本文關(guān)鍵詞：生脈真武救心湯治療慢性心衰的療效觀察　出處：《廣州中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 慢性心力衰竭 生脈真武救心湯 生存質(zhì)量量表 心功能

【摘要】：目的：通過對慢性心力衰竭患者的生存質(zhì)量量表評分,以及心功能分級改善情況的統(tǒng)計分析,探討黃春林教授自擬方生脈真武救心湯在心腎陽虛、水瘀互結(jié)型慢性心力衰竭患者中的治療作用,并為其臨床療效提供客觀依據(jù)。方法：采用簡單隨機的方法將符合納入及排除標(biāo)準(zhǔn)的,廣東省中醫(yī)院大德路總院住院部及門診就診的慢性心力衰竭患者,分為試驗組和對照組,分別編號。建立相關(guān)數(shù)據(jù)記錄表格,記錄兩組患者的性別、年齡、心功能分級、生存質(zhì)量量表評分、來自門診或住院部等基本信息。試驗組予西藥常規(guī)治療藥物加上生脈真武救心湯；對照組只予以西藥治療。觀察病人的心衰情況,評估其心功能分級以及生存質(zhì)量情況,并分別于治療前和治療后一周填寫生存質(zhì)量量表,同時記錄心功能分級情況。最后,建立數(shù)據(jù)庫,錄入心功能分級改善情況及量表評分。并采用SPSS23.0版本將所得數(shù)據(jù)進(jìn)行統(tǒng)計學(xué)處理與分析。結(jié)果：本研究中共納入病例40例,分為試驗組與對照組,每組分別20例。其中男性19例,女性21例；試驗組中男性占8例,女性12例；對照組中男性共11例,女性9例。年齡最小37歲,最大87歲；其中試驗組中年齡最小的為37歲,最大的為87歲,其均數(shù)加減標(biāo)準(zhǔn)差71.35±11.93；對照組年齡最小59歲,最大84歲,均數(shù)加減標(biāo)準(zhǔn)差為75.40±7.23。兩組中各有13例患者來自門診部,7例來自住院部。經(jīng)過統(tǒng)計分析,試驗組治療前生存質(zhì)量量表評分(102.89±18.78)與治療后評分(34.95±10.56)差別具有統(tǒng)計學(xué)意義(P=0.00)；對照組病例在治療前的生存質(zhì)量量表評分(106.00±13.42)與治療后的評分(51.05±12.59)之間的差別具有統(tǒng)計學(xué)意義(P=0.00)。試驗組治療前后得分的差值(67.95±15.26)與對照組治療前后的得分的差值(54.95±5.24)之間的差別比較具有統(tǒng)計學(xué)意義(P=0.001)。在心功能改善方面,試驗組治療無效0人,有效2人,顯效17人；對照組無效0人,有效4人,顯效16人；兩組的治療在心功能改善方面有效率均為100%。對比兩組心功能改善情況,統(tǒng)計結(jié)果顯示P=0.106,P值大于0.05,無統(tǒng)計學(xué)意義,考慮兩組治療在心功能改善方面無明顯差異。結(jié)論：本研究統(tǒng)計結(jié)果表明,生脈真武救心湯加常規(guī)西藥與單純西藥在慢性心力衰竭的治療中,無論是在患者的生存質(zhì)量的改善方面,還是在心功能改善方面均有療效。在生存質(zhì)量改善方面,生脈真武救心湯加常規(guī)西藥治療的療效優(yōu)于單純西藥治療；在心功能改善方面,二者無明顯差異。對于辯證為心腎陽虛、水瘀互結(jié)的慢性心力衰竭患者,在常規(guī)西藥治療的基礎(chǔ)上加用生脈真武救心湯,可提高患者生存質(zhì)量。
[Abstract]:Objective: to evaluate the quality of life scale (QOL) of patients with chronic heart failure (CHF) and the improvement of cardiac function classification, and to explore Professor Huang Chunlin's self-designed decoction of "Fang Sheng Mai Zhenwu Jiu Xin Tang" for deficiency of heart and kidney yang. The therapeutic effect in patients with chronic heart failure with water stasis and blood stasis, and provide objective basis for its clinical efficacy. Methods: a simple and random method will be adopted to meet the inclusion and exclusion criteria. The patients with chronic heart failure (CHF) were divided into two groups: experimental group and control group. The related data record table was established to record the sex and age of the two groups. Cardiac function grading, quality of life scale score, from outpatient or inpatient departments and other basic information. The experimental group was given routine western medicine drugs plus Shengmai Zhenwu Jiuxin decoction; The patients in the control group were treated with western medicine only. The patients' heart failure was observed, cardiac function grading and quality of life were evaluated, and the quality of life scale was completed before treatment and one week after treatment. At the same time, the classification of cardiac function was recorded. Finally, the database was established. The improvement of cardiac function classification and the score of the scale were recorded. The data were statistically processed and analyzed by SPSS23.0 version. Results: 40 cases were included in this study. The patients were divided into experimental group and control group with 20 cases in each group, of which 19 cases were males and 21 cases were females. There were 8 males and 12 females in the trial group. There were 11 males and 9 females in the control group. The age was 37 years old and the oldest was 87 years old. In the test group, the youngest was 37 years old, the biggest was 87 years old, and the mean value was 71.35 鹵11.93 years old. The control group was the youngest 59 years old, the oldest 84 years old, the average addition and subtractive standard deviation was 75.40 鹵7.23.There were 13 patients from the outpatient department and 7 from the inpatient department in each group. The scores of QOL before treatment (102.89 鹵18.78) and after treatment (34.95 鹵10.56) in the trial group were significantly different from those in the control group (P < 0.001). The difference of QOL score before treatment (106.00 鹵13.42) and after treatment (51.05 鹵12.59) was statistically significant (P < 0.05). The difference of scores before and after treatment between the test group (67.95 鹵15.26) and the control group (54.95 鹵5.24). The difference was statistically significant in the improvement of cardiac function. In the experimental group, there were 0 ineffective, 2 effective and 17 effective. In the control group, 0 cases were ineffective, 4 cases were effective and 16 cases had remarkable effect. The effective rate of cardiac function improvement in the two groups was 100. Compared with the improvement of cardiac function in the two groups, the statistical results showed that the P value was greater than 0.05, there was no statistical significance. There was no significant difference between the two groups in the improvement of cardiac function. Conclusion: the statistical results of this study show that Shengmai Zhenwu jiuxin decoction conventional western medicine and simple western medicine in the treatment of chronic heart failure. Both in the improvement of patients' quality of life and in the improvement of cardiac function, the curative effect of Shengmai Zhenwu jiuxin decoction was better than that of western medicine alone. In the improvement of cardiac function, there is no significant difference between the two. For the patients with chronic heart failure who are dialectical of deficiency of heart and kidney yang and mutual formation of water and blood stasis, add Shengmai Zhenwu Jiuxin decoction on the basis of routine western medicine treatment. It can improve the quality of life of patients.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259

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