后两组患者的收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)、左室射血分数(LVEF)、每搏输出量(SV)、每分输出量(CO)及缩期峰值血流速度(AV)观察其变化,观察临床症状改善情况。通过统计学方法分析三组在年龄、性别、是否伴有脑血管病、冠心病、糖尿病等基线水平上是否存在差异性,三组在治疗前后血流动力学改变对比,治疗前后临床症状改善情况对比。结果:治疗组及对照组在年龄、性别、是否伴有脑血管病、冠心病、糖尿病等基线水平的病例数上统计学无差异(P0.05)。队列一治疗0周和4周的生活质量及超声指标均有明显改变且具有统计学意义(P0.05);队列二与队列三在治疗0周时生活质量及超声无明显差异不具有统计学意义(P0.05);队列三治疗0周和4周的生活质量及超声指标均有明显改变且具有统计学意义(P0.05)。结论:心肾阳虚、血脉瘀阻是缓慢性心律失常的主要病机特点及证候特征,通过简明健康状况调查问卷(SF-36量表)分析比较发现中药联合起搏器组的生活质量改善情况优于起搏器组。中药复方治疗缓慢性心律失常疗效显著可改善患者临床症状及血流动力学是未达到起搏器治疗标准或不愿安装起搏器的缓慢性心律失常首选治疗药物。目前对于起搏器术后联合中药治疗的研究较少,本研究证明参仙升脉口服液对于接受起搏器治疗后患者的临床症状及血流动力学有优化作用。
[Abstract]:Objective: based on the prospective cohort study, based on warming the heart and kidney, activating blood circulation and removing blood stasis to treat bradyarrhythmia, we observed and analyzed the effect of traditional Chinese medicine on treating bradyarrhythmia, and discussed its curative effect. The changes of hemodynamics after oral Chinese medicine compound were evaluated by ultrasound, and the changes of life therapy quantity were evaluated by the brief health status questionnaire (SF-36). Materials and methods: from December 2015 to February 2016, 40 patients with bradyarrhythmia (untreated) and 80 patients with pacemaker implantation were randomly divided into two groups. There were 40 cases in each group (queue two, three). Queue 1 and queue 3 were given Shenxian Shengmai oral liquid for 4 weeks. Age, sex and baseline levels of cerebrovascular disease, coronary heart disease and diabetes were recorded in all three groups. The quality of life (QOL) was evaluated by the brief Health status questionnaire (SF-36). End systolic volume (LVESV),) left ventricular end-diastolic volume (LVEDV),) left ventricular ejection fraction (LVEF),) left ventricular ejection fraction (CO) and peak systolic velocity (AV) were measured before and after treatment. The differences in baseline levels of age, sex, cerebrovascular disease, coronary heart disease and diabetes were analyzed by statistical method. The hemodynamic changes of the three groups before and after treatment were compared. Comparison of the improvement of clinical symptoms before and after treatment. Results: there was no statistical difference between the treatment group and the control group in terms of age, sex, whether accompanied by cerebrovascular disease, coronary heart disease, diabetes and other baseline cases (P0.05). The quality of life and ultrasound were significantly changed at 0 and 4 weeks after cohort 1 treatment (P0.05), but there was no significant difference in QOL and ultrasound between cohort 2 and cohort 3 at 0 weeks (P0.05). The quality of life and ultrasound were significantly changed at 0 and 4 weeks after treatment (P0.05). Conclusion: deficiency of heart and kidney yang and blood stasis are the main pathogenesis and syndromes of bradyarrhythmia. The quality of life in the pacemaker group was better than that in the pacemaker group through the brief health status questionnaire (SF-36). The curative effect of traditional Chinese medicine on bradyarrhythmia can improve the clinical symptoms and hemodynamics of patients. It is the first choice to treat slow arrhythmias that do not meet the standard of pacemaker therapy or do not want to install pacemakers. At present, there is little research on pacemaker combined with traditional Chinese medicine treatment. This study proves that Shenxianshengmai oral liquid can optimize the clinical symptoms and hemodynamics of patients after pacemaker therapy.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259
，
本文编号：2256174
[Abstract]:Objective: based on the prospective cohort study, based on warming the heart and kidney, activating blood circulation and removing blood stasis to treat bradyarrhythmia, we observed and analyzed the effect of traditional Chinese medicine on treating bradyarrhythmia, and discussed its curative effect. The changes of hemodynamics after oral Chinese medicine compound were evaluated by ultrasound, and the changes of life therapy quantity were evaluated by the brief health status questionnaire (SF-36). Materials and methods: from December 2015 to February 2016, 40 patients with bradyarrhythmia (untreated) and 80 patients with pacemaker implantation were randomly divided into two groups. There were 40 cases in each group (queue two, three). Queue 1 and queue 3 were given Shenxian Shengmai oral liquid for 4 weeks. Age, sex and baseline levels of cerebrovascular disease, coronary heart disease and diabetes were recorded in all three groups. The quality of life (QOL) was evaluated by the brief Health status questionnaire (SF-36). End systolic volume (LVESV),) left ventricular end-diastolic volume (LVEDV),) left ventricular ejection fraction (LVEF),) left ventricular ejection fraction (CO) and peak systolic velocity (AV) were measured before and after treatment. The differences in baseline levels of age, sex, cerebrovascular disease, coronary heart disease and diabetes were analyzed by statistical method. The hemodynamic changes of the three groups before and after treatment were compared. Comparison of the improvement of clinical symptoms before and after treatment. Results: there was no statistical difference between the treatment group and the control group in terms of age, sex, whether accompanied by cerebrovascular disease, coronary heart disease, diabetes and other baseline cases (P0.05). The quality of life and ultrasound were significantly changed at 0 and 4 weeks after cohort 1 treatment (P0.05), but there was no significant difference in QOL and ultrasound between cohort 2 and cohort 3 at 0 weeks (P0.05). The quality of life and ultrasound were significantly changed at 0 and 4 weeks after treatment (P0.05). Conclusion: deficiency of heart and kidney yang and blood stasis are the main pathogenesis and syndromes of bradyarrhythmia. The quality of life in the pacemaker group was better than that in the pacemaker group through the brief health status questionnaire (SF-36). The curative effect of traditional Chinese medicine on bradyarrhythmia can improve the clinical symptoms and hemodynamics of patients. It is the first choice to treat slow arrhythmias that do not meet the standard of pacemaker therapy or do not want to install pacemakers. At present, there is little research on pacemaker combined with traditional Chinese medicine treatment. This study proves that Shenxianshengmai oral liquid can optimize the clinical symptoms and hemodynamics of patients after pacemaker therapy.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259
，
本文编号：2256174
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