益氣滋陰活血通絡法治療糖尿病合并冠心病的臨床觀察
本文選題:2型糖尿病 切入點:冠心病 出處:《青島大學》2017年碩士論文 論文類型:學位論文
【摘要】:目的:探討益氣滋陰活血通絡法在治療糖尿病合并冠心病方面的應用價值。方法:將我院內(nèi)分泌科及心內(nèi)科于2013年10月至2015年11月期間診治的84例2型糖尿病合并冠心病患者,按照入院先后順序隨機分為觀察組及對照組兩組,每組各42例,其中對照組給予西醫(yī)常規(guī)治療,如生活方式改變、調(diào)節(jié)血糖、血脂水平、控制血壓、改善心臟功能等治療措施,觀察組則在對照組治療的基礎上聯(lián)合參芪地黃湯加減內(nèi)服,連續(xù)應用4周后,檢測分析兩組患者的血糖水平、血脂水平、心電圖變化、左心功能、炎性因子水平、中醫(yī)癥狀積分、焦慮評分變化情況,總體療效及不良反應發(fā)生情況。結果:經(jīng)連續(xù)治療4周后,兩組患者的空腹血糖水平及餐后2h血糖水平均較治療前有所改善,但觀察組改善更為明顯,且與對照組比較,差異具有統(tǒng)計學意義(P0.05)。觀察組患者血脂水平均較治療前明顯改善,且差異具有統(tǒng)計學意義(P0.05),而對照組與治療前比較改善不明顯,差異無統(tǒng)計學意義(P0.05);組間比較顯示,觀察組HDL-C、LDL-C、TG及TC水平改善情況均明顯優(yōu)于對照組,且差異具有統(tǒng)計學意義(P0.05)。觀察組的心電圖評價有效率為88.1%,明顯高于對照組(69.0%),差異明顯(P0.05);在心功能方面,觀察組患者的左心功能較對照組改善明顯,其E/A比值與對照組比較,差異明顯,具有統(tǒng)計學意義(P0.05);在炎性因子變化方面,兩組患者治療前后的IL-6無明顯變化,而hs-CRP均較前明顯改善,但觀察組改善更為顯著,且與對照組比較差異具有統(tǒng)計學意義(P0.05);中醫(yī)癥狀積分改善情況明顯優(yōu)于對照組,且差異具有統(tǒng)計學意義(P0.05);焦慮評分方面,兩組患者生活焦慮評分均有所改善,但觀察組患者改善尤為明顯,與對照組比較差異具有統(tǒng)計學意義(P0.05);在總體療效方面,觀察組總體有效率為92.8%,明顯優(yōu)于對照組(76.2%),差異亦具有統(tǒng)計學意義(P0.05);不良反應發(fā)生率方面,觀察組與對照組均出現(xiàn)輕微不良反應,觀察組不良反應發(fā)生率雖略高,但與對照組比較,無明顯差異(P0.05)。結論:益氣滋陰活血通絡法(參芪地黃湯加減)治療2型糖尿病合并冠心病臨床效果較為顯著,可有效改善患者的血糖、血脂水平,改善心功能及臨床癥狀,抑制機體的非特異性炎癥,改善患者心理狀態(tài),提高臨床治療有效率;同時不良反應較為輕微,患者可耐受,安全性好。
[Abstract]:Objective: To explore the application value of Invigorating Qi and nourishing yin and activating blood and collaterals in the treatment of diabetes mellitus complicated with coronary heart disease. Methods: Patients with type 2 diabetes mellitus patients with coronary heart disease in our hospital department of Endocrinology and Department of Cardiology in the diagnosis and treatment of 84 cases during the period from October 2013 to November 2015, according to the order of admission randomly divided into observation group and control group two groups, 42 cases in each group, including the control group received conventional treatment, such as lifestyle changes, adjusting blood glucose, blood lipid level, blood pressure control, improve heart function and other treatment measures, the observation group based on the control group treatment combined with Shenqi decoction to Decoction taken orally, after 4 weeks of continuous application, detection and analysis of two groups of patients with blood glucose levels, blood lipid levels. Changes of ECG, left ventricular function, the levels of inflammatory factors, TCM symptom score, anxiety score changes, and the incidence of adverse reaction of overall curative effect. Results: after 4 weeks of continuous treatment, two The fasting blood glucose level and the meal group 2H blood sugar levels were improved compared with before treatment, but the observation group improved more obviously, and compared with the control group, the difference was statistically significant (P0.05). Patients in the observation group blood lipid levels were significantly improved after treatment, and the difference was statistically significant (P0.05). While the control group compared with before treatment improved significantly, the difference was not statistically significant (P0.05); group comparison showed that the observation group HDL-C, LDL-C, TG and TC level of improvement were significantly better than the control group, and the difference was statistically significant (P0.05). The concept of ECG in the evaluation of observation group was 88.1%, significantly higher than the control group (69%), significant difference (P0.05); the cardiac function, left ventricular function in patients with observation group than the control group improved significantly, compared to the E/A ratio was significantly different from control, with statistical significance (P0.05); the changes of inflammatory factors, two groups of patients Before and after treatment there was no significant change in IL-6, and hs-CRP were significantly improved, but the observation group improved significantly, and the difference was statistically significant compared with the control group (P0.05); TCM symptoms improved significantly better than the control group, and the difference was statistically significant (P0.05); anxiety score, two groups of life the anxiety scores were improved, but the observation group were improved obviously, the difference was statistically significant compared with the control group (P0.05); in general treatment, the observation group total effective rate was 92.8%, significantly better than the control group (76.2%), the differences were statistically significant (P0.05); the incidence of adverse reactions in observation group. And the control group had mild adverse reaction, the incidence of adverse reactions is slightly high, but compared with the control group, no significant difference (P0.05). Conclusion: Supplementing Qi and nourishing yin and activating blood and collaterals (Shenqi Dihuang Decoction) in treating type 2 The clinical effect of diabetes mellitus complicated with coronary heart disease is significant, which can effectively improve the patient's blood glucose, blood lipid levels, improve heart function and clinical symptoms, nonspecific inflammation and inhibit the body, improve the psychological status of patients, improve clinical efficiency; at the same time relatively minor adverse reactions, patients can be tolerated, good safety.
【學位授予單位】:青島大學
【學位級別】:碩士
【學位授予年份】:2017
【分類號】:R259
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