本文選題：陣發(fā)性房顫 + 血瘀證�。� 參考：《福建中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:通過研究陣發(fā)性房顫患者的左室重構(gòu)與血瘀證及心率變異性與血瘀證的關(guān)系,為陣發(fā)性房顫的臨床預(yù)防和治療提供新的思路。研究方法:收錄2016年1月至2017年1月時(shí)間段內(nèi),就診于福建中醫(yī)藥大學(xué)附屬第二人民醫(yī)院門診或病房的、符合陣發(fā)性房顫診斷標(biāo)準(zhǔn)的患者的資料。根據(jù)中醫(yī)四診辨證論治,對(duì)入選的陣發(fā)性房顫患者進(jìn)行血瘀證的辨證分析,最終將入選者分為血瘀證組(40例)、非血瘀證組(20例),并同時(shí)收錄福建中醫(yī)藥大學(xué)附屬第二人民醫(yī)院健康體檢者20例,作為正常對(duì)照組;再根據(jù)血瘀證積分情況,將血瘀證組內(nèi)入選者分為積分≥10分組和積分10分組。檢測(cè)所入選者的血瘀證信息和心臟彩超相關(guān)指數(shù)(舒張期末期室間隔厚度(IVST)、舒張期末期左室后壁厚度(LVPWT)、左心室舒張末內(nèi)徑(LVEDD)、左心室質(zhì)量指數(shù)(LVMI))及動(dòng)態(tài)心電圖中心率變異性(HRV)各指數(shù)(RR間期標(biāo)準(zhǔn)差(SDNN)、均值標(biāo)準(zhǔn)差(SDANN)、相鄰RR間期均方差(RMSSD)、低間期差值大于50ms所占百分比(PNN50)),運(yùn)用SPSS20對(duì)數(shù)據(jù)進(jìn)行分析。結(jié)果:1.血瘀證組的IVST、LVPWT、LVEDD、LVMI的數(shù)值較對(duì)照組明顯增高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);血瘀證組的IVST、LVMI的數(shù)值較非血瘀證組明顯增高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);非血瘀證組的LVPWT較對(duì)照組明顯增高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。2.血瘀證組的SDNN、SDANN、RMSSD、PNN50的數(shù)值較對(duì)照組明顯增高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);血瘀證組的SDNN、SDANN、RMSSD、PNN50的數(shù)值較非血瘀證組明顯增高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);非血瘀證組的RMSSD較對(duì)照組數(shù)值明顯增高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。3.積分≥10分組的IVST、LVPWT、LVEDD、LVMI的數(shù)值較對(duì)照組明顯增高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);積分≥10分組的LVEDD、LVMI的數(shù)值較積分10分組明顯增高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);積分10分組的LVPWT較對(duì)照組數(shù)值明顯增高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。4.積分≥10分組的SDNN、SDANN、RMSSD、PNN50的數(shù)值較對(duì)照組明顯增高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);積分≥10分組較積分10分組的數(shù)值差異無統(tǒng)計(jì)學(xué)意義(P0.05);積分10分組的SDNN、SDANN、PNN50較對(duì)照組數(shù)值明顯增高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1.PAF患者存在左室重構(gòu),且血瘀證較非血瘀證嚴(yán)重。2.PAF患者心率變異性增高,且血瘀證較非血瘀證嚴(yán)重。3.PAF患者左室重構(gòu)程度隨血瘀證積分的增高而加重。4.血瘀證組較非血瘀證組IVST、LVMI、SDNN、SDANN、RMSSD、PNN50等有明顯增高。因此,血瘀可能參與心臟組織重構(gòu),引起左室重構(gòu),使心室的解剖結(jié)構(gòu)變化,且隨著血瘀程度增加而加重;同時(shí)影響自主神經(jīng)對(duì)于心臟的調(diào)節(jié),從而導(dǎo)致PAF的發(fā)生和發(fā)展。
[Abstract]:Objective: to study the relationship between left ventricular remodeling and blood stasis syndrome, heart rate variability and blood stasis syndrome in patients with paroxysmal atrial fibrillation, so as to provide new ideas for clinical prevention and treatment of paroxysmal atrial fibrillation. Methods: the data of patients who met the diagnostic criteria of paroxysmal atrial fibrillation were collected from January 2016 to January 2017 in the outpatient or ward of the second people's Hospital affiliated to Fujian University of traditional Chinese Medicine. According to the four diagnosis and treatment of TCM, the selected patients with paroxysmal atrial fibrillation were analyzed based on the syndrome differentiation of blood stasis. Finally, the selected patients were divided into blood stasis syndrome group (n = 40) and non-blood stasis syndrome group (n = 20). At the same time, 20 healthy persons in the second people's Hospital affiliated to Fujian University of traditional Chinese Medicine were included as normal control group, and then according to the score of blood stasis syndrome, The selected patients in blood stasis group were divided into integral 鈮，

本文編號(hào)：1979949