本文選題：高血壓　切入點：加味半夏白術(shù)天麻湯　出處：《遼寧中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

【摘要】：目的:本研究通過應用“祛瘀化痰”中藥加味半夏白術(shù)天麻湯治療痰瘀互結(jié)型原發(fā)性高血壓患者,觀察該藥對高血壓患者的臨床療效的影響,證明“祛瘀化痰”治療高血壓的臨床療效,通過療效指標的變化,進一步揭示“祛瘀化痰,活血通絡”治療高血壓的病理機制。為明確“祛瘀化痰”與高血壓的病機實質(zhì)的相關性研究提供新的方法和客觀依據(jù)。材料與方法:本試驗全部研究對象均來自遼寧中醫(yī)藥大學附屬醫(yī)院門診2015年1月至2015年6月的門診就診患者,其中符合此次分析標準的高血壓患者共90例。將被納入的患者隨機分組成治療組和對照組,其中治療組45例,對照組45例。對照組予苯磺酸氨氯地平片口服,治療組在對照組的治療基礎上再予加味半夏白術(shù)天麻湯口服,每次1劑,每日2次,兩組療程均為1月。觀察兩組患者治療前后診室血壓、24h動態(tài)血壓、中醫(yī)證候積分、生活質(zhì)量量表評分、臨床單項療效,并觀察記錄患者治療期間的基本生命體征,不良反應。結(jié)果:1.治療前兩組患者在性別、年齡、病程、家族史、體重、中醫(yī)證候積分、診室血壓、24h動態(tài)血壓、臨床單項療效、生活質(zhì)量量表評分等方面進行比較,均無顯著差異(P0.05),說明兩組患者具有可比性,隨機分組效果較好。2.治療后兩組患者診室血壓比較,治療組總有效率為97.37%,對照組為78.84%,有統(tǒng)計學差異(P0.05),且治療組診室血壓降低水平優(yōu)于對照組,診室血壓改善水平具有顯著性差異(P0.01)。3.治療前后兩組患者24h動態(tài)血壓變化比較,有顯著性差異(P值均0.01),且治療組優(yōu)于對照組。治療后兩組患者d SBP、n SBP和24h SBP比較,有統(tǒng)計學差異(P值均㩳0.05);兩組患者d DBP、n DBP和24h DBP比較,有顯著性差異(P值均0.01)。4.治療后治療組與對照組高血壓中醫(yī)證候積分變化比較,治療組總有效率97.78%,對照組為83.42%,治療組的療效優(yōu)于對照組。5.治療后兩組患者臨床單項療效比較,有統(tǒng)計學差異(P0.05),說明治療組在緩解頭痛、眩暈、嘔吐痰涎、胸悶等癥狀方面療效優(yōu)于對照組。6.治療后兩組患者生活質(zhì)量量表積分均降低,有統(tǒng)計學差異性(P0.05),且治療組療效優(yōu)于對照組(P0.05),說明加味半夏白術(shù)天麻湯可以顯著提高患者生活質(zhì)量。7.在治療期間,兩組患者均未出現(xiàn)明顯的不良反應出現(xiàn),安全性和耐受性良好。結(jié)論:1.加味半夏白術(shù)天麻湯可顯著降低痰瘀互結(jié)型高血壓患者的血壓水平。2.加味半夏白術(shù)天麻湯可顯著降低痰瘀互結(jié)型高血壓患者的中醫(yī)證候積分,緩解頭痛、頭暈、氣短、乏力、手足麻木等臨床癥狀。3.加味半夏白術(shù)天麻湯可顯著提高高血壓患者生活質(zhì)量。
[Abstract]:Objective: to study the clinical effect of Banxia Atractylodes Tianma decoction (Banxia Atractylodes Tianma decoction) on patients with essential hypertension. It is proved that "dispelling blood stasis and resolving phlegm" is the clinical curative effect of hypertension. Through the change of curative effect index, it is further revealed that "dispelling blood stasis and resolving phlegm," To provide a new method and objective basis for the study of the correlation between "removing blood stasis and resolving phlegm" and the pathogenesis of hypertension. Materials and methods: all the subjects of this study come from. The outpatients of the affiliated Hospital of Liaoning University of traditional Chinese Medicine from January 2015 to June 2015, The patients were randomly divided into two groups: treatment group (n = 45) and control group (n = 45). The control group (n = 45) received amlodipine benzenesulfonic acid tablets orally, and the control group (n = 45) received amlodipine benzenesulfonate orally. The treatment group was treated with modified Banxia Atractylodes Tianma decoction on the basis of the treatment of the control group, once a time, twice a day, the course of treatment was January. The blood pressure of the two groups was observed before and after treatment, and 24 hours ambulatory blood pressure was observed, and the TCM syndromes score was observed. Quality of life scale score, clinical single curative effect, and observe and record patients' basic vital signs, adverse reactions during treatment. Results: before treatment, the two groups of patients in gender, age, course of disease, family history, weight, TCM syndrome score, There was no significant difference in 24 h ambulatory blood pressure, single clinical curative effect and quality of life scale score between the two groups, indicating that the two groups were comparable, and the effect of randomized grouping was better. 2. After treatment, the blood pressure of the two groups was compared. The total effective rate of the treatment group was 97.37 and that of the control group was 78.84. The difference was statistically significant (P 0.05), and the blood pressure in the treatment group was lower than that in the control group, and the improvement level of blood pressure in the treatment group was significantly different (P 0.01 路3). The changes of ambulatory blood pressure in 24 hours before and after treatment were compared between the two groups. There was significant difference between the two groups (P < 0.01), and the treatment group was superior to the control group (P < 0.05). After treatment, there were significant differences in the d SBPn SBP and 24 h SBP between the two groups. D DBP n DBP and 24 h DBP were significantly different between the two groups. After treatment, the scores of TCM syndromes in the treatment group and the control group were higher than those in the control group. The total effective rate of the treatment group was 97.78 and that of the control group was 83.42. The curative effect of the treatment group was better than that of the control group .5.After the treatment, there was a statistical difference between the two groups (P 0.05), indicating that the treatment group was relieving headache, dizziness, vomiting, sputum and salivation. The curative effect of chest tightness and other symptoms was better than that of control group .6.After treatment, the scores of quality of life scale decreased in both groups. The difference was statistically significant (P 0.05), and the curative effect of the treatment group was better than that of the control group (P 0.05), which indicated that the modified Banxia Atractylodes Tianma decoction could significantly improve the quality of life of the patients. During the treatment period, there were no obvious adverse reactions in both groups. Conclusion: the modified Banxia Atractylodes Tianma decoction can significantly reduce the blood pressure level of hypertension patients with phlegm and blood stasis. 2. The modified Banxia Atractylodes Tianma decoction can significantly reduce the TCM syndromes integral of hypertension patients with phlegm and blood stasis. Relieving headache, dizziness, shortness of breath, fatigue, numbness of hand and foot and other clinical symptoms .3.Adjusted Banxia Atractylodes Tianma decoction can significantly improve the quality of life of patients with hypertension.
【學位授予單位】：遼寧中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R259
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本文編號：1607535