本文選題：慢性充血性心力衰竭 + 抑郁�。� 參考：《山東中醫(yī)藥大學(xué)》2014年碩士論文

【摘要】：目的：觀察解郁顆粒治療慢性充血性心力衰竭伴抑郁狀態(tài)患者的臨床療效。 方法：將60例慢性充血性心力衰竭伴抑郁患者，隨機(jī)分為2組，每組各30例，兩組慢性充血性心力衰竭伴抑郁患者均給以常規(guī)利尿劑、血管緊張轉(zhuǎn)化酶抑制劑、β-受體阻滯劑、地高辛、醛固酮拮抗劑等藥物治療；對(duì)照組予加服黛力新（氟哌噻噸美利曲辛片，丹麥靈北制藥有限公司生產(chǎn)），每早1片，治療組加服解郁顆粒（濰坊市中醫(yī)院自制劑）口服，一日一劑，早晚分服。觀察治療組與對(duì)照組在治療前及治療后2周、4周后在心衰癥狀、中醫(yī)癥候積分、BNP前體(NT-proBNP)、左室舒張末容積（LVEDD）、左室射血分?jǐn)?shù)（LVEF）及HAMD量表評(píng)分等方面的差異。并經(jīng)相應(yīng)統(tǒng)計(jì)方法對(duì)結(jié)果進(jìn)一步分析判定。 結(jié)果：1.在緩解中醫(yī)癥候積分方面，兩組均有顯著效果（p0.01），癥候療效方面治療組顯效率及總有效率高于對(duì)照組，但差異統(tǒng)計(jì)學(xué)無(wú)意義（p0.05）。2.與治療前相比較，兩組BNP前體(NT-proBNP)、左室舒張末容積（LVEDD）明顯降低、左室射血分?jǐn)?shù)（LVEF）明顯升高，（P＜0.01）；與對(duì)照組比較，治療4周后患者抑郁程度及生活質(zhì)量明顯改善，BNP前體(NT-proBNP)、左室舒張末容積（LVEDD）明顯降低、左室射血分?jǐn)?shù)（LVEF）明顯升高（P＜0.05），治療組優(yōu)于對(duì)照組。3.兩組在HAMD量表積分改善方面均有顯著效果（p0.01），治療組及對(duì)照組差異無(wú)統(tǒng)計(jì)學(xué)意義（p0.05）。 結(jié)論：解郁顆粒治療慢性充血性心力衰竭伴抑郁狀態(tài)患者療效確切，，與對(duì)照組相比在HAMD量表積分改善方面兩者相似，在改善患者心功能方面優(yōu)于對(duì)照組，長(zhǎng)時(shí)間服用與對(duì)照組相比無(wú)副作用。
[Abstract]:Objective: to observe the clinical effect of Jieyu granule on chronic congestive heart failure with depression. Methods: sixty patients with chronic congestive heart failure and depression were randomly divided into two groups, 30 patients in each group. The patients in both groups were given routine diuretics, angiotensin-converting enzyme inhibitors and 尾 -blockers. Digoxin, aldosterone antagonist and other drugs were used in the control group. The control group was treated with dimethylpyridine (droperthiothioate) metriaxine tablets, and the Danish Lingbei Pharmaceutical Co., Ltd., one tablet per morning. The treatment group was treated with Jieyu granule (self-made medicine of Weifang traditional Chinese Hospital), and the control group was given oral administration of digoxin, aldosterone antagonist, etc. One dose a day, sooner or later. The difference was observed between the treatment group and the control group in the symptoms of heart failure before treatment and after 2 weeks and 4 weeks after treatment. The scores of NT-proBNPN, left ventricular end-diastolic volume (LVEDDN), left ventricular ejection fraction (LVEF) and HAMD scale were compared between the treatment group and the control group in terms of BNP precursor, left ventricular end-diastolic volume (LVEDDN), left ventricular ejection fraction (LVEF) and HAMD scale. The results were further analyzed and determined by the corresponding statistical methods. The result is 1: 1. In the aspect of relieving TCM symptom integral, the two groups had significant effect, the effective rate and total effective rate of the treatment group were higher than that of the control group, but there was no significant difference between the two groups. Compared with before treatment, NT-proBNPN, left ventricular end-diastolic volume (LVEDDD) and left ventricular ejection fraction (LVEF) increased significantly in both groups (P < 0.01), and compared with control group. After 4 weeks of treatment, the degree of depression and quality of life of patients with BNP were significantly improved. NT-proBNPN, left ventricular end-diastolic volume (LVEDDD), left ventricular ejection fraction (LVEF) were significantly increased (P < 0.05), and the treatment group was superior to the control group (.3). The improvement of HAMD score in the two groups was significant (P 0.01), but there was no significant difference between the treatment group and the control group (P 0.05). Conclusion: Jieyu granule is effective in the treatment of chronic congestive heart failure with depression. Compared with the control group, the improvement of HAMD scale score is similar, and it is superior to the control group in improving the heart function of the patients. There was no side effect compared with the control group.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R541.6;R749.4

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