本文關(guān)鍵詞：耳尖放血治療陰虛陽(yáng)亢型高血壓病的即時(shí)療效觀察　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 高血壓病 陰虛陽(yáng)亢 耳尖放血 療效觀察

【摘要】：[目的]觀察耳尖放血療法的即時(shí)降壓效果,驗(yàn)證其療效并探討其作用機(jī)制,為臨床陰虛陽(yáng)亢型高血壓病的治療及護(hù)理提供一種簡(jiǎn)便有效且副作用小的輔助中醫(yī)治療方法,也是為了提供更多的佐證支持傳統(tǒng)中醫(yī)治療手段在臨床中的推廣。[方法]本研究采取臨床交叉試驗(yàn)原則,選取在2015年10月至2016年6月期間江蘇省中醫(yī)院老年醫(yī)學(xué)科收治的30例原發(fā)性陰虛陽(yáng)亢型高血壓患者,利用交叉試驗(yàn)方法,將其配對(duì)分為試驗(yàn)組及對(duì)照組,各30例,試驗(yàn)組用耳尖放血法治療,對(duì)照組舌下含服卡托普利片治療,比較治療前后兩組在一段時(shí)間內(nèi)血壓變化。[結(jié)果]耳尖放血干預(yù)陰虛陽(yáng)亢型高血壓即時(shí)療效的觀察結(jié)果:①將治療前試驗(yàn)組和對(duì)照組的血壓進(jìn)行比較,發(fā)現(xiàn)其無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),所以能夠在組間進(jìn)行試驗(yàn)研究。②將對(duì)照組和試驗(yàn)組治療前及治療后5分鐘、10分鐘、30分鐘、60分鐘、120分鐘的收縮壓值進(jìn)行組間兩兩比較,經(jīng)方差分析后結(jié)果顯示:治療后5分鐘、10分鐘試驗(yàn)組及對(duì)照組的收縮壓值未見(jiàn)明顯差異(P0.05);治療后的30分鐘、60分鐘、120分鐘試驗(yàn)組和對(duì)照組的收縮壓值比較,兩組值間有顯著性差異(P＜0.05)。③將對(duì)照組和試驗(yàn)組治療前及治療后5分鐘、10分鐘、30分鐘、60分鐘、120分鐘的舒張壓值進(jìn)行組間兩兩比較,經(jīng)方差分析后結(jié)果顯示:治療后5分鐘、10分鐘試驗(yàn)組及對(duì)照組的舒張壓值未見(jiàn)明顯差異(P0.05);治療后的30分鐘、60分鐘、120分鐘試驗(yàn)組和對(duì)照組的舒張壓值比較,兩組值間有顯著性差異(P＜0.05)。④對(duì)試驗(yàn)組與對(duì)照組各時(shí)間點(diǎn)收縮壓進(jìn)行組間均值比較,運(yùn)用折線圖分析,發(fā)現(xiàn)試驗(yàn)組收縮壓在治療后5分鐘-60分鐘,均呈下降趨勢(shì),至120分鐘時(shí),收縮壓回升。⑤對(duì)試驗(yàn)組與對(duì)照組各時(shí)間點(diǎn)舒張壓進(jìn)行組間均值比較,運(yùn)用折線圖分析,發(fā)現(xiàn)試驗(yàn)組舒張壓在治療后5分鐘-60分鐘,均呈下降趨勢(shì),至120分鐘時(shí),舒張壓回升。⑥組內(nèi)比較兩組患者各時(shí)間點(diǎn)的收縮壓值,經(jīng)方差分析后結(jié)果顯示:對(duì)照組治療前和治療后各時(shí)間點(diǎn)收縮壓值比較均有非常明顯差異(P＜0.01),治療后5分鐘與治療后10分鐘、30分鐘、60分鐘、120分鐘收縮壓值比較,均有非常明顯差異(P＜0.01),治療后10分鐘和治療后30分鐘、60分鐘、120分鐘收縮壓值比較,均有非常明顯差異(P0.01),治療后30分鐘和治療后60分鐘、120分鐘收縮壓值比較,均有非常明顯差異(P00.01),治療后60分鐘和治療后120分鐘收縮壓值比較,有非常明顯差異(P＜0.01);試驗(yàn)組治療前和治療后各時(shí)間點(diǎn)收縮壓值比較,均有非常明顯差異(P0.01),治療后5分鐘和治療后10分鐘、30分鐘、60分鐘、120分鐘收縮壓值比較,均有非常明顯差異(P0.01),治療后10分鐘和治療后30分鐘、60分鐘收縮壓值比較,均有非常明顯差異(P0.01),但和治療后120分鐘收縮壓值比較,未見(jiàn)明顯差異(P0.05),治療后30分鐘和治療后60分鐘、120分鐘收縮壓值比較,均有非常明顯差異(P＜0.01),治療后60分鐘和治療后120分鐘收縮壓值比較,有非常明顯差異(P＜0.01)。⑦組內(nèi)比較兩組患者各時(shí)間點(diǎn)的舒張壓值,經(jīng)方差分析后結(jié)果顯示:對(duì)照組治療前和治療后各時(shí)間點(diǎn)舒張壓值比較均有非常明顯差異(P0.01),治療后5分鐘與治療后10分鐘、30分鐘、60分鐘、120分鐘舒張壓值比較,均有非常明顯差異(P＜0.01),治療后10分鐘和治療后30分鐘、60分鐘、120分鐘舒張壓值比較,均有非常明顯差異(P0.01),治療后30分鐘和治療后60分鐘、120分鐘舒張壓值比較,均有非常明顯差異(P0.01),治療后60分鐘和治療后120分鐘舒張壓值比較,有非常明顯差異(P＜0.01);試驗(yàn)組治療前和治療后各時(shí)間點(diǎn)舒張壓值比較,均有非常明顯差異(P＜0.01),治療后5分鐘和治療后10分鐘、30分鐘、60分鐘、120分鐘舒張壓值比較,均有非常明顯差異(P0.01),治療后10分鐘和治療后30分鐘、60分鐘舒張壓值比較,均有非常明顯差異(P0.01),但和治療后120分鐘舒張壓值比較,未見(jiàn)明顯差異(P0.05),治療后30分鐘和治療后60分鐘、120分鐘舒張壓值比較,均有非常明顯差異(P0.01),治療后60分鐘和治療后120分鐘舒張壓值比較,有非常明顯差異(P＜0.01)。⑧在試驗(yàn)組和對(duì)照組治療后60分鐘時(shí),檢驗(yàn)干預(yù)效果,運(yùn)用秩和檢驗(yàn)后結(jié)果顯示:Z=-0.359,P=0.720(P0.05),即試驗(yàn)組和對(duì)照組治療后60分鐘時(shí)干預(yù)效果無(wú)統(tǒng)計(jì)學(xué)差異。[結(jié)論]兩組患者經(jīng)治療后,收縮壓與舒張壓均下降,治療后10min、30min、60min的血壓改善情況均比較顯著(P0.05),而在60min時(shí)患者的血壓改善情況最好,60min-120min之內(nèi),試驗(yàn)組降壓效果不明顯,對(duì)照組仍有降壓效果。兩組可改善中醫(yī)證候,但療效無(wú)明顯差異(P0.05)。
[Abstract]:[Objective] to observe the antihypertensive effect of instant ear apex bloodletting therapy, verify its efficacy and to explore its mechanism, treatment and clinical nursing of Yinxu Yangkang provides a simple and effective auxiliary method of Chinese medicine treatment and the side effect is small, but also to provide more evidence to support the promotion of traditional Chinese medicine treatment in clinic the. [method] this study adopted clinical cross test principle, 30 cases of primary hypertension patients with hyperactivity were selected during the period from October 2015 to June 2016 in Jiangsu Province Traditional Chinese Medicine Hospital from the Department of Geriatrics, using cross test method, which were divided into experimental group and control group, 30 cases in each, the experimental group was treated with auricular apex bloodletting therapy. The control group of sublingual Captopril Tablets treatment, compared two groups before and after treatment for a period of time the change of blood pressure. [results] the effect of ear tip bloodletting intervention on hypertension of yin deficiency yang hyperactivity was observed: (1) comparing the blood pressure between the experimental group and the control group before treatment, it was found that there was no statistical difference (P0.05), so we could carry out an experimental study between the groups. The control group and the experimental group before and after treatment for 5 minutes, 10 minutes, 30 minutes, 60 minutes, 120 minutes of systolic blood pressure between the 22 groups were compared by analysis of variance results showed that: after treatment, 5 minutes, 10 minutes of the test group and control group, there was no obvious difference in systolic blood pressure (P0.05); contraction of 30 minutes and 60 minutes, 120 minutes of the test group and the control group after treatment, the pressure value comparison, two groups there was a significant difference between the values (P < 0.05). The control group and the experimental group before and after treatment for 5 minutes, 10 minutes, 30 minutes, 60 minutes, 120 minutes the diastolic blood pressure values were compared between the 22 groups, by the analysis of variance results showed that: the treatment after 5 minutes, 10 minutes of test group and control group, there was no obvious difference in diastolic blood pressure (P0.05); 30 minutes, 60 minutes, 120 minutes of the test group and the control group diastolic blood pressure values after treatment between the two groups, there was a significant difference between the values (P < 0.05). (4) comparing the mean value of systolic blood pressure between the experimental group and the control group at each time point, using the broken line chart analysis, we found that the systolic blood pressure of the experimental group decreased after 5 minutes and -60 minutes after treatment, and the systolic blood pressure increased after 120 minutes. (5) comparing the mean value of the diastolic blood pressure between the experimental group and the control group at each time point, using the broken line chart analysis, we found that the diastolic blood pressure of the experimental group decreased after 5 minutes -60 minutes after treatment, and the diastolic blood pressure increased again to 120 minutes. The group of two groups were compared at each time point of the value of systolic blood pressure, through the variance analysis results showed: the control group before and after treatment of each time point value of systolic blood pressure is relatively obvious differences (P < 0.01), 5 minutes after treatment and after treatment for 10 minutes, 30 minutes, 60 minutes, 120 minutes the systolic blood pressure value, have very significant difference (P < 0.01), 10 minutes after treatment and after treatment for 30 minutes, 60 minutes, 120 minutes, the systolic blood pressure value, have very significant difference (P0.01), 30 min after treatment and after treatment for 60 minutes, 120 minutes, the systolic blood pressure value, have very significant differences (P00.01) after treatment, 60 minutes and 120 minutes after treatment systolic blood pressure value, has a very significant difference (P < 0.01); the SBP values of experimental group before and after treatment, have very significant difference (P0.01), 5 minutes after treatment and after treatment for 10 minutes, 30 minutes, 60 minutes, 120 minutes, the systolic blood pressure value, have very significant difference (P0.01), 10 min after treatment and after treatment for 30 minutes, 60 minutes, the systolic blood pressure value, have very significant difference (P0.01), but compared with 120 minutes after treatment there was no significant difference between the value of systolic blood pressure (P0.05), after treatment 30 minutes and 60 minutes after 120 minutes treatment, systolic blood pressure, have very significant difference (P < 0.01), after treatment for 60 minutes and 120 minutes after treatment systolic blood pressure value, has a very significant difference (P < 0.01). The diastolic blood pressure values within groups were compared between the two groups at each time point, the variance analysis results showed: the control at each time point of the diastolic blood pressure values were very obvious differences between groups before and after treatment (P0.01), 5 min after treatment and after treatment for 10 minutes, 30 minutes, 60 minutes, 120 points Zhong Shuzhang pressure value comparison, have very significant differences (P < 0.01), 10 minutes after treatment and after treatment for 30 minutes, 60 minutes, 120 minutes the diastolic blood pressure value, have very significant difference (P0.01), 30 min after treatment and after treatment for 60 minutes, 120 minutes the diastolic blood pressure value, have very significant difference (P0.01), 60 minutes after treatment and after treatment 120 minutes the diastolic blood pressure value, has a very significant difference (P < 0.01); diastolic blood pressure values at each time point in experimental group before and after treatment, have very significant difference (P < 0.01), 5 minutes after treatment and after treatment for 10 minutes, 30 minutes, 6 0 minutes, 120 minutes the diastolic blood pressure value, have very significant difference (P0.01), 10 min after treatment and after treatment for 30 minutes, 60 minutes the diastolic blood pressure value, have very significant difference (P0.01), and 120 minutes after treatment but the diastolic blood pressure value, there is no significant difference (P0.05), after treatment 30 minutes and 60 minutes, 120 minutes after the treatment of diastolic blood pressure values, have very significant difference (P0.01), 60 min after treatment and after treatment 120 minutes the diastolic blood pressure value, has a very significant difference (P < 0.01). In the experimental group and control group after treatment for 60 minutes, test the effect of intervention, with rank test results showed: Z=-0.359, P=0.720 (P0.05), the experimental group and the control group after treatment for 60 minutes when the intervention had no significant difference. [Conclusion] the two groups of patients after treatment, systolic blood pressure and diastolic blood pressure were decreased after treatment, 10min, 30min, 60min were significantly improved blood pressure (P0.05), and the improvement of blood pressure in patients with 60min best, within 60min-120min, the hypotensive effect of experimental group is not obvious, there is still the antihypertensive effect of the control group. The two groups can improve the TCM syndrome, but there is no significant difference in the curative effect (P0.05).
【學(xué)位授予單位】：南京中醫(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)】：R248.1

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