發(fā)布時(shí)間：2018-01-30 18:34

  本文關(guān)鍵詞： 體外反搏 氣陰兩虛 心血瘀阻證 慢性心衰 生活質(zhì)量　出處：《長(zhǎng)春中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:本課題主要通過(guò)對(duì)慢性心力衰竭患者輔助體外反搏的臨床療效進(jìn)行評(píng)價(jià),為慢性心力衰竭患者的非藥物治療提供證據(jù)。方法:選取72例長(zhǎng)春中醫(yī)藥大學(xué)附屬醫(yī)院心功能II、III級(jí),中醫(yī)證型為氣陰兩虛,心血瘀阻證型的患者為研究對(duì)象,將入組患者按1:1比例分為治療組和對(duì)照組,每組36例,進(jìn)行臨床觀察。對(duì)照組給予慢性心衰常規(guī)藥物治療,治療組在常規(guī)藥物治療的基礎(chǔ)上加用體外反搏。在治療前采集患者性別、年齡、病程、合并疾病分布情況、心功能分級(jí)、以及中醫(yī)癥狀、體征,進(jìn)行辨證分型,并填寫(xiě)明尼蘇達(dá)生活質(zhì)量表進(jìn)行評(píng)分。治療后6個(gè)月通過(guò)回訪了解心血管不良事件發(fā)生情況,中醫(yī)證候情況以及明尼蘇達(dá)生活質(zhì)量表評(píng)分。結(jié)果:兩組患者心血管不良事件治療前后比較,治療組患者再住院占3%;對(duì)照組患者再住院占23%;在再住院項(xiàng)上P0.05,提示兩組患者有顯著差異。在心肌梗死、死亡兩項(xiàng)上P0.05,提示兩組比較無(wú)顯著差異;經(jīng)t檢驗(yàn),兩組患者治療前后中醫(yī)癥狀療效比較,在心悸、氣短,疲乏、下肢浮腫、面色、頭暈、脅下痞塊、汗出、口干、舌質(zhì)、舌苔、脈象中醫(yī)癥狀方面均有顯著差異(P0.05),具有可比性,治療組明顯優(yōu)于對(duì)照組。兩組患者治療前后中醫(yī)證候總療效比較,治療組總有效率85.7%,對(duì)照組總有效率65.7%,兩組中醫(yī)證候總療效比較有顯著差異,有統(tǒng)計(jì)學(xué)意義(P0.05),說(shuō)明治療組中醫(yī)證候總療效優(yōu)于對(duì)照組;兩組患者治療前后心功能療效比較,治療組總有效率85.7%,對(duì)照組總有效率77.1%,兩組患者心功能療效比較方面有顯著差異,有統(tǒng)計(jì)學(xué)意義(P0.05);兩組患者治療前后6分鐘步行試驗(yàn)比較(P0.05),有統(tǒng)計(jì)學(xué)意義,治療組優(yōu)于對(duì)照組;兩組治療前后LVEF值比較(P0.05),具有統(tǒng)計(jì)學(xué)意義,治療組治療效果優(yōu)于對(duì)照組;兩組患者治療前后明尼蘇達(dá)生活質(zhì)量表評(píng)分,有統(tǒng)計(jì)學(xué)意義(P0.05),說(shuō)明體外反搏療法對(duì)患者的生命質(zhì)量有明確的改善作用,在慢性心力衰竭患者中的應(yīng)用研究具有重要意義。結(jié)論:體外反搏療法可以改善慢性心力衰竭(氣陰兩虛,心血瘀阻證)心血管不良事件的發(fā)生,改善患者的心功能,中醫(yī)癥狀以及提高生活質(zhì)量及運(yùn)動(dòng)耐量。
[Abstract]:Objective: This paper mainly through the evaluation of clinical efficacy in patients with chronic heart failure secondary external counterpulsation, provide evidence for non drug treatment in patients with chronic heart failure. Methods: 72 cases of cardiac function in Affiliated Hospital of Changchun University of Traditional Chinese Medicine, II, III, TCM syndrome type of Qi and yin deficiency, syndrome of heart blood stasis patients as the research object, the the patients according to the proportion of 1:1 divided into treatment group and control group, each group of 36 cases for clinical observation. The control group was given routine drug treatment of chronic heart failure, treatment group on the basis of routine therapy combined with external counterpulsation. Before treatment were collected in gender, age, disease duration, disease distribution, heart function classification and TCM symptoms, signs, syndromes, and fill out the Minnesota quality of life table score. 6 months after the treatment by a return visit to understand the incidence of adverse cardiovascular events, Chinese Medicine The syndrome and quality of life scale in Minnesota. Results: two groups of patients before and after treatment of cardiovascular adverse events compared with patients in the treatment group hospitalization accounted for 3%; the patients in the control group re hospitalization accounted for 23%; in hospitalization on P0.05, suggesting that patients in the two groups had significant difference. In myocardial infarction, death two P0.05 tips the two groups had no significant difference; by t test, two groups of patients before and after treatment of TCM symptoms in comparison, palpitations, shortness of breath, fatigue, edema of lower limbs, complexion, dizziness, breast lump, sweating, dry mouth, tongue, tongue, pulse and symptoms were significant differences (P0.05), were comparable, the treatment group was significantly better than the control group. Compare the total effect of Chinese medicine syndromes of two groups of patients before and after treatment, the total effective rate of treatment group 85.7%, control group total effectiveness 65.7%, two groups of TCM syndrome curative effect more significant differences, with statistical significance (P0.05), indicating that the treatment group TCM syndrome total effect is better than the control group; comparison of curative effect on cardiac function in two groups before and after treatment, the total effective rate of treatment group 85.7%, control group total efficiency of 77.1%, there is significant difference between the efficacy of cardiac function in patients with two groups was statistically significant (P0.05); two groups of patients before and after the 6 minute walk test comparison (P0.05), was statistically significant, the treatment group than the control group; the two groups before and after treatment LVEF value (P0.05), was statistically significant, the treatment group better than the control group; two groups of patients before and after treatment of Minnesota quality of life score, with statistical significance (P0.05), that the external counterpulsation therapy is effective to clear the quality of life of patients, has important significance to research the application in patients with chronic heart failure. Conclusion: external counterpulsation therapy can improve chronic heart failure (yin deficiency, blood stasis syndrome) the adverse cardiovascular events To improve the heart function of the patients, the symptoms of traditional Chinese medicine and the improvement of the quality of life and the endurance of exercise.

【學(xué)位授予單位】：長(zhǎng)春中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R259

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本文編號(hào)：1476941