本文關(guān)鍵詞：生脈散加減治療心肌梗死后心絞痛氣陰兩虛型的臨床療效評價　出處：《山東中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

  更多相關(guān)文章： 生脈散加減 心肌梗死后心絞痛 氣陰兩虛型 臨床療效

【摘要】：目的:本試驗旨在觀察生脈散加減治療氣陰兩虛型心肌梗死后心絞痛的臨床療效,評價其安全性,并初步探究其作用機理。方法:將筆者自2015年4月至2016年2月于山東中醫(yī)藥大學附屬醫(yī)院心內(nèi)科門診、病房及綜合內(nèi)科病房實習收集的60例病例,符合氣陰兩虛型心肌梗死后心絞痛的納入排除標準,隨機分為中藥治療組與對照組,每組30例,兩組患者的一般情況無統(tǒng)計學差異。兩組均給予西醫(yī)常規(guī)綜合治療,中藥治療組在此基礎(chǔ)上加服加減生脈散,日一劑,分早、晚兩次飯后溫服。試驗為期4周,觀察兩組患者治療前后的心絞痛發(fā)作情況(疼痛程度、發(fā)作頻率及持續(xù)時間)、中醫(yī)證候積分判定、心電圖變化、硝酸甘油停減率、相關(guān)實驗室檢查,進行對比分析,評估其臨床療效及藥物安全性。結(jié)果:4周后,對比中藥治療組及對照組的臨床療效,中藥治療組在改善心絞痛的發(fā)作情況(疼痛程度、發(fā)作頻率、發(fā)作持續(xù)時間)方面療效優(yōu)于對照組,中醫(yī)癥狀評分改善明顯,在硝酸甘油停減率、心電圖改變方面也展現(xiàn)了服用中藥的優(yōu)勢,在肌鈣蛋白I、CK-MB、TG、TC、LDL-C、CRP、纖維蛋白原、血流變等實驗室檢查指標方面,二者對比有統(tǒng)計學差異,顯示中藥治療組較對照組有較好的臨床療效,在肝腎功能等安全性指標方面顯示無統(tǒng)計學差異,應用安全。結(jié)論:結(jié)果顯示生脈散加減聯(lián)合西醫(yī)常規(guī)治療能顯著提高氣陰兩虛型心肌梗死后心絞痛的臨床療效,對比單純的西醫(yī)常規(guī)治療,中藥治療組在改善患者的臨床癥狀體征以及相關(guān)實驗室指標方面療效顯著。其相關(guān)機制可能為增加心肌細胞血供、抑制炎癥反應、調(diào)脂穩(wěn)定斑塊、改善血管內(nèi)皮功能、延緩動脈硬化進展等,并具有良好的耐受性及安全性,值得進一步應用及推廣。
[Abstract]:Objective: To observe the clinical efficacy of Shengmai Powder in the treatment of angina pectoris after myocardial infarction, evaluate its safety and explore its mechanism. Methods: 60 cases of the author from April 2015 to February 2016 in the outpatient department of Cardiology, wards and comprehensive medical ward of Affiliated Hospital of Shandong University of Traditional Chinese Medicine internship collected, in accordance with the inclusion of angina pectoris of Qi Yin deficiency after myocardial infarction were excluded, were randomly divided into treatment group and control group, 30 cases in each group, no significant difference between the two groups in general. The two groups were given conventional western medicine treatment, Chinese medicine treatment group on the basis of Jiajian Shengmaisan, a agent, divided into early and late two after dinner. The experiment lasted for 4 weeks, two groups were observed before and after treatment in patients with angina pectoris (pain, seizure frequency and duration), TCM syndrome score determination, ECG, nitroglycerin withdrawal rate, laboratory examination, comparative analysis, to evaluate the clinical efficacy and safety of medicines. Results: after 4 weeks, the clinical curative effect of traditional Chinese medicine treatment group and control group, the onset of traditional Chinese medicine treatment group in improving angina pectoris (pain, seizure frequency and duration) has better effect than the control group, TCM symptom scores improved significantly, the decrease rate of nitroglycerin, ECG changes also show taking the advantages of traditional Chinese medicine, in CK-MB, TG, troponin I, TC, LDL-C, CRP, fibrinogen, blood rheology and other laboratory indexes, two compared with statistical difference, Chinese medicine treatment group has better clinical efficacy than the control, showed no significant difference in the liver and kidney function and other safety indicators, application safety. Conclusion: the results showed that Shengmai Decoction Combined with conventional western medicine therapy can significantly improve the clinical curative effect of Qi Yin deficiency myocardial infarction angina pectoris after the conventional treatment of Western medicine compared to pure Chinese medicine treatment group, significant improvement in patients with clinical symptoms and related laboratory index of curative effect. Its related mechanisms may increase myocardial blood supply, inhibit inflammatory reaction, regulate lipid, stabilize plaque, improve endothelial function and delay the progression of arteriosclerosis. It is well tolerated and safe, and is worthy of further application and promotion.
【學位授予單位】：山東中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R259

【參考文獻】

相關(guān)期刊論文 前10條

1 李衛(wèi)東;;瓜蔞薤白桂枝湯治療急性心肌梗死后心絞痛68例[J];河南中醫(yī);2015年06期

2 徐群威;;中西醫(yī)結(jié)合治療急性心肌梗死后心絞痛的療效觀察[J];中國慢性病預防與控制;2014年04期

3 趙闖;;急性心肌梗死后早期心絞痛臨床探析[J];亞太傳統(tǒng)醫(yī)藥;2013年02期

4 鄧悅;吳宗貴;陳穎;姜麗紅;郭家娟;常立萍;崔英子;李雙娣;;痰瘀伏絡(luò)是心血管疾病鏈的主要機制[J];中醫(yī)雜志;2011年20期

5 盧兵;;藥物在心肌梗死二級預防中的應用[J];中國醫(yī)藥指南;2010年14期

6 丁斗;董小君;;氣元論在胸痹心痛證治中的病因病機規(guī)律研究[J];長春中醫(yī)藥大學學報;2010年02期

7 吳人照;楊兵勛;黃飛華;李亞平;陳意;陶筱娟;;鐵皮楓斗顆粒(膠囊)治療氣陰兩虛證高血壓病180例觀察[J];浙江中醫(yī)雜志;2010年01期

8 安洪澤;;范新發(fā)從濕、熱、郁論治胸痹臨床舉隅[J];河北中醫(yī);2009年12期

9 鮑素華;查學強;郝杰;羅建平;;不同分子量鐵皮石斛多糖體外抗氧化活性研究[J];食品科學;2009年21期

10 付麗新;;急性心肌梗死后心絞痛78例原因分析[J];中國醫(yī)藥指南;2009年03期

相關(guān)博士學位論文 前1條

1 華允芬;鐵皮石斛多糖成分研究[D];浙江大學;2005年

，

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