發(fā)布時(shí)間：2018-04-18 01:03

  本文選題：益氣養(yǎng)陰 + 活血利水法�。� 參考：《北京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:觀察益氣養(yǎng)陰、活血利水法及血液超濾治療對(duì)老年慢性心衰急性失代償患者的療效方法:回顧分析49例慢性心衰急性失代償期老年住院患者,分別配合益氣養(yǎng)陰、活血利水法中藥(26例,稱(chēng)為中藥組)和血液超濾治療(23例,稱(chēng)為超濾組),在常規(guī)西藥治療的基礎(chǔ)上,中藥治療組在基礎(chǔ)方"生黃芪10-30g、黨參10-30g、石斛15-30g、毛冬青 10-20g、茯苓 10-30g、桂枝 10-20g、豬苓 10-20g、澤蘭 10-20g、白術(shù) 10-20g、灸甘草5-6g"之上隨證加減,超濾治療組超濾方案為脫水速度200-350ml/h,超濾脫水量500ml-2000ml。觀察2組治療前及治療后10天左右的心功能分級(jí)、NT-proBNP、eGFR的變化,并通過(guò)SPSS 22.0統(tǒng)計(jì)軟件分析兩組組內(nèi)及組間的差異。結(jié)果:1.組內(nèi)比較,中藥組及超濾組治療后NT-proBNP均較治療前明顯下降(P0.01);中藥組及超濾組治療后NT-proBNP分別下降33.2±33.8%、41.1±25.5%;超濾組治療后NT-proBNP下降百分?jǐn)?shù)的95%置信區(qū)間為29.8%～52.5%,中藥組為19.6～46.9%,組間比較,超濾組與中藥組NT-proBNP下降百分?jǐn)?shù)未達(dá)到統(tǒng)計(jì)學(xué)差異(P0.05),但超濾組NT-proBNP下降百分?jǐn)?shù)置信區(qū)間較中藥組更高且集中。2.組內(nèi)比較,兩組治療前后eGFR無(wú)顯著差異(P0.05),組間比較亦無(wú)顯著差異(P0.05)。3.兩組治療前后心功能改善總有效率分別為84.6%、91.3%,組間比較無(wú)顯著差異(P0.05)。結(jié)論:在常規(guī)西藥治療的基礎(chǔ)上,配合益氣養(yǎng)陰、活血利水法中藥或血液超濾治療,均可能明顯改善患者心功能、降低NT-proBNP;同時(shí),兩種治療方法均未引起eGFR下降。
[Abstract]:Objective: to observe the curative effect of supplementing qi and nourishing yin, activating blood circulation and promoting water and blood ultrafiltration in treating senile patients with acute decompensation of chronic heart failure. Methods: 49 cases of senile inpatients with acute decompensation of chronic heart failure were analyzed retrospectively.On the basis of routine western medicine treatment, 26 cases were treated by activating blood circulation and promoting water, and 23 cases were treated by ultrafiltration.The traditional Chinese medicine treatment group was added and subtracted from the basic prescription "ShengHuangqi 10-30g, Codonopsis pilosula 10-30g, Dendrobium candidum 15-30g, Maotongqian 10-20g, Poria cocos 10-30g, Cinnamomum umbellata 10-20g, Zhelan 10-20g, Atractylodes macrocephalae 10-20g, moxibustion licorice 5-6g". The ultrafiltration treatment group was treated with dehydration rate 200-350 ml / h and ultrafiltration dehydration volume 500ml-2000ml.The changes of NT-proBNPN eGFR were observed before and 10 days after treatment in the two groups, and the differences between the two groups were analyzed by SPSS 22.0 software.The result is 1: 1.After treatment, NT-proBNP in the Chinese medicine group and ultrafiltration group was significantly lower than that in the pre-treatment group, NT-proBNP in the Chinese medicine group and ultrafiltration group decreased 33.2 鹵33.8 鹵41.1 鹵25.50.The 95% confidence interval of the decrease in the percentage of NT-proBNP in the ultrafiltration group after treatment was 29.80.52.5, and that in the traditional Chinese medicine group was 19.66.9.The decrease percentage of NT-proBNP in ultrafiltration group and traditional Chinese medicine group was not significant difference (P 0.05), but the confidence interval of decreasing percentage of NT-proBNP in ultrafiltration group was higher than that in traditional Chinese medicine group.There was no significant difference in eGFR between the two groups before and after treatment (P 0.05), and there was no significant difference between the two groups (P 0.05).The total effective rate of heart function improvement in the two groups before and after treatment was 84.6 and 91.3, respectively. There was no significant difference between the two groups (P 0.05).Conclusion: on the basis of routine western medicine therapy combined with supplementing qi and nourishing yin activating blood circulation and promoting water therapy or blood ultrafiltration treatment can obviously improve the heart function of patients and reduce NT-proBNP.The two treatment methods have not caused the decrease of eGFR at the same time.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R541.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 石衍梅;劉曉倩;尉若川;李虹;薛一濤;李長(zhǎng)生;;生脈養(yǎng)心顆粒聯(lián)合西藥治療老年慢性心力衰竭50例臨床觀察[J];中醫(yī)雜志;2016年23期

2 崔冬梅;;強(qiáng)心益氣方聯(lián)合西藥對(duì)急性心力衰竭患者血管內(nèi)皮功能、心功能、血漿NT-proBNP的影響[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2016年31期

3 陳偉偉;高潤(rùn)霖;劉力生;朱曼璐;王文;王擁軍;吳兆蘇;李惠君;顧東風(fēng);楊躍進(jìn);鄭哲;蔣立新;胡盛壽;;《中國(guó)心血管病報(bào)告2015》概要[J];中國(guó)循環(huán)雜志;2016年06期

4 王愛(ài)華;廖榮宏;王靜;;呋塞米聯(lián)合小劑量多巴胺治療失代償性心力衰竭的Meta分析[J];重慶醫(yī)學(xué);2016年14期

5 葉淑萍;;參附注射液治療急性心力衰竭療效觀察[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2016年13期

6 魏立俠;張英杰;翟桂蘭;;托伐普坦治療頑固性心力衰竭的療效研究[J];中國(guó)循環(huán)雜志;2016年04期

7 陳可冀;吳宗貴;朱明軍;毛靜遠(yuǎn);徐浩;;慢性心力衰竭中西醫(yī)結(jié)合診療專(zhuān)家共識(shí)[J];中國(guó)中西醫(yī)結(jié)合雜志;2016年02期

8 盧志強(qiáng);張艷軍;莊朋偉;張金保;周會(huì)芳;陳卓;孫萌;徐利滿(mǎn);;附子對(duì)急性心力衰竭大鼠血流動(dòng)力學(xué)影響及其機(jī)制研究[J];中草藥;2015年21期

9 李爭(zhēng);錢(qián)玉紅;周靜;王敏;范志媛;張淋淋;梁鳳蘭;史俊玲;;芪藶強(qiáng)心膠囊治療老年收縮性心力衰竭的臨床療效觀察[J];疑難病雜志;2015年09期

10 李雙雙;李東澤;馬依彤;;血液超濾治療急性心力衰竭綜合征的Meta分析[J];重慶醫(yī)學(xué);2015年24期

，

本文編號(hào)：1766082