發(fā)布時(shí)間：2018-01-29 06:15

  本文關(guān)鍵詞： 耳穴壓豆 慢性腎臟病 高血壓　出處：《山東中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的觀察耳穴壓豆輔助治療慢性腎臟病3~4期伴有1~2級(jí)高血壓患者的降壓療效及其依從性,為耳穴壓豆輔助降壓提供客觀依據(jù)。方法根據(jù)研究對(duì)象納入標(biāo)準(zhǔn)選擇山東中醫(yī)藥大學(xué)附屬醫(yī)院腎內(nèi)科病房和門診慢性腎臟病3~4期伴有1~2級(jí)高血壓患者60例,采用分層隨機(jī)化的方法,根據(jù)患者的腎功能、伴有高血壓級(jí)別隨機(jī)分為試驗(yàn)組和對(duì)照組,每組各30例。兩組均給予常規(guī)降壓藥物,高血壓1級(jí)者:氨氯地平5mg日一次;高血壓2級(jí)者:氨氯地平5mg日二次。對(duì)照組在給予常規(guī)降壓藥物的基礎(chǔ)上給予耳穴貼布,依照選穴原則統(tǒng)一選取目前降壓最常用的七個(gè)穴位(心、肝、腎、神門、降壓溝、交感、皮質(zhì)下),同時(shí)給予心理暗示提示貼布有藥效作用,完全不需要按壓。而試驗(yàn)組在給予常規(guī)降壓藥物的基礎(chǔ)上給予,加用王不留行籽耳穴壓豆治療,選取同樣七個(gè)穴位(心、肝、腎、神門、降壓溝、交感、皮質(zhì)下),分別觀察兩組患者壓豆前,壓豆后3天,10天,28天血壓變化情況。結(jié)果1.試驗(yàn)組平均均動(dòng)脈壓(治療后3天vs治療前:108.88±11.69 vs 118.77±11.56)、收縮壓(治療后3天vs治療前:150.87±11.99 vs 173.56±12.01)、舒張壓(治療后3天vs治療前:88.16±10.07 vs 94.97±10.97)均下降(P0.05),有統(tǒng)計(jì)學(xué)差異。試驗(yàn)組平均均動(dòng)脈壓(治療后10天vs治療前:104.83±11.27 vs118.77±11.56)、收縮壓(治療后10天vs治療前:140.55±11.78 vs 173.56±12.01)、舒張壓(治療后10天vs治療前:84.98±10.89 vs 94.97±10.97)均下降(P0.05),有統(tǒng)計(jì)學(xué)差異。試驗(yàn)組平均均動(dòng)脈壓(治療后28天vs治療前:100.98±12.12 vs 118.77±11.56)、收縮壓(治療后28天vs治療前:134.26±12.08 vs 173.56±12.01)均下降(P0.01),有顯著統(tǒng)計(jì)學(xué)差異;舒張壓(治療后28天vs治療前:83.02.±10.76 vs 94.97±10.97)下降(P0.05),有統(tǒng)計(jì)學(xué)差異。試驗(yàn)組治療后3天達(dá)到理想的降壓效果,且收縮壓的降壓幅度大于舒張壓,治療后28天內(nèi)血壓保持在較穩(wěn)定的水平。2.試驗(yàn)組與對(duì)照組相比較,治療后3天平均動(dòng)脈壓(試驗(yàn)組vs對(duì)照組:108.88±11.69vs112.30±11.97)、收縮壓(試驗(yàn)組vs對(duì)照組:150.87±11.99 vs 158.76±12.33)均下降(P0.05),有統(tǒng)計(jì)學(xué)差異;舒張壓(試驗(yàn)組vs對(duì)照組:88.16±10.07 vs 90.58±11.56)無明顯下降(P(29)0.05),無統(tǒng)計(jì)學(xué)差異。試驗(yàn)組與對(duì)照組相比較,治療后10天平均動(dòng)脈壓(試驗(yàn)組vs對(duì)照組:104.83±11.27vs 108.54±11.56)、收縮壓(試驗(yàn)組vs對(duì)照組:140.55±11.78 vs 149.09±12.18)均下降顯著(P0.05),有統(tǒng)計(jì)學(xué)差異;舒張壓(試驗(yàn)組vs對(duì)照組:84.98±10.89 vs 87.27.±12.01)無明顯下降(P(29)0.05),無統(tǒng)計(jì)學(xué)差異。試驗(yàn)組與對(duì)照組相比較,治療后28天平均動(dòng)脈壓(試驗(yàn)組vs對(duì)照組:100.98±12.12vs 105.48±12.01)、收縮壓(試驗(yàn)組vs對(duì)照組:134.26±12.08 vs 141.72±12.26)均下降(P0.05),有統(tǒng)計(jì)學(xué)差異;舒張壓(試驗(yàn)組vs對(duì)照組:83.02.±10.76 vs 85.37±11.52)無明顯下降(P(29)0.05),無統(tǒng)計(jì)學(xué)差異。3.慢性腎臟病3~4期伴有1~2級(jí)高血壓患者,在常規(guī)降壓的基礎(chǔ)上,加用耳穴壓豆治療能更有效地降低患者血壓,且治療效果隨著時(shí)間延長呈增強(qiáng)趨勢(shì)。結(jié)論耳穴壓豆對(duì)慢性腎臟病3~4期伴有1~2級(jí)高血壓的患者有一定的輔助降壓作用,可在治療后3天達(dá)到理想的降壓效果,且收縮壓的降壓幅度大于舒張壓,并在治療后28天內(nèi)血壓維持在較穩(wěn)定的水平。
[Abstract]:Objective To observe the antihypertensive efficacy and compliance of auricular plaster therapy in adjuvant treatment of stage 3~4 chronic kidney disease with 1~2 in patients with hypertension, for auricular pressure auxiliary blood pressure provides the objective basis. Methods included 60 cases of Affiliated Hospital of Shandong University of Traditional Chinese Medicine 3~4 renal medical ward and outpatient chronic renal disease with grade 1~2 patients with hypertension according to the research object, using the method stratified randomization, according to the patient's renal function, hypertension grade were randomly divided into experimental group and control group, 30 cases in each group. The two groups were given conventional antihypertensive drugs, grade 1 hypertension: Amlodipine 5mg once a day; grade 2 hypertension: Amlodipine 5mg two times a day. The control group in addition to the routine antihypertensive drugs given auricular acupoint selection in accordance with the principle of unity of cloth, selects the seven most commonly used acupoints (heart, liver, kidney and blood pressure, Shenmen, jinagyagou, sympathetic, subcortical), at the same time to 浜堝績鐞嗘殫紺烘彁紺鴻創(chuàng)甯冩湁鑽晥浣滅敤,瀹屽叏涓嶉渶瑕佹寜鍘，

本文編號(hào)：1472757