【摘要】：目的：評價(jià)活絡(luò)利水飲治療瘀水互結(jié)型鈣離子拮抗劑導(dǎo)致下肢水腫病的臨床療效及中醫(yī)證候積分,并初步探討其作用機(jī)理。方法：2014年6月至2015年3月,60例服用氨氯地平(22例)、硝苯地平(38例)后出現(xiàn)水腫的輕、中度原發(fā)性高血壓患者納入研究。將60例患者隨機(jī)分為治療組與對照組,各30例。治療組西醫(yī)標(biāo)準(zhǔn)降壓基礎(chǔ)上加服活絡(luò)利水飲,對照組西醫(yī)標(biāo)準(zhǔn)降壓加服一定劑量的利尿劑,觀察期6周。觀察和比較治療前后水腫程度、中醫(yī)證候評分的變化情況及其他不良反應(yīng)事件,采用SPSS19.0軟件對數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。結(jié)果：1.治療組與對照組在用藥后消腫綜合療效比較,在治療后中藥治療組未見水腫者13例,輕度水腫者15例,足背仍水腫者2例,利尿劑對照組未見水腫者4例,輕度水腫者6例,足背仍水腫者20例。兩組經(jīng)卡方檢驗(yàn),治療組比對照組有明顯優(yōu)勢(P0.01)。2.治療組足背凹陷程度在治療前2.67±0.52mmm,治療后0.55±0.44mmm,治療幅度為0.78±0.16；對照組足背凹陷程度在治療前為2.58±0.55mmm,治療后1.51±0.76mm,治療幅度為0.43±0.25,兩組治療前后及治療幅度經(jīng)t檢驗(yàn)P0.01,有統(tǒng)計(jì)學(xué)意義。3.治療組小腿圍洗脫后35.59±4.24cm,治療前為37.90±4.12cm,治療后35.77±4.25cm,治療幅度為0.92±0.42；對照組小腿圍洗脫后36.22±4.80cm,治療前為38.5±4.70cm,治療后37.53±4.64cm,治療幅度為0.43±0.08,兩組治療前后及治療幅度經(jīng)t檢驗(yàn)P0.01,有統(tǒng)計(jì)學(xué)意義。4.治療組足頸圍洗脫后25.53±3.55cm,治療前為28.08±3.60cm,治療后25.77±3.55cm,治療幅度為0.90±0.03。對照組足頸圍洗脫后25.88±4.53cm,治療前為28.23±4.41cm,治療后26.85±4.54cm,治療幅度為0.41±0.07。兩組治療前后經(jīng)t檢驗(yàn)皆有明顯差異(P0.01)。兩組治療幅度經(jīng)成組t檢驗(yàn),有明顯差異,治療組明顯優(yōu)于對照組。5.治療組與對照組在用藥后中醫(yī)證候總積分有顯著降低(P0.01),但是治療后治療組總積分明顯低于對照組,有顯著性差異(P0.01)。治療組中醫(yī)證候綜合療效總有效率為100%,明顯高于對照組40.00%,具有顯著差異(P0.01)。在各個(gè)癥狀總有效率上,治療組優(yōu)于對照組,各項(xiàng)癥狀的改善明顯優(yōu)于對照組,具有顯著性差異(P0.01)。結(jié)論：治療組在改善鈣離子拮抗劑導(dǎo)致下肢水腫病消腫療效及中醫(yī)臨床癥狀方面優(yōu)于對照組。
[Abstract]:Objective: to evaluate the clinical efficacy and TCM syndrome score of Huoluo Lishuiyin in the treatment of lower extremity edema caused by water stasis type calcium antagonists, and to explore its mechanism. Methods: from June 2014 to March 2015, 60 patients with mild to moderate essential hypertension with edema after taking amlodipine (22 cases) and nifedipine (38 cases) were included in the study. Sixty patients were randomly divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated with Huoluo Lishui decoction on the basis of the standard hypotension of western medicine, and the control group was treated with a certain dose of diuretics for 6 weeks. The degree of edema, the changes of TCM syndrome score and other adverse events were observed and compared before and after treatment, and the data were statistically analyzed by SPSS19.0 software. Results: 1. Compared with the control group, there were 13 cases of edema, 15 cases of mild edema, 2 cases of still edema of foot, 4 cases of no edema, 6 cases of mild edema and 20 cases of still edema of foot in the treatment group and the control group after treatment with traditional Chinese medicine (TCM) treatment group (13 cases), 15 cases (15 cases), 2 cases (2 cases), 4 cases (4 cases), 6 cases (6 cases) and 20 cases (20 cases). After chi-square test, the treatment group had obvious advantages over the control group (P01). 2. The degree of foot back depression was 2.67 鹵0.52 mm before treatment, 0.55 鹵0.44 mm after treatment and 0.78 鹵0.16 before treatment, and 2.58 鹵0.55 mm before treatment, 1.51 鹵0.76 mm after treatment and 0.43 鹵0.25 mm after treatment in the control group, and there was significant difference between the two groups before and after treatment (P 0.01, P < 0.05), and the degree of foot back depression was 2.67 鹵0.52 mm before and after treatment, 0.55 鹵0.44 mm and 0.78 鹵0.16 before and after treatment, and 2.58 鹵0.55 mm before treatment, 1.51 鹵0.76 mm after treatment and 0.43 鹵0.25 mm after treatment. In the treatment group, 35.59 鹵4.24 cm after leg eluting, 37.90 鹵4.12 cm before treatment and 35.77 鹵4.25 cm after treatment, the treatment range was 0.92 鹵0.42, while that in the control group was 36.22 鹵4.80 cm, 38.5 鹵4.70 cm before and 37.53 鹵4.64 cm after treatment, and the treatment range was 0.43 鹵0.08 before and after treatment. In the treatment group, 25.53 鹵3.55 cm after neck circumference eluting, 28.08 鹵3.60 cm before treatment, 25.77 鹵3.55 cm after treatment, and 0.90 鹵0.03 cm after treatment. In the control group, 25.88 鹵4.53 cm after foot neck eluting, 28.23 鹵4.41 cm before treatment and 26.85 鹵4.54 cm after treatment, the range of treatment was 0.41 鹵0.07. There was significant difference between the two groups before and after treatment by t test (P 0.01). The treatment range of the two groups was significantly different by group t test, and the treatment group was significantly better than the control group. 5. After treatment, the total score of TCM syndromes in the treatment group and the control group was significantly lower than that in the control group (P 0.01), but the total score in the treatment group was significantly lower than that in the control group (P 0.01). The total effective rate of TCM syndrome in the treatment group was 100%, which was significantly higher than that in the control group (40.00%) (P 0.01). The total effective rate of each symptom in the treatment group was better than that in the control group, and the improvement of each symptom was significantly better than that in the control group (P 0.01). Conclusion: the treatment group is superior to the control group in improving the antiswelling effect and clinical symptoms of lower extremity edema caused by calcium antagonists.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R544.1

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