本文選題：益氣活血 + 冠心病��； 參考：《廣州中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：背景:冠狀動(dòng)脈粥樣硬化性心臟病(冠心病)是死亡率最高的疾病之一,嚴(yán)重威脅著人類健康與社會(huì)發(fā)展。經(jīng)皮冠狀動(dòng)脈介入治療(PCI)已成為治療冠心病并提高患者生存質(zhì)量的重要手段,雖然現(xiàn)代治療技術(shù)有了長(zhǎng)足進(jìn)步,但是冠狀動(dòng)脈支架內(nèi)再狹窄(ISR)等問(wèn)題的存在使患者死亡率依然沒(méi)有明顯下降。目的:通過(guò)對(duì)臨床資料的回顧分析研究,探索益氣活血中藥對(duì)冠心病患者冠狀動(dòng)脈靶血管的作用及其他效果。方法:本研究通過(guò)回顧性分析,利用廣東省中醫(yī)院胸痛診療中心2010年1月1日至2014年12月31日的冠脈造影患者數(shù)據(jù)庫(kù)進(jìn)行篩選、數(shù)據(jù)整理與分析,納入曾在此期間于我院行兩次或兩次以上冠狀動(dòng)脈造影或PCI術(shù)的病例(同一名患者兩次手術(shù)至少間隔6個(gè)月),將第一次術(shù)后長(zhǎng)期堅(jiān)持服用通冠膠囊的人群定義為益氣活血中藥組,將單純使用西藥治療的人群定義為標(biāo)準(zhǔn)西藥治療組。通過(guò)分析前后兩次手術(shù)的冠脈造影及實(shí)驗(yàn)室檢驗(yàn)結(jié)果等資料,對(duì)益氣活血中藥對(duì)冠心病患者冠狀動(dòng)脈血管的作用進(jìn)行評(píng)價(jià)。結(jié)果:本研究納入70個(gè)病例,男性48人,女性22人,患者平均年齡為58.35±7.04歲。其中益氣活血中藥組患者39人(55.7%),標(biāo)準(zhǔn)西藥治療組31人(44.3%),他們?cè)谌丝趯W(xué)資料、個(gè)人史、既往病史、第一次PCI術(shù)前實(shí)驗(yàn)室指標(biāo)、冠狀動(dòng)脈Gensini評(píng)分等基線差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),兩組人群具有可比性。兩組人群在第一次PCI術(shù)前兩組人群在Gensini評(píng)分上未見(jiàn)統(tǒng)計(jì)學(xué)差異,然而,在第二次術(shù)后益氣活血中藥組的Gensini評(píng)分顯著低于標(biāo)準(zhǔn)西藥治療組(P0.05)。而且益氣活血中藥組的支架內(nèi)斑塊發(fā)生率(12.8%)明顯低于標(biāo)準(zhǔn)西藥治療組(35.5%,P0.05)。在血脂指標(biāo)方面,兩種治療方案均能降低總膽固醇(TC),但是益氣活血中藥組對(duì)總膽固醇的降低程度更明顯(P0.05)。另外,益氣活血中藥組對(duì)于心臟彩超指標(biāo)射血分?jǐn)?shù)(EF)、每搏輸出量(SV)具有明顯的改善作用。研究結(jié)論:氣虛血瘀證冠心病患者在PCI術(shù)后服用益氣活血中藥能夠降低支架內(nèi)斑塊的發(fā)生,同時(shí)很可能具有改善血脂異常和改善心臟射血功能等作用。
[Abstract]:Background: coronary atherosclerotic heart disease (coronary heart disease) is one of the highest mortality diseases, which is a serious threat to human health and social development. Percutaneous coronary intervention (PCI) has become an important means to treat coronary heart disease and improve the quality of life of patients, although modern treatment technology has made great progress. But problems such as restenosis in coronary stents caused no significant decrease in mortality. Objective: to explore the effect of Yiqi Huoxue herbs on coronary artery target vessels in patients with coronary heart disease by retrospective analysis of clinical data. Methods: through retrospective analysis, the database of coronary arteriography from January 1, 2010 to December 31, 2014 in chest pain diagnosis and treatment Center of Guangdong traditional Chinese Medicine Hospital was used to screen and analyze the data. Those who had performed two or more coronary angiography or PCI procedures in our hospital during the same period (the same patient had two operations at least 6 months apart) were included in the study. The people who took Tongguan capsule for a long period of time after the first operation were defined as the people who took Tongguan capsule for a long time after the first operation. Invigorating Qi and activating Blood Circulation Group, The people who were treated with western medicine alone were defined as the standard western medicine treatment group. By analyzing the results of coronary angiography and laboratory examination before and after two operations, the effect of Yiqi Huoxue herbs on coronary artery vessels in patients with coronary heart disease was evaluated. Results: this study included 70 cases, male 48, female 22, the average age of the patients was 58.35 鹵7.04 years old. Among them, 39 patients in the group of supplementing qi and activating blood circulation were treated with 55.75.7U, 31 patients in the standard western medicine treatment group were treated with 44.3s, their demographic data, personal history, past medical history, laboratory indexes before the first PCI operation, The baseline difference of coronary Gensini score was not statistically significant (P 0.05), and the two groups were comparable. There was no significant difference in Gensini score between the two groups before the first PCI, however, the Gensini score in the second postoperative group was significantly lower than that in the standard western medicine group (P 0.05). In addition, the incidence of plaque in stents in the group of invigorating qi and activating blood circulation was significantly lower than that in the treatment group of standard western medicine (P 0.05). In the aspect of blood lipid index, the two kinds of treatment schemes can reduce the total cholesterol of TCX, but the group of supplementing qi and activating blood circulation can reduce the total cholesterol more obviously (P0.05N). In addition, Yiqi Huoxue Chinese medicine group has obvious improvement effect on ejection fraction (EFG) and stroke volume (SVV) of cardiac color Doppler ultrasound index. Conclusion: taking Qi-deficiency and blood-stasis syndrome in patients with coronary heart disease after PCI can reduce the occurrence of plaque in stents and may also improve the blood lipid abnormality and cardiac ejection function.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R541.4

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