活血通脉方治疗老年心房颤动（瘀阻心脉型）的临床研究

发布时间：2019-03-02 13:36

【摘要】：目的:本课题通过临床研究,初步评价活血通脉方对瘀阻心脉型老年房颤的临床疗效及安全性。方法:将符合纳入标准的60例已确诊为瘀阻心脉型老年房颤患者,随机分为两组:治疗组和对照组各30例。对照组:晨起口服华法林片3mg,日一次,治疗组:在口服华法林的基础上加服活血通脉方,日一剂。两组疗程均为14天一疗程。对两组患者治疗前后中医证候、安全性等相关指标的变化及临床出血事件进行观察比较并总结分析。结果:1.治疗一疗程后治疗组中医综合证候积分低于对照组,治疗组和对照组的总有效率分别为93.33%、66.67%,两组比较差异有统计学意义(P0.05)。2.治疗一疗程后两组患者中医证候总积分前后进行比较均差异有统计学意义(P0.01)。3.治疗一疗程后对两组患者治疗后的中医证候积分进行比较差异具有统计学意义(P0.05),说明治疗后治疗组在整体症状改善方面明显优于对照组。4.治疗一疗程后对两组患者各单项症状积分均值进行比较,治疗组在改善心悸、胸闷、气短、乏力症状方面均明显优于对照组(P0.05)。5.治疗一疗程后两组患者治疗前和治疗后的PT、APTT、INR相比较,均在治疗后优于治疗前(P0.05),治疗组在PT、APTT方面优于对照组(P0.05)。6.治疗组与对照组均未发现明显的毒副反应,两组治疗前后,血常规、尿常规、粪便常规加粪便隐血,肝肾功能、心电图等方面均无显著差异。两组患者在观察期间都没有出现与房颤相关性血栓栓塞事件和严重出血事件。结论:活血通脉方对老年心房颤动(瘀阻心脉型)的治疗取得了很好的临床疗效,且安全未出现毒副反应。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of Huoxue Tongmai recipe (Huoxue Tongmai recipe) in the treatment of senile atrial fibrillation with stasis and blockage of heart vein by clinical study. Methods: 60 elderly patients with atrial fibrillation were divided into two groups randomly: treatment group (n = 30) and control group (n = 30). Control group: warfarin tablets 3 mg, once a day, treatment group: on the basis of oral warfarin plus Huoxue Tongmai prescription, a daily dose. The course of treatment in both groups was 14 days a course. Two groups of patients before and after treatment of TCM syndrome, safety and other related indicators of changes and clinical bleeding events were observed and compared and summarized and analyzed. Results: 1. The total effective rate of the treatment group and the control group were 93.33% and 66.67%, respectively. The difference between the two groups was statistically significant (P0.05). 2. The total effective rate of the treatment group and the control group were 93.33% and 66.67% respectively (P0.05). After one course of treatment, the total scores of TCM syndromes between the two groups were significantly different before and after treatment (P0.01). After one course of treatment, the scores of TCM syndromes between the two groups were significantly different (P0.05), indicating that the overall symptoms of the treatment group were significantly better than that of the control group. 4. After one course of treatment, the mean scores of each single symptom in the two groups were compared. The treatment group was better than the control group in improving palpitation, chest tightness, shortness of breath and fatigue symptoms (P0.05). After one course of treatment, the PT,APTT,INR of the two groups was better than that of the control group before and after treatment (P0.05), and the treatment group was superior to the control group in PT,APTT (P0.05). No obvious toxic and side effects were found between the two groups. There were no significant differences in blood routine, urine routine, stool routine plus fecal occult blood, liver and kidney function and electrocardiogram between the two groups before and after treatment. No atrial fibrillation-associated thromboembolism and severe bleeding were observed in both groups. Conclusion: Huoxue Tongmai recipe has achieved good clinical effect in the treatment of senile atrial fibrillation (stagnation of heart vein type), and there is no toxic and side effect.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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