發(fā)布時(shí)間：2018-05-25 21:08

  本文選題：祛風(fēng)穩(wěn)斑湯 + 從風(fēng)論治��； 參考：《湖北中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的旨在通過祛風(fēng)穩(wěn)斑湯治療寒凝心脈型不穩(wěn)定心絞痛患者,觀察其臨床的治療效果以及其對(duì)患者易損斑塊的血清學(xué)相關(guān)指標(biāo)變化的作用,從而為冠心病不穩(wěn)定心絞痛、易損斑塊的形成與預(yù)防提供進(jìn)一步的中醫(yī)理論基礎(chǔ)和臨床依據(jù)。方法選取冠心病不穩(wěn)定心絞痛患者中符合中醫(yī)癥候診斷為寒凝心脈型者76例,采用隨機(jī)分組對(duì)照的研究方法,將上述患者分為兩個(gè)組別,治療組38例,對(duì)照組38例。所有受試者均給予抗心絞痛、降脂等基礎(chǔ)治療,對(duì)照組在維持基礎(chǔ)治療同時(shí),加用復(fù)方丹參滴丸(10丸/次,3次/日,口服);而治療組在基礎(chǔ)治療上加用祛風(fēng)穩(wěn)斑湯,由本院藥房統(tǒng)一代煎,每付藥分裝成兩袋,各150ml,于早飯、晚飯后半小時(shí)溫?zé)岷蠓�。上�?6例患者治療4周后,詳細(xì)記錄每個(gè)患者心絞痛發(fā)作頻率、持續(xù)時(shí)間長(zhǎng)短、嚴(yán)重程度以及治療前后患者心電圖變化等指標(biāo);同時(shí),記錄患者舌苔、脈象等中醫(yī)癥候改變;此外,還需定期測(cè)定患者不穩(wěn)定斑塊狀況的血清學(xué)指標(biāo),例如超敏C反應(yīng)蛋白(high-sensitivity C-reactiveprotein,hs-CRP)、血漿同型半胱氨酸(homocysteine,Hcy)、氧化性低密度脂蛋白(ox LDL)等。結(jié)果⑴實(shí)驗(yàn)結(jié)束后,治療組的總有效率(86.84%),對(duì)照組總有效率(68.42%),兩個(gè)組相比較差異有統(tǒng)計(jì)學(xué)的意義(P0.05);⑵治療后兩組的臨床癥狀與治療前相比均改善(P0.05),且治療組的改善優(yōu)于對(duì)照組(P0.05),尤其是在胸痛、氣短、神疲乏力、自汗等癥狀上改善更加明顯;⑶治療前,兩組間中醫(yī)證候總積分相比沒有顯著差異(P0.05);治療后,兩組證候總積分與治療前相比都明顯下降,有顯著差異(P0.05),且治療后兩組間相比也有顯著的差異(P0.05);⑷治療前,兩組心電圖指標(biāo)比較均沒有差異(P0.05);治療后,兩組心電圖指改善與自身治療前比較有差異(P0.05);兩組之間治療后比較,心電圖水平的改善有明顯的差異(P0.05);⑸兩組治療前血脂代謝比較沒有差異性(P0.05);對(duì)照組治療前后血脂比較無差異(P0.05);治療組治療后血脂,與治療前比較有差異(P0.05);⑹治療前后,兩組相比,hs-CRP均有明顯的差異(P0.05);治療后兩個(gè)組比較,hs-CRP均有明顯差異(P0.05);⑺治療前,兩組ox-LDL指標(biāo)之間比較差異無顯著性(P0.05);治療后,兩組自身與治療前相比,均有顯著差異(P0.05),有統(tǒng)計(jì)學(xué)意義;兩組治療后比較,有顯著性差異(P0.05),有統(tǒng)計(jì)學(xué)意義。⑻治療前,兩組HCY指標(biāo)之間比較差異無顯著性(P0.05);治療后,兩組自身與治療前比較,均有顯著差異(P0.05),有統(tǒng)計(jì)學(xué)意義;兩組治療后比較,有顯著性差異(P0.05),有統(tǒng)計(jì)學(xué)意義。⑼治療組1例患者出現(xiàn)輕微腹痛隱痛癥狀,但可耐受。未出現(xiàn)其他嚴(yán)重并發(fā)癥、終末事件,對(duì)照組7例患者病情轉(zhuǎn)為加重。結(jié)論運(yùn)用祛風(fēng)穩(wěn)斑湯聯(lián)合常規(guī)西藥治療治療可明顯縮短寒凝心脈型冠心病不穩(wěn)定型心絞痛患者心絞痛持續(xù)時(shí)間,緩解心絞痛疼痛程度,改善患者心電圖表現(xiàn),不僅可以顯著提高治療的總有效率,降低患者的中醫(yī)證候總積分,而且改善患者的中醫(yī)臨床癥狀;此外,祛風(fēng)穩(wěn)斑湯可明顯改善患者血脂、血漿同型半胱氨酸(HCY)、氧化性低密度脂蛋白(ox LDL)、超敏C反應(yīng)蛋白(hs-CRP)的水平,與單用西藥治療相比,未出現(xiàn)明顯的不良反應(yīng)、毒副作用,安全性較高,在臨床治療不穩(wěn)定型心絞痛中值得推廣。
[Abstract]:Objective To observe the effect of the treatment of cold coagulant angina pectoris with the treatment of cold coagulant angina pectoris, and its effect on the changes of the serum related indexes of vulnerable plaque, so as to provide further theoretical basis and clinical basis for the development of unstable angina pectoris, the formation and prevention of vulnerable plaque. Methods 76 cases of coronary heart disease patients with unstable angina pectoris were selected and divided into two groups, 38 cases in the treatment group and 38 in the control group. All the subjects were treated with anti angina pectoris, lipid lowering and other basic treatment, while the control group was maintained at the same time in the maintenance of basic treatment. Combined with Compound Danshen Dripping Pills (10 pills / times, 3 times a day, oral), and the treatment group was combined with the decoction of dispelling wind and stabilizing the spot on the basis of the treatment, the medicine room of our hospital was decocted together and divided into two bags, each 150ml, in breakfast, after supper half an hour after supper. After 4 weeks of treatment, the frequency of angina pectoris in each patient was recorded and the duration of each patient was recorded in detail. Length, severity, and electrocardiogram changes in patients before and after treatment; at the same time, TCM syndrome changes such as tongue coating and pulse condition are recorded; in addition, the serological indexes of unstable plaque condition in patients, such as hypersensitive C reactive protein (high-sensitivity C-reactiveprotein, hs-CRP), plasma homocysteine (homocysteine Hcy), oxidative low density lipoprotein (ox LDL) and so on. Results (1) after the experiment, the total effective rate of the treatment group (86.84%), the total effective rate (68.42%) in the control group (68.42%), the difference between the two groups was statistically significant (P0.05); 2. After treatment, the clinical symptoms were improved compared with before treatment (P0.05), and the improvement of the treatment group was better than that of the control group (P0.05). Especially in the chest pain, shortness of breath, fatigue, sweating and other symptoms improved more obviously; (3) before treatment, the total score of TCM syndromes between the two groups was not significantly different (P0.05); after treatment, the total score of the two groups was significantly lower than before treatment (P0.05), and there were significant differences between the two groups after treatment (P0.05); 4 Before treatment, there was no difference in electrocardiogram between the two groups (P0.05). After treatment, the two groups had a difference (P0.05) before the treatment, and the improvement of electrocardiogram level between the two groups was significantly different (P0.05); there was no difference between the two groups before treatment (P0.05), and the blood lipid before and after treatment in the control group. There was no difference (P0.05); the blood lipid in the treatment group was different from that before treatment (P0.05); before and after treatment, there were significant differences between the two groups (P0.05); after the treatment, there was a significant difference between the two groups after treatment (P0.05); before the treatment, there was no significant difference between the two groups of ox-LDL indexes (P0.05); after treatment, the two groups themselves and the two groups were not significantly different (P0.05). Before treatment, there were significant differences (P0.05), statistically significant; there were significant differences between the two groups after treatment (P0.05). Before treatment, there was no significant difference between the two groups of HCY indexes (P0.05); after treatment, the two groups were significantly different from before treatment (P0.05), with statistical significance; the two groups were compared after treatment. There were significant differences (P0.05). There were 1 cases of mild abdominal pain in the treatment group, but they were tolerable. There were no other serious complications, end events and 7 cases in the control group. Conclusion the treatment of coronary heart disease with the combination of dispelling wind and stabilizing the spot soup combined with the conventional western medicine can obviously shorten the unstable angina pectoris type coronary heart disease instability. The duration of angina pectoris in patients with angina pectoris, alleviating angina pectoris and improving patients' electrocardiogram can not only significantly improve the total effective rate of treatment, reduce the total score of TCM syndrome, but also improve the clinical symptoms of Chinese medicine. In addition, it can obviously improve the blood lipid and plasma homocysteine (HC Y), the level of oxidized low density lipoprotein (ox LDL) and hypersensitive C reactive protein (hs-CRP), compared with western medicine alone, has no obvious adverse reactions, toxic side effects and high safety. It is worth popularizing in the clinical treatment of unstable angina pectoris.
【學(xué)位授予單位】：湖北中醫(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

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 柴婧予;王連志;;中醫(yī)藥治療痰瘀互結(jié)胸痹研究概況[J];實(shí)用中醫(yī)內(nèi)科雜志;2017年02期

2 張艷麗;;血府逐瘀湯對(duì)不穩(wěn)定型心絞痛患者血栓前狀態(tài)的影響[J];新中醫(yī);2017年02期

3 蘭瑛;;胸痹的中醫(yī)辨證施護(hù)[J];中國(guó)中醫(yī)藥現(xiàn)代遠(yuǎn)程教育;2017年02期

4 張偉;連愛霞;王松;;柴胡疏肝散穴位敷貼佐治老年不穩(wěn)定型心絞痛(氣滯心胸證)的療效觀察[J];中西醫(yī)結(jié)合心腦血管病雜志;2017年02期

5 王靜平;;益心康泰膠囊聯(lián)合曲美他嗪對(duì)老年不穩(wěn)定型心絞痛的治療效果[J];臨床醫(yī)學(xué);2017年01期

6 郭緒昆;井永樂;李明珍;;微囊泡與冠狀動(dòng)脈粥樣硬化不穩(wěn)定斑塊關(guān)系的研究[J];臨床心血管病雜志;2017年01期

7 趙云;鐘守樂;;黃芪注射液治療早期不穩(wěn)定型心絞痛的臨床效果觀察[J];社區(qū)醫(yī)學(xué)雜志;2017年01期

8 趙發(fā)兵;姚衛(wèi);;血清sCD40L、sCD40含量與ACS患者病情進(jìn)展、斑塊性質(zhì)改變的關(guān)系[J];海南醫(yī)學(xué)院學(xué)報(bào);2017年03期

9 郭華濤;徐麗華;常征利;王智;陳曉麗;常哲興;;冠脈斑塊CT值改變及血清炎性因子與冠脈斑塊穩(wěn)定性的相關(guān)研究[J];北華大學(xué)學(xué)報(bào)(自然科學(xué)版);2017年01期

10 徐志娜;周建松;古憶;盧新政;;血漿同型半胱氨酸與冠心病的相關(guān)性及其與冠心病傳統(tǒng)危險(xiǎn)因素的關(guān)系[J];貴州醫(yī)科大學(xué)學(xué)報(bào);2016年11期

相關(guān)重要報(bào)紙文章 前1條

1 張效科;趙文景;張華東;;藤類風(fēng)藥的臨床應(yīng)用體會(huì)[N];中國(guó)中醫(yī)藥報(bào);2016年

相關(guān)碩士學(xué)位論文 前1條

1 楊永剛;從腎論治胸痹心痛病及導(dǎo)師經(jīng)驗(yàn)總結(jié)[D];北京中醫(yī)藥大學(xué);2013年

，

本文編號(hào)：1934660