丹郁調(diào)心舒治療射血分?jǐn)?shù)保留性心衰患者的臨床觀察
發(fā)布時(shí)間：2019-03-27 13:02
【摘要】：研究目的:本課題旨在觀察丹郁調(diào)心舒聯(lián)合西藥治療中醫(yī)辨證為肝腎不足,心血瘀阻證射血分?jǐn)?shù)保留性心衰(HFPEF)患者的臨床療效及安全性,探討其對HFPEF的心功能、超氧化物歧化酶(SOD)、血脂、中醫(yī)癥狀及生活質(zhì)量的影響,為臨床開發(fā)治療肝腎不足,心血瘀阻證HFPEF中藥新藥提供臨床數(shù)據(jù)。研究方法:采用隨機(jī)單盲法,將符合診斷納入標(biāo)準(zhǔn)的72例患者分為治療組、對照組。對照組采用常規(guī)西藥治療,治療組在對照組基礎(chǔ)上加用丹郁調(diào)心舒治療,療程3月。觀察比較兩組HFPEF患者治療前后腦鈉肽(BNP)、心臟超聲(E/A、DT、LA、E/E’)、SOD、血脂(TC、TG、HDL-C、LDL-C)、6分鐘步行試驗(yàn)(6MWD)、中醫(yī)癥狀積分、明尼蘇達(dá)生活質(zhì)量評分(MLHFQ)、肝腎功能、電解質(zhì),并對治療后兩組間的數(shù)據(jù)進(jìn)行對比分析和統(tǒng)計(jì)學(xué)處理。研究結(jié)果:1.研究期間,兩組治療前后肝功能(AST、ALT)、腎功能(Scr、BUN)、電解質(zhì)(K+、Na+)進(jìn)行比較,均無異常(P0.05)。2.兩組治療前后患者BNP、6MWD水平比較均有差異,其中對照組BNP、6MWD差異非常顯著(P0.01),治療組BNP、6MWD差異非常顯著(P0.01)。治療組與對照組治療后比較BNP、6MWD差異顯著(P0.05)。3.兩組治療前后患者心臟超聲指標(biāo)比較均有差異,其中對照組E/A、LA差異顯著(P0.05),E/E’、DT差異非常顯著(P0.01),治療組DT差異顯著(P0.05),E/A、E/E’、LA差異非常顯著(P0.01)。治療組與對照組治療后比較無差異(P0.05)。4.兩組治療前后患者M(jìn)LHFQ比較均有差異,其中對照組軀體狀況、情緒狀況、其他狀況評分差異非常顯著(P0.01),治療組軀體狀況、情緒狀況、其他狀況評分差異非常顯著(P0.01)。治療組與對照組治療后比較,軀體狀況、其他狀況評分差異顯著(P0.05),情緒狀況評分差異非常顯著(P0.01)。5.兩組治療前后患者血脂比較均有差異,其中對照組LDL-C差異顯著(P0.05),TC、TG、HDL-C差異非常顯著(P0.01);治療組TC、TG、LDL-C、HDL-C差異非常顯著(P0.01)。治療組與對照組治療后比較,TC、HDL-C無差異(P0.05),TG、LDL-C差異顯著(P0.05)。6.兩組治療前后患者SOD比較均有差異,其中對照組SOD差異顯著(P0.05),治療組SOD差異非常顯著(P0.01)。治療組與對照組治療后比較差異非常顯著(P0.01)。7.兩組治療前后患者單項(xiàng)中醫(yī)癥狀評分、中醫(yī)癥候療效比較均有差異。治療組與對照組單項(xiàng)中醫(yī)癥狀評分治療后比較,心悸、胸悶(痛)、氣喘、氣短、失眠、畏寒肢冷、面肢浮腫無差異(P0.05),眩暈、腰膝酸軟、疲倦乏力差異顯著(P0.05),耳鳴差異非常顯著(P0.01)。治療組與對照組中醫(yī)癥候積分療效治療后比較,心悸、氣喘、氣短、失眠、耳鳴、腰膝酸軟、畏寒肢冷、面肢浮腫無差異(P0.05),胸悶(痛)、疲倦乏力差異顯著(P0.05),眩暈差異非常顯著(P0.01)。結(jié)論:1.丹郁調(diào)心舒組方有較好的安全性。2.兩組治療均能改善患者HFPEF心功能,治療組療效優(yōu)于對照組。3.兩組治療均能改善患者的MLHFQ,治療組療效優(yōu)于對照組,在情緒狀況改善方面治療組較為突出。4.兩組治療均能改善患者的血脂水平,治療組TG、LDL-C療效優(yōu)于對照組。5.兩組治療均能改善患者的SOD水平,治療組療效顯著優(yōu)于對照組。6.兩組均能改善患者的中醫(yī)癥狀,治療組改善優(yōu)于對照組,其中以胸悶(痛)、眩暈、腰膝酸軟、疲倦乏力、耳鳴癥狀改善較為顯著。
[Abstract]:Objective: To observe the clinical effect and safety of the combination of the combination of Danone and the western medicine in the treatment of the deficiency of the liver and the kidney, the blood stasis and the ejection fraction of the patients with heart failure (HFPEF), and to study the cardiac function, the superoxide dismutase (SOD) and the blood lipid of the patients with HFPEF. The effect of the symptoms and the quality of life of the Chinese medicine is to provide clinical data for the clinical development of the traditional Chinese medicine for treating the deficiency of the liver and the kidney, the blood stasis and the blood stasis syndrome HFPEF. Methods:72 patients who met the criteria of diagnosis were divided into treatment group and control group by random single-blind method. The control group was treated with conventional western medicine, and the treatment group was treated with Danone's self-aligning shu on the basis of the control group, and the course of treatment was 3 months. The treatment of brain natriuretic peptide (BNP), cardiac ultrasound (E/ A, DT, LA, E/ E '), SOD, blood lipid (TC, TG, HDL-C, LDL-C),6-minute walk test (6MWD), symptom integration of TCM, Minnesota life quality score (MLHFQ), liver and kidney function, electrolyte, The results of the study were as follows:1. During the study, the liver function (AST, ALT), renal function (Scr, BUN), electrolyte (K +, Na +) before and after treatment were compared. The BNP and 6MWD of the control group were significantly different (P0.01), and the difference of BNP and 6MWD in the treatment group was very significant (P0.01). BNP was compared in the treatment group and the control group. The difference between the two groups was significant (P0.05). The difference between the two groups was significant (P0.05), the difference of E/ E 'and DT was very significant (P0.01), and the difference of DT in the treatment group was significant (P0.05), E/ A, E/ E', The LA difference was very significant (P0.01). There was no difference between the treatment group and the control group (P0.05). The scores of the other conditions were significantly different (P0.01). After the treatment group and the control group, the scores of body condition and other conditions were significantly different (P0.05), and the scores of emotional state scores were very significant (P0.01). In the control group, the difference of LDL-C was significant (P0.05), and the difference of TC, TG, HDL-C was very significant (P0.01). The difference of TC, TG, LDL-C and HDL-C in the treatment group was very significant (P0.01). The difference of SOD between the two groups was significant (P0.05). The difference of SOD in the control group was significant (P <0.01). The difference between the treatment group and the control group was very significant (P0.01). There was a difference in the curative effect of the symptom of the Chinese medicine. After the treatment group and the control group, the symptom scores of the single Chinese medicine were compared, the palpitations, the chest distress (pain), the asthma, the shortness of breath, the insomnia, the cold of the cold limbs and the edema of the surface limbs were not different (P0.05), the dizziness, the soreness of the waist and knees and the fatigue and weakness were significant (P0.05). The difference of tinnitus was very significant (P0.01). The treatment group and the control group were compared with the control group for the treatment of symptoms and symptoms, palpitations, asthma, shortness of breath, insomnia, tinnitus, soreness of the waist and knees, cold and cold limbs, no difference in edema of the surface limbs (P0.05), chest distress (pain) and fatigue and fatigue (P0.05). Conclusion:1. The combination of the two groups can improve the function of HFPEF in the patients, and the curative effect of the treatment group is better than that of the control group.3. Both groups can improve the MLHFQ of the patients, and the curative effect of the treatment group is better than that of the control group. 4. The treatment group was more prominent in the improvement of emotional state.4. Both groups can improve the blood lipid level of the patients, and the curative effect of TG and LDL-C in the treatment group is better than that of the control group.5. Both groups can improve the SOD level of the patients. The curative effect of the treatment group is better than that of the control group.6. Both groups can improve the symptoms of the Chinese medicine of the patient, and the improvement of the treatment group is better than that of the control group, in which the symptoms of chest distress (pain), vertigo, soreness of the waist and knees, fatigue and weakness, and the improvement of the tinnitus symptom are more remarkable.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541.6
本文編號：2448205
[Abstract]:Objective: To observe the clinical effect and safety of the combination of the combination of Danone and the western medicine in the treatment of the deficiency of the liver and the kidney, the blood stasis and the ejection fraction of the patients with heart failure (HFPEF), and to study the cardiac function, the superoxide dismutase (SOD) and the blood lipid of the patients with HFPEF. The effect of the symptoms and the quality of life of the Chinese medicine is to provide clinical data for the clinical development of the traditional Chinese medicine for treating the deficiency of the liver and the kidney, the blood stasis and the blood stasis syndrome HFPEF. Methods:72 patients who met the criteria of diagnosis were divided into treatment group and control group by random single-blind method. The control group was treated with conventional western medicine, and the treatment group was treated with Danone's self-aligning shu on the basis of the control group, and the course of treatment was 3 months. The treatment of brain natriuretic peptide (BNP), cardiac ultrasound (E/ A, DT, LA, E/ E '), SOD, blood lipid (TC, TG, HDL-C, LDL-C),6-minute walk test (6MWD), symptom integration of TCM, Minnesota life quality score (MLHFQ), liver and kidney function, electrolyte, The results of the study were as follows:1. During the study, the liver function (AST, ALT), renal function (Scr, BUN), electrolyte (K +, Na +) before and after treatment were compared. The BNP and 6MWD of the control group were significantly different (P0.01), and the difference of BNP and 6MWD in the treatment group was very significant (P0.01). BNP was compared in the treatment group and the control group. The difference between the two groups was significant (P0.05). The difference between the two groups was significant (P0.05), the difference of E/ E 'and DT was very significant (P0.01), and the difference of DT in the treatment group was significant (P0.05), E/ A, E/ E', The LA difference was very significant (P0.01). There was no difference between the treatment group and the control group (P0.05). The scores of the other conditions were significantly different (P0.01). After the treatment group and the control group, the scores of body condition and other conditions were significantly different (P0.05), and the scores of emotional state scores were very significant (P0.01). In the control group, the difference of LDL-C was significant (P0.05), and the difference of TC, TG, HDL-C was very significant (P0.01). The difference of TC, TG, LDL-C and HDL-C in the treatment group was very significant (P0.01). The difference of SOD between the two groups was significant (P0.05). The difference of SOD in the control group was significant (P <0.01). The difference between the treatment group and the control group was very significant (P0.01). There was a difference in the curative effect of the symptom of the Chinese medicine. After the treatment group and the control group, the symptom scores of the single Chinese medicine were compared, the palpitations, the chest distress (pain), the asthma, the shortness of breath, the insomnia, the cold of the cold limbs and the edema of the surface limbs were not different (P0.05), the dizziness, the soreness of the waist and knees and the fatigue and weakness were significant (P0.05). The difference of tinnitus was very significant (P0.01). The treatment group and the control group were compared with the control group for the treatment of symptoms and symptoms, palpitations, asthma, shortness of breath, insomnia, tinnitus, soreness of the waist and knees, cold and cold limbs, no difference in edema of the surface limbs (P0.05), chest distress (pain) and fatigue and fatigue (P0.05). Conclusion:1. The combination of the two groups can improve the function of HFPEF in the patients, and the curative effect of the treatment group is better than that of the control group.3. Both groups can improve the MLHFQ of the patients, and the curative effect of the treatment group is better than that of the control group. 4. The treatment group was more prominent in the improvement of emotional state.4. Both groups can improve the blood lipid level of the patients, and the curative effect of TG and LDL-C in the treatment group is better than that of the control group.5. Both groups can improve the SOD level of the patients. The curative effect of the treatment group is better than that of the control group.6. Both groups can improve the symptoms of the Chinese medicine of the patient, and the improvement of the treatment group is better than that of the control group, in which the symptoms of chest distress (pain), vertigo, soreness of the waist and knees, fatigue and weakness, and the improvement of the tinnitus symptom are more remarkable.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541.6
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 李金偉;鄧?yán)?嚴(yán)靜;;射血分?jǐn)?shù)保留的心力衰竭研究進(jìn)展[J];中國醫(yī)師進(jìn)修雜志;2015年06期
2 任春琦;張盼;趙春勇;趙慧慧;;6分鐘步行運(yùn)動訓(xùn)練對射血分?jǐn)?shù)保留的心力衰竭患者運(yùn)動耐力的影響[J];中外醫(yī)學(xué)研究;2014年30期
3 沈曉旭;馬蘇林;王君;李俊平;王顯;王碩仁;;舒張性心力衰竭與中醫(yī)證候分型相關(guān)性研究[J];中國中醫(yī)藥信息雜志;2014年09期
4 張健;鄒長虹;;2014年中國心力衰竭指南更新亮點(diǎn)解讀[J];中國循環(huán)雜志;2014年05期
5 林建民;宮麗鴻;于波;;中醫(yī)藥對舒張性心力衰竭患者的BNP和6min步行試驗(yàn)的影響[J];世界中西醫(yī)結(jié)合雜志;2013年03期
6 閆明昌;趙春芝;張東菊;;6分鐘步行試驗(yàn)和腦鈉肽對纈沙坦治療慢性充血性心力衰竭的療效評價(jià)[J];中國醫(yī)學(xué)創(chuàng)新;2013年04期
7 曹全;姜紅;;左室射血分?jǐn)?shù)保留的心力衰竭研究進(jìn)展[J];中國實(shí)用內(nèi)科雜志;2012年04期
8 牛天福;劉朋云;李娟;祁慧霞;耿強(qiáng);;八味通絡(luò)顆粒治療舒張性心力衰竭30例臨床觀察[J];中西醫(yī)結(jié)合心腦血管病雜志;2011年01期
9 朱明軍;李彬;王永霞;;充血性心力衰竭中醫(yī)病因病機(jī)分析[J];世界中西醫(yī)結(jié)合雜志;2009年01期
10 李松松;劉克強(qiáng);張東玲;;腦鈉肽對左室舒張功能不全診斷價(jià)值的研究[J];天津醫(yī)藥;2008年01期
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