發(fā)布時間：2018-03-18 04:38

  本文選題：人參養(yǎng)榮湯　切入點：慢性心力衰竭　出處：《福建中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:本研究旨在觀察人參養(yǎng)榮湯加減方對心肺氣虛型慢性心力衰竭合并缺鐵性貧血的臨床療效,為慢性心力衰竭合并缺鐵性貧血的治療提供新的中醫(yī)思路。方法:將2016年1月-2017年1月期間在我院門診及病房診斷為慢性心力衰竭合并缺鐵性貧血(中醫(yī)辨證為心肺氣虛型)的60例患者,根據(jù)隨機對照原則,將其分成對照組與治療組各30例。對照組采用慢性心力衰竭的常規(guī)西藥治療:β受體阻滯劑(美托洛爾緩釋片(倍他樂克)23.75-47.5mgqd;醛固酮拮抗劑(螺內(nèi)酯20-40mgqd);血管緊張素轉(zhuǎn)換酶抑制劑(ACEI)類藥物(培哚普利(雅施達)4-8mgqd),有合并癥者相應(yīng)對癥治療;治療組在對照組常規(guī)抗心衰西藥治療基礎(chǔ)上,同時予人參養(yǎng)榮湯加減方,每日兩次(方藥組成固定:人參10g,當(dāng)歸15g,黃芪20g,白術(shù)10g,茯苓茶10g,陳皮10g,益母草20g,白芍10g,丹參15g,炙甘草10g)。兩組療程均為4周,觀察治療前后心功能、NT-proBNP、Hb、轉(zhuǎn)鐵蛋白飽和度、HFEI、中醫(yī)證候量化評分的變化,并監(jiān)測肝腎功能及其不良反應(yīng)。結(jié)果采用SPSS20統(tǒng)計軟件進行數(shù)據(jù)分析。結(jié)果:1、兩組心衰患者年齡、性別構(gòu)成、原發(fā)疾病、NT-proBNP、Hb、轉(zhuǎn)鐵蛋白飽和度、紐約心功能分級、HFEI等病情程度分布差異無統(tǒng)計學(xué)意義(P0.05)。2、兩組均能改善臨床中醫(yī)證候,與對照組相比,治療組改善臨床證候效果更明顯(P0.05)。3、兩組NT-proBNP、轉(zhuǎn)鐵蛋白飽和度、HFEI、心功能分級較治療前相比均有明顯改善,與對照組相比,治療組效果更優(yōu)于對照組(P0.05)。4、兩組患者均順利完成試驗,未發(fā)生明顯或嚴重不良反應(yīng)。結(jié)論:1、人參養(yǎng)榮湯加減方對心肺氣虛型慢性心力衰竭合并缺鐵性貧血的患者能較好的減輕臨床癥狀,改善NT-proBNP,提高心功能分級,減少心力衰竭超聲心動圖綜合參數(shù),優(yōu)于常規(guī)抗心衰治療對照組。2、人參養(yǎng)榮湯加減方對心肺氣虛型慢性心力衰竭合并缺鐵性貧血的患者能較好改善Hb、轉(zhuǎn)鐵蛋白飽和度指標(biāo),優(yōu)于常規(guī)抗心衰治療對照組。3、人參養(yǎng)榮湯加減方在治療觀察過程中未見明顯的不良反應(yīng)及毒副作用,故其安全性良好。
[Abstract]:Objective: to observe the clinical effect of Shenyangrong decoction on chronic heart failure complicated with iron deficiency anemia of heart and lung qi deficiency type. Methods: from January 2016 to January 2017, the outpatients and wards of our hospital were diagnosed as chronic heart failure with iron deficiency anemia. Of 60 patients with deficiency of heart and lung qi, According to the principle of random control, The control group was divided into control group (n = 30) and treatment group (n = 30). The control group was treated with conventional western medicine for chronic heart failure: 尾 -receptor blocker (metoprolol sustained release tablet (betaloprolol 23.75-47.5 mg / qd); aldosterone antagonist (spironolactone 20-40mgqdN; angiotensin converting). Enzyme exchange inhibitor ACEI (perindopril 4-8mgqdD) for patients with complications; The treatment group was treated with Ginseng Yangrong decoction on the basis of routine anti-heart failure medicine in the control group. Two times a day (prescription composition: ginseng 10g, Angelica 15g, Astragalus 20g, Atractylodes macrocephala 10g, Poria cocos tea 10g, old skin 10g, motherwort 20g, Radix Paeoniae Alba 10g, Salvia miltiorrhiza 15g, Radix Glycyrrhiza 10g). Before and after treatment, the changes of NT-proBNPN HB, transferrin saturation and the quantitative score of TCM syndromes were observed, and the liver and kidney function and its adverse reactions were monitored. Results the data were analyzed by SPSS20 software. Results the age and sex composition of the two groups of patients with heart failure were analyzed by SPSS20 software. The distribution of NT-proBNPN Hb, transferrin saturation, New York cardiac function grading and HFEI were not significantly different between the two groups. The two groups could improve the clinical syndrome of TCM, compared with the control group. NT-proBNPP, transferrin saturation, HFEI, cardiac function grade were improved significantly in the treatment group. Compared with the control group, the effect of the treatment group was better than that of the control group (P 0.05 .4), and the two groups completed the test successfully, and compared with the control group, the effect of the treatment group was better than that of the control group. No significant or serious adverse reactions occurred. Conclusion the decoction of "1: 1", "Ginseng Yangrong decoction" can relieve the clinical symptoms, improve NT-proBNPs and improve the classification of cardiac function in patients with chronic heart failure complicated with iron deficiency anemia of cardiopulmonary qi deficiency type. Reducing the comprehensive parameters of heart failure echocardiography was better than that of the control group of routine anti-heart failure therapy. The decoction of Ginseng Yangrong decoction could improve the indexes of HB and transferrin saturation in patients with chronic heart failure with deficiency anemia of heart and lung qi deficiency. It is superior to the control group of routine anti-heart failure treatment. The decoction of Ginseng Yangrong decoction has no obvious side effects and side effects in the course of treatment observation, so its safety is good.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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本文編號：1628059