本文選題：慢性心力衰竭　切入點(diǎn)：氣陰兩虛　出處：《山東中醫(yī)藥大學(xué)》2016年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:通過(guò)對(duì)生脈養(yǎng)心顆粒的臨床觀察,探討生脈養(yǎng)心顆粒對(duì)氣陰兩虛型慢性心力衰竭(CHF)患者臨床癥狀、實(shí)驗(yàn)室檢查結(jié)果(免疫炎性指標(biāo))的影響;評(píng)價(jià)生脈養(yǎng)心顆粒在氣陰兩虛型慢性心力衰竭患者中使用的有效性、安全性。方法:將50例氣陰兩虛型CHF患者隨機(jī)分為試驗(yàn)組25例,對(duì)照組25例。對(duì)照組給予單純常規(guī)西藥治療,試驗(yàn)組在常規(guī)西藥治療基礎(chǔ)上加用生脈養(yǎng)心顆粒;兩組分別治療6周后,觀察兩組治療前后中醫(yī)證候及綜合療效、明尼蘇達(dá)生活質(zhì)量評(píng)分、心臟超聲指標(biāo)(左室射血分?jǐn)?shù))、心功能分級(jí)(NHYA分級(jí))、腦鈉肽(BNP)、免疫炎性指標(biāo)(白介素-6、腫瘤壞死因子-α、內(nèi)皮素-1)等指標(biāo)的變化情況。結(jié)果:1.試驗(yàn)組與對(duì)照組治療前后中醫(yī)癥候均明顯改善(P0.01),且試驗(yàn)組明顯優(yōu)于對(duì)照組(P0.01)。兩組中醫(yī)綜合療效總有效率96%,兩組綜合療效進(jìn)行非參數(shù)檢驗(yàn),有顯著統(tǒng)計(jì)學(xué)意義(P0.01),試驗(yàn)組明顯優(yōu)于對(duì)照組。2.兩組生活質(zhì)量積分進(jìn)行統(tǒng)計(jì)學(xué)分析,試驗(yàn)組與對(duì)照組均明顯改善患者生活質(zhì)量(P0.01),且試驗(yàn)組明顯優(yōu)于對(duì)照組(P0.01)。3.生脈養(yǎng)心顆粒:試驗(yàn)組與對(duì)照組對(duì)左室射血分?jǐn)?shù)的影響統(tǒng)計(jì)學(xué)結(jié)果均得到P0.01,說(shuō)明兩組治療在改善患者左室射血分?jǐn)?shù)方面均有明顯療效;試驗(yàn)組與對(duì)照組療效相比,在改善左室射血分?jǐn)?shù)方面有統(tǒng)計(jì)學(xué)差異,且試驗(yàn)組優(yōu)于對(duì)照組(P0.05)。4.生脈養(yǎng)心顆粒對(duì)心功能分級(jí)(NHYA)的影響:兩組治療前組內(nèi)比較(P0.05)及治療后組間比較(P0.05)均無(wú)統(tǒng)計(jì)學(xué)差異。5.兩組治療在降低慢性心衰患者BNP方面均有明顯療效(P=0.01);試驗(yàn)組與對(duì)照組療效相比,在降低BNP方面有統(tǒng)計(jì)學(xué)差異,且試驗(yàn)組優(yōu)于對(duì)照組(P0.05)。6.兩組組內(nèi)統(tǒng)計(jì)學(xué)分析均P0.01,有顯著統(tǒng)計(jì)學(xué)意義;兩組組間進(jìn)行統(tǒng)計(jì)學(xué)分析P0.05(腫瘤壞死因子-αP=0.045、白介素-6 P=0.031、內(nèi)皮素-1 P=0.038)均具有統(tǒng)計(jì)學(xué)意義,說(shuō)明試驗(yàn)組在改善患者心衰免疫炎性方面優(yōu)于對(duì)照組。結(jié)論:本試驗(yàn)結(jié)果提示,試驗(yàn)組與對(duì)照組均能明顯改善慢性心衰患者的療效指標(biāo),但試驗(yàn)組能進(jìn)一步減輕患者癥狀及體征,提高運(yùn)動(dòng)耐量及生活質(zhì)量,提示西藥基礎(chǔ)上加用生脈養(yǎng)心顆粒治療慢性心力衰竭的療效優(yōu)于單純西藥治療。說(shuō)明運(yùn)用生脈養(yǎng)心顆粒聯(lián)合西藥治療慢性心力衰竭安全有效,值得臨床參考及推廣。
[Abstract]:Objective: to investigate the effect of Shengmai Yangxin granule on the clinical symptoms and laboratory results (immune inflammatory index) of CHF patients with chronic heart failure with deficiency of Qi and Yin through the clinical observation of Shengmai Yangxin granule. To evaluate the efficacy and safety of Shengmai Yangxin granule in patients with chronic heart failure with deficiency of both qi and yin. Methods: fifty patients with CHF with deficiency of both qi and yin were randomly divided into two groups. There were 25 cases in the control group. The control group was treated with simple routine western medicine, the experimental group was treated with Shengmai Yangxin granule on the basis of routine western medicine treatment, the two groups were treated for 6 weeks, and the syndromes of TCM and comprehensive curative effect were observed before and after treatment. Minnesota quality of Life score, Changes of echocardiographic parameters (left ventricular ejection fraction (LVEF), cardiac function grading (NHYA), brain natriuretic peptide (BNPN), immune inflammatory markers (interleukin-6, tumor necrosis factor- 偽, endothelin -1). Results 1. The experimental group and the control group were treated. The symptoms of TCM were significantly improved before and after treatment, and the experimental group was obviously superior to the control group (P 0.01). The total effective rate of the two groups was 96%. There was significant statistical significance (P 0.01), and the quality of life (QOL) score in the experimental group was significantly better than that in the control group (.2.). Both the experimental group and the control group significantly improved the quality of life of the patients, and the test group was obviously superior to the control group in P0.01n.3.Shengmai Yangxin granule: the effects of the experimental group and the control group on left ventricular ejection fraction were all significantly improved, indicating that the two groups were treated with P0.01. It has obvious curative effect in improving left ventricular ejection fraction. There was significant difference in the improvement of left ventricular ejection fraction between the experimental group and the control group. The effect of Shengmai Yangxin granule on the classification of cardiac function was better in the experimental group than that in the control group. There was no statistical difference between the two groups before and after treatment. There was no statistical difference between the two groups in reducing BNP in patients with chronic heart failure. Compared with the control group, the therapeutic effect of the test group was higher than that of the control group. There was statistical difference in reducing BNP, and the test group was better than the control group (P0.05A. 6. both P 0.01), there was significant statistical significance in the two groups. Statistical analysis of P0.05 (tumor necrosis factor- 偽 P0. 045, interleukin-6 P0. 031, endothelin-1-P0. 038) between the two groups showed that the experimental group was superior to the control group in improving the immune inflammation of patients with heart failure. Both the experimental group and the control group could obviously improve the curative effect index of the patients with chronic heart failure, but the experimental group could further alleviate the symptoms and signs of the patients, and improve the exercise tolerance and quality of life. It is suggested that the effect of adding Shengmai Yangxin granule in the treatment of chronic heart failure is better than that of western medicine alone, which indicates that the combination of Shengmai Yangxin granule and western medicine is safe and effective in the treatment of chronic heart failure, which is worthy of clinical reference and popularization.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R259

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