本文關(guān)鍵詞： 調(diào)脾護(hù)心方 心脾兩虛 室性早搏 臨床觀察　出處：《安徽中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:運(yùn)用中藥復(fù)方湯劑(調(diào)脾護(hù)心方)治療室性早搏患者,觀察其對(duì)室性早搏患者臨床癥狀的控制及其安全性。通過(guò)對(duì)其選用的相關(guān)指標(biāo)的剖析,聯(lián)合觀察室性早搏患者的中醫(yī)癥狀表現(xiàn),綜合辨病及辨證分析,探討調(diào)脾護(hù)心方中醫(yī)臨床診治的有效性及安全性。方法:選取2014年11月至2015年11月期間就診于安徽中醫(yī)藥大學(xué)第一附屬醫(yī)院心內(nèi)科門診或住院部,西醫(yī)診斷為室性早搏,同時(shí)傳統(tǒng)醫(yī)學(xué)辨證屬心脾兩虛證型的60例患者,隨機(jī)分成2組:中西藥治療組30例,西藥對(duì)照組30例。治療組:口服美托洛爾47.5mg(原研),每次23.75-47.5mg,每日1次。同時(shí)口服調(diào)脾護(hù)心方中藥顆粒劑沖服,每日一帖,分兩次服用。對(duì)照組:口服美托洛爾47.5mg(原研),每次23.75-47.5mg,每日1次。兩組療程均為4周,實(shí)驗(yàn)期間原則上停用影響臨床療效的相關(guān)藥物,生活方式基本不變。觀察兩組及組間治療前后中醫(yī)證候積分、中醫(yī)證候療效和24h小時(shí)動(dòng)態(tài)心電圖室性早搏次數(shù)的及療效變化情況。結(jié)果:(1)療效性評(píng)價(jià):(1)觀察指標(biāo)在治療后療效的比較:治療組治療后總有效率為86.67%;對(duì)照組總有效率為83.33%,組間比較,計(jì)算P0.05,治療后兩組無(wú)明顯差異;(2)室性早搏治療前后總數(shù)的比較:兩組治療后室早總數(shù)明顯減少,治療后組間比較無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);(3)中醫(yī)證候及單項(xiàng)癥狀療效的比較:治療組中醫(yī)證候總有效率達(dá)96.67%,對(duì)照組中醫(yī)證候總有效率是70.00%,組間比較差異顯著(P0.05);中醫(yī)單項(xiàng)癥狀改善方面治療組優(yōu)于對(duì)照組(P0.05)。(2)臨床安全性指標(biāo):本課題進(jìn)行期間,治療組30例患者中,僅1人出現(xiàn)偶有反酸表現(xiàn),經(jīng)護(hù)胃治療后,癥狀好轉(zhuǎn),完成臨床觀察,其余均無(wú)明顯不適反應(yīng),兩組治療前后血常規(guī)、小便常規(guī)、大便常規(guī)以及肝腎功能結(jié)果無(wú)明顯改變,未出現(xiàn)不良反應(yīng)。結(jié)論如下:(1)調(diào)脾護(hù)心方聯(lián)合琥珀酸美托洛爾治療室性早搏總有效率達(dá)86.67%。臨床治療室性早搏療效確切,方案可行。(2)通過(guò)健脾益氣、養(yǎng)心安神為原則組方的調(diào)脾護(hù)心方緊扣病機(jī),對(duì)于心脾兩虛型室性早搏患者,治療后中醫(yī)證候積分明顯降低,總有效率高達(dá)96.67%,優(yōu)于對(duì)照組,說(shuō)明調(diào)脾護(hù)心方能明顯改善中醫(yī)證候,改善患者臨床癥狀。(3)調(diào)脾護(hù)心方在改善患者心悸、胸悶、乏力、失眠等方面有很大優(yōu)勢(shì),且無(wú)明顯不良發(fā)應(yīng),未發(fā)現(xiàn)毒副作用,為室早的診治增添了可靠的中醫(yī)特色方劑。
[Abstract]:Objective: to observe the clinical symptom control and safety of the patients with ventricular premature beats treated with traditional Chinese medicine compound decoction (Tiaopi Huxin recipe). To observe the symptoms of the patients with ventricular premature beat, and to analyze the syndrome differentiation and syndrome differentiation of the patients with ventricular premature beat. To explore the efficacy and safety of Tiaopi Huxin recipe in the clinical diagnosis and treatment of ventricular premature beat (VPB). Methods: from November 2014 to November 2015, the patients were admitted to the Department of Cardiology of the first affiliated Hospital of Anhui University of traditional Chinese Medicine, and the patients were diagnosed as ventricular premature beats by Western medicine. At the same time, 60 patients with syndrome differentiation of deficiency of heart and spleen were randomly divided into two groups: 30 cases in Chinese and western medicine treatment group, 30 cases in traditional Chinese medicine treatment group, 30 cases in western medicine treatment group, Treatment group: oral metoprolol 47.5 mg per time, once a day, while oral administration of Tiaopihuxin prescription Chinese medicine granules, one tablet per day, the treatment group was treated with metoprolol 47.5 mg / day, the control group was treated with metoprolol 47.5 mg / day. The control group was given metoprolol 47.5 mg orally once a day, 23.75-47.5 mg per day. The course of treatment in both groups was 4 weeks. In principle, the related drugs affecting the clinical efficacy were stopped during the experiment. The life style was basically unchanged. Observe the integral of TCM syndromes before and after treatment between the two groups, The curative effect of TCM syndromes, the times of ventricular premature beat in 24 h ambulatory electrocardiogram and the change of curative effect. Results: the comparison of curative effect after treatment with observation index: the total effective rate of treatment group was 86.67; the control group was 86.67; the control group was 86.67; the control group was 86.67; the control group was 86.67; the control group was 86.67. The efficiency was 83.33. After treatment, there was no significant difference between the two groups in the total number of ventricular premature beats before and after treatment: the total number of ventricular premature beats in the two groups decreased significantly after treatment. Comparison of TCM syndromes and single symptoms after treatment: the total effective rate of TCM syndromes in the treatment group was 96.67g, the total effective rate of the TCM syndrome in the control group was 70.000.The difference between the two groups was significant (P 0.05); The treatment group was superior to the control group (P0.05P0.05. 2) the clinical safety index: during the course of this project, the treatment group was better than the control group. Of 30 patients in the treatment group, only 1 had occasional regurgitation. After gastric care, symptoms improved and clinical observation was completed. There was no obvious discomfort between the two groups. Blood routine and urine routine before and after treatment were observed in both groups. There were no obvious changes in stool routine and liver and kidney function, and no adverse reactions. Conclusion the total effective rate of Tiaopihuxin decoction combined with metoprolol succinate in the treatment of ventricular premature beats is 86.67.The curative effect of clinical treatment on ventricular premature beats is definite. The scheme is feasible. (2) through the principle of invigorating spleen and invigorating qi, nourishing the heart and soothing the mind, the formula of regulating spleen and protecting the heart is closely related to the pathogenesis. For the patients with ventricular premature beats with deficiency of both heart and spleen, the score of TCM syndromes is obviously reduced after treatment, and the total effective rate is up to 96.67, which is superior to that of the control group. It shows that Tiaopi Huxin prescription can obviously improve TCM syndromes and improve the clinical symptoms of patients. It has great advantages in improving palpitation, chest tightness, fatigue, insomnia and so on, and has no obvious adverse reaction and no toxic side effects. For the room early diagnosis and treatment to add reliable traditional Chinese medicine characteristic prescription.
【學(xué)位授予單位】：安徽中醫(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

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 李華;治室性早搏[J];農(nóng)村新技術(shù);2001年10期

2 韓寶德,雷建萍;中西醫(yī)結(jié)合治療潛在惡性室性早搏22例[J];中國(guó)中醫(yī)急癥;2005年02期

3 高銘利;劉今秀;宮靜;;中西醫(yī)結(jié)合治療室性早搏80例[J];中國(guó)民間療法;2005年12期

4 ;病例62:65歲女性急性下壁心肌梗死,室性早搏[J];中華高血壓雜志;2006年11期

5 董學(xué)杰;;三參平律湯治療室性早搏19例[J];中國(guó)民族民間醫(yī)藥;2011年02期

6 應(yīng)土貴;;自擬抗早湯治療室性早搏療效觀察[J];海峽藥學(xué);2012年01期

7 歐陽(yáng)百安;蘇學(xué)秦;;室性早搏的臨床意義附235例分析[J];煤礦醫(yī)學(xué);1982年03期

8 張紹景;孫弘宜;肖正倫;麥秀慧;;189例室性早搏臨床意義的探索[J];廣州醫(yī)藥;1985年05期

9 張紹景;孫弘宜;肖正倫;麥秀慧;;室性早搏臨床意義的探索[J];廣州醫(yī)學(xué)院學(xué)報(bào);1985年02期

10 沈同戊;;健康兒童的室性早搏[J];國(guó)外醫(yī)學(xué).心血管疾病分冊(cè);1986年05期

相關(guān)會(huì)議論文 前10條

1 徐金湯;黃文清;王鉛珍;吳清華;吳延慶;;五參飲治療室性早搏100例分析[A];全國(guó)中醫(yī)藥科研與教學(xué)改革研討會(huì)論文集[C];2000年

2 楊向軍;羅圓;王健;;200例室性早搏的預(yù)后分類與臨床[A];第十三次全國(guó)心血管病學(xué)術(shù)會(huì)議論文集[C];2011年

3 張志丹;沈紅權(quán);;心復(fù)平方治療冠心病室性早搏臨床研究[A];中華中醫(yī)藥學(xué)會(huì)心病分會(huì)第十一屆學(xué)術(shù)年會(huì)論文精選[C];2009年

4 呂丹;徐南圖;趙立明;;心室晚電位與室性早搏形態(tài)之間的相關(guān)性探討[A];第二屆全國(guó)心功能學(xué)術(shù)研討會(huì)論文摘要匯編[C];1990年

5 姚靜;許迪;陸鳳翔;雍永宏;陸美娟;洪牮;徐亮;;單心動(dòng)周期成像技術(shù)在室性早搏容積變化模式分析中的應(yīng)用[A];第十屆全國(guó)超聲心動(dòng)圖學(xué)術(shù)會(huì)議論文[C];2010年

6 劉慧玲;于震;吳祥;;成對(duì)性室性早搏誘發(fā)反復(fù)搏動(dòng)[A];2007年浙江省心電生理與起搏學(xué)術(shù)年會(huì)論文匯編[C];2007年

7 劉蓓;胡元會(huì);;中醫(yī)藥治療室性早搏的臨床研究近況[A];第九次全國(guó)中醫(yī)心病學(xué)術(shù)研討會(huì)論文精選[C];2007年

8 蘇浩;徐健;孫賢林;;經(jīng)右側(cè)尺動(dòng)脈成功消融主動(dòng)脈瓣下室性早搏一例[A];中華醫(yī)學(xué)會(huì)心電生理和起搏分會(huì)第十次全國(guó)學(xué)術(shù)年會(huì)會(huì)議匯編[C];2012年

9 許世雄;潘真;陳兵;;室性早搏前后動(dòng)脈阻抗及順應(yīng)性、心輸出量的無(wú)創(chuàng)對(duì)照研究[A];第二屆全國(guó)心功能學(xué)術(shù)研討會(huì)論文摘要匯編[C];1990年

10 鄭鵬;朱燦焰;;基于神經(jīng)網(wǎng)絡(luò)的房性與室性早搏檢測(cè)技術(shù)[A];全國(guó)第4屆信號(hào)和智能信息處理與應(yīng)用學(xué)術(shù)會(huì)議論文集[C];2010年

相關(guān)重要報(bào)紙文章 前10條

1 上海市南匯區(qū)沈旭飛;拍胸治室性早搏[N];解放日?qǐng)?bào);2003年

2 本報(bào)特約記者　吉爾;室性早搏有多嚴(yán)重？[N];健康時(shí)報(bào);2005年

3 海軍總醫(yī)院內(nèi)科主任醫(yī)師 俞啟福;正確認(rèn)識(shí)和對(duì)待室性早搏[N];大眾科技報(bào);2005年

4 于艷平;室性早搏要服藥嗎？[N];大眾衛(wèi)生報(bào);2005年

5 健康時(shí)報(bào)特約記者　 李春梅;室性早搏先別急著服藥[N];健康時(shí)報(bào);2006年

6 心血管病專家 胡大一;治療室性早搏別入誤區(qū)[N];保健時(shí)報(bào);2008年

7 上海第二醫(yī)科大學(xué)附屬第九人民醫(yī)院教授 徐濟(jì)民;治療室性早搏的藥物[N];家庭醫(yī)生報(bào);2003年

8 黑龍江省中醫(yī)院心血管科教授 徐惠梅　本報(bào)記者 曾令浩 整理;中西雙劍合璧,改善室性早搏[N];醫(yī)藥經(jīng)濟(jì)報(bào);2011年

9 漯河市中心醫(yī)院一分院 張博　劉芳 段曉霞;步長(zhǎng)穩(wěn)心顆粒治療室性早搏的療效觀察[N];醫(yī)藥經(jīng)濟(jì)報(bào);2011年

10 北京大學(xué)人民醫(yī)院心內(nèi)科副主任醫(yī)師　張海澄;心慌未必是大毛病[N];健康時(shí)報(bào);2003年

相關(guān)博士學(xué)位論文 前3條

1 徐文華;室性早搏7天自然變異度分析與其對(duì)心臟結(jié)構(gòu)功能的影響及生活質(zhì)量的調(diào)查研究[D];南京醫(yī)科大學(xué);2013年

2 周鳳華;基于循證的中西醫(yī)結(jié)合治療冠心病室性早搏多中心隨機(jī)對(duì)照臨床試驗(yàn)研究[D];南方醫(yī)科大學(xué);2013年

3 吳華慧;養(yǎng)心湯對(duì)室性早搏患者（氣血虧虛型）的血清miRNA-1和尿代謝組學(xué)的影響[D];黑龍江中醫(yī)藥大學(xué);2012年

相關(guān)碩士學(xué)位論文 前10條

1 杜海曼;心電信號(hào)中室性早搏的自動(dòng)診斷算法研究[D];河北大學(xué);2015年

2 邵銀;柴芩溫膽湯治療痰火擾心型室性早搏的臨床研究[D];河北聯(lián)合大學(xué);2014年

3 何樂;特發(fā)性室性早搏致心臟結(jié)構(gòu)及功能改變的臨床研究[D];新疆醫(yī)科大學(xué);2015年

4 張靜;青礞石栓抗大鼠室性早搏的實(shí)驗(yàn)研究[D];黑龍江省中醫(yī)藥科學(xué)院;2015年

5 潘宇;加味補(bǔ)心湯治療氣血兩虛型室性早搏的臨床觀察[D];黑龍江省中醫(yī)藥科學(xué)院;2015年

6 趙莉;龍芪安脈膠囊治療氣血兩虛型室性早搏的臨床研究[D];河南中醫(yī)學(xué)院;2015年

7 王令杰;滋陰清火定悸方治療陰虛火旺型室性早搏的臨床研究[D];山東中醫(yī)藥大學(xué);2015年

8 劉慶華;芪參保心湯治療氣虛血瘀型室性早搏的臨床研究[D];山東中醫(yī)藥大學(xué);2014年

9 孫琳琳;養(yǎng)心定悸湯治療室性早搏臨床療效觀察[D];黑龍江中醫(yī)藥大學(xué);2016年

10 朱宇婷;賈海忠教授運(yùn)用微循環(huán)與升清降濁理論治療室性早搏的經(jīng)驗(yàn)總結(jié)[D];北京中醫(yī)藥大學(xué);2016年

，

本文編號(hào)：1540980