本文關(guān)鍵詞： 缺血性心肌病 中醫(yī)辯證 療效 心功能　出處：《中國(guó)地方病防治雜志》2017年02期 　論文類型：期刊論文

【摘要】：目的分析缺血性心肌病患者40例中醫(yī)辯證治療的療效及心功能改善。方法選取2014年6月-2015年6月來我科室治療的心功能II-IV級(jí)的80例缺血性心肌病患者為研究對(duì)象,隨機(jī)選擇40例為觀察組采用中醫(yī)病癥療法,40例為對(duì)照組采用常規(guī)的西醫(yī)療法。分析兩組患者的6 min步行試驗(yàn),中西醫(yī)證候與心功能情況和超聲心動(dòng)圖參數(shù)。結(jié)果觀察組患者中醫(yī)癥候的顯效20例,顯效率為50.00%,高于對(duì)照組的25.00%,對(duì)比有明顯統(tǒng)計(jì)學(xué)差異(χ~2=5.3333,P=0.0209)。觀察組患者無效3例,無效率為7.50%,遠(yuǎn)低于對(duì)照組的30.00%。兩組總有效率對(duì)比差異顯著(χ~2=6.6462,P=0.0099),說明在西醫(yī)療法的基礎(chǔ)上輔助中醫(yī)辨證療法效果更加顯著。觀察組患者心功能指標(biāo)的顯效19例,顯效率為47.50%,高于對(duì)照組的25.00%,對(duì)比有明顯統(tǒng)計(jì)學(xué)差異(χ~2=4.3813,P=0.0363)。觀察組患者無效4例,無效率為10.00%,遠(yuǎn)低于對(duì)照組的27.50%。兩組總有效率對(duì)比差異顯著(χ~2=4.0205,P=0.0450),說明在西醫(yī)療法的基礎(chǔ)上輔助中醫(yī)辨證療法效果更加顯著。觀察組患者心臟超聲各參數(shù)LVEF(43.27±5.21)%,LVEDd(59.34±5.43)mm,ΔFS(26.32±1.63)%,E/A(1.23±0.22)均優(yōu)于對(duì)照組的對(duì)應(yīng)指標(biāo),兩組對(duì)比有顯著統(tǒng)計(jì)學(xué)差異(t=2.3628,P=0.0206;t=2.4643,P=0.0159;t=2.7831,P=0.0068;t=2.5023,P=0.0144),表明在西醫(yī)療法的基礎(chǔ)上輔助中醫(yī)辨證療法可以有效改善心功能狀態(tài)。兩組患者治療前的6 min步行試驗(yàn)對(duì)比無明顯統(tǒng)計(jì)學(xué)差異(P0.05)。在治療后,觀察組患者的6 min步行試驗(yàn)為(362.21±63.47)m明顯大于對(duì)照組的,兩組對(duì)比有顯著統(tǒng)計(jì)學(xué)差異(t=2.1428,P=0.0352)。結(jié)論缺血性心肌病患者在西醫(yī)治療的基礎(chǔ)上,采用中醫(yī)辨證治療可以極大地改善患者心功能,療效突出,在臨床上應(yīng)大力推廣。
[Abstract]:Objective to analyze the curative effect and cardiac function improvement of 40 patients with ischemic cardiomyopathy treated with traditional Chinese medicine. Methods 80 cases of cardiac function II-IV grade treated from June 2014 to June 2015 in our department were selected. Patients with ischemic cardiomyopathy were studied. 40 cases were randomly selected as observation group, 40 cases were treated with TCM symptom therapy and 40 cases as control group were treated with routine western medicine therapy. The 6 min walking test of the two groups was analyzed. Results there were 20 cases of TCM symptoms in the observation group, the effective rate was 50.00g, which was higher than that of the control group (25.00% cases). There was significant difference between the two groups (蠂 ~ (2) 2) 5.3333 (P < 0.05). In the observation group, 3 cases had no effect and the inefficiency rate was 7.50%. The total effective rate of the two groups was significantly lower than that of the control group (蠂 ~ 2 = 6.6462P ~ 0. 0099). On the basis of western medicine therapy, the effect of assistant TCM syndrome differentiation therapy was more remarkable. The significant effect of cardiac function index in the observation group was 47.50, which was higher than that in the control group (25.00%). There was significant statistical difference between the two groups (蠂 ~ (2 +) 4.3813) (P < 0.05). In the observation group, 4 cases had no effect, and the ineffective rate was 10.00%. The total effective rate of the two groups was significantly lower than that of the control group (蠂 2 + 4.0205%, P < 0.045). The results showed that the effect of TCM syndrome differentiation therapy was more remarkable on the basis of western medicine therapy. The parameters of heart ultrasound in observation group were LVEF(43.27 鹵5.21%. LVEDd(59.34 鹵5.43 mm, 螖 FS(26.32 鹵1.63 鹵1.23 鹵0.22) were better than those of the control group. There was significant statistical difference between the two groups. T (2.4643) (P = 0.0159); T = 2.7831, P = 0.0068; T = 2.5023, P = 0.0144). The results showed that the aid of TCM syndrome differentiation therapy on the basis of western medicine therapy could effectively improve the state of cardiac function. There was no significant difference between the two groups in 6 min walking test before treatment (P0.05). After treatment. The 6 min walking test of the patients in the observation group was 362.21 鹵63.47m significantly higher than that in the control group, and there was a significant difference between the two groups (t = 2.1428). Conclusion on the basis of western medicine treatment, TCM syndrome differentiation treatment can greatly improve the cardiac function of patients with ischemic cardiomyopathy, the curative effect is outstanding, and it should be popularized in clinic.
【作者單位】： 義烏市中心醫(yī)院特需病房;
【分類號(hào)】：R259
【正文快照】： 缺血性心肌病(Ischemic cardiomyopathy,ICM)是由于冠狀動(dòng)脈狹窄或閉塞后引起慢性心肌缺血而導(dǎo)致心肌細(xì)胞凋亡、重筑,誘發(fā)嚴(yán)重的心肌功能障礙,甚至心力衰竭[1-2]。心力衰竭患者病亡率較高,是心血管病癥的終末期,這嚴(yán)重威脅患者的生命安全[3]。為修復(fù)心力衰竭患者心機(jī)能,提高患

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