本文選題：經(jīng)方　切入點(diǎn)：慢性心力衰竭　出處：《湖北中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：慢性心力衰竭是臨床常見危重疾病,西醫(yī)對(duì)其的研究頗深,治療手段包括藥物治療和非藥物治療,近來隨著中醫(yī)對(duì)其認(rèn)識(shí)加深,治療方法逐步多樣,包括經(jīng)方治療、驗(yàn)方治療、中成藥、中藥注射液等不同方法,其中有關(guān)經(jīng)方的使用的臨床研究越來越多,本研究的目的:探討經(jīng)方在慢性心力衰竭中運(yùn)用的辨證規(guī)律,分為兩部分進(jìn)行論述:第一部分通過研究理論文獻(xiàn),探討慢性心力衰竭的中醫(yī)學(xué)病名、病因病機(jī)、結(jié)合中醫(yī)辨證理論及現(xiàn)代研究予以辨證分型研究。慢性心力衰竭病機(jī)為本虛標(biāo)實(shí)、本虛為心氣虛、陽(yáng)氣虛,標(biāo)實(shí)為水飲、瘀血、痰濁。第二部分為臨床文獻(xiàn)研究,方法:通過收集近10年關(guān)于經(jīng)方治療慢性心力衰竭的臨床研究,合格文獻(xiàn)總計(jì)為116篇,通過excel建立表格,統(tǒng)計(jì)文獻(xiàn)名、發(fā)表年代、病人例數(shù)、辨證分型、療效判定標(biāo)準(zhǔn)等相關(guān)資料,對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì),結(jié)果顯示:1、慢性心衰中不同經(jīng)方使用頻率依次為:真武湯、苓桂術(shù)甘湯、四逆湯、五苓散、木防己湯、葶藶大棗瀉肺湯、瓜蔞薤白半夏湯、防己茯苓湯。2、慢性心衰以西醫(yī)基礎(chǔ)治療聯(lián)合經(jīng)方治療后患者平均有效率高低依次為:五苓散92.12%、真武湯91.67%、苓桂術(shù)甘湯90.9%、四逆湯90.86%、木防己湯85.3%。心衰中常見證型為:心腎陽(yáng)虛型、陽(yáng)虛水泛型、氣虛血瘀型、痰瘀互阻型、陽(yáng)氣虧虛型。3、總結(jié)經(jīng)方在治療本病中涉及的診斷、治療方法、療效判定標(biāo)準(zhǔn)。根據(jù)總結(jié)臨床研究文獻(xiàn),探討經(jīng)方使用的規(guī)律,包括運(yùn)用規(guī)律和辨證規(guī)律;5、組方療效對(duì)照研究顯示:116篇文獻(xiàn)中115篇均采用以西醫(yī)藥物治療聯(lián)合經(jīng)方治療進(jìn)行臨床觀察,西醫(yī)聯(lián)合經(jīng)方作為觀察組,以單純西醫(yī)基礎(chǔ)治療作為對(duì)照組、觀察組療效均高于單純組,說明經(jīng)方在心力衰竭的治療中起到積極作用,提高了臨床療效。6、探討經(jīng)方的功效;探索不同階段心衰治療經(jīng)方選擇的簡(jiǎn)單原則,包括早期的積極治療原發(fā)病,中期的重在補(bǔ)虛扶正,后期的扶正驅(qū)邪并重。7、探索經(jīng)方治療慢性心力衰竭的辨證要點(diǎn),包括辨病因、辨病位、辨病性、辨陰陽(yáng)、辨虛實(shí)五個(gè)部分,并分別探究靈活運(yùn)用經(jīng)方的方法,以提高臨床療效。
[Abstract]:Chronic heart failure (CHF) is a common clinical critical disease. Western medicine has studied it very deeply. Treatment methods include drug therapy and non-drug therapy. Recently, with the deepening of the understanding of CHF, the treatment methods have gradually varied, including the treatment of Jing Fang and the treatment of prescription test. There are more and more clinical studies on the use of traditional Chinese medicine and traditional Chinese medicine injection. The purpose of this study is to explore the law of syndrome differentiation used by Jing Fang in chronic heart failure. It is divided into two parts: the first part discusses the name, etiology and pathogenesis of chronic heart failure by studying the theoretical literature. Combined with the theory of TCM syndrome differentiation and modern research, the pathogenesis of chronic heart failure (CHF) is based on deficiency, deficiency of heart qi, deficiency of yang qi, standard of water drink, blood stasis and turbid phlegm. The second part is clinical literature research. Methods: in the past 10 years, the clinical study on the treatment of chronic heart failure by Meridian prescription was carried out. There were 116 articles of qualified literature. The table was established by excel, the name of the documents was published, the number of patients was published, and the patients were classified according to syndrome differentiation. The result shows that the frequency of different prescriptions in chronic heart failure is Zhenwu Tang, Lingguizhugan decoction, Sini decoction, Wuling Powder, Mu Fang Ji Tang, Tingli Da Zao Xiefei decoction, etc. Guilou Xiebai Banxia decoction, Fangji Fuling decoction. 2. The average effective rate of chronic heart failure treated by western medicine combined with meridian prescription is: Wuling Powder 92.12, Zhenwu decoction 91.67, Lingguizhugan decoction 90.9, Sini decoction 90.86 and Mufangji decoction 85.3. The common syndromes in heart failure are heart and kidney yang deficiency. Yang deficiency and water generality, qi deficiency and blood stasis, phlegm and blood stasis mutual obstruction, Yang Qi deficiency and deficiency of yang. 3. The diagnosis, treatment method and curative effect judgment standard of Meridian prescription in the treatment of this disease are summarized. Including the use of the law and the law of syndrome differentiation. A comparative study of the efficacy of the group showed that 115 of the 116 articles were treated with western medicine combined with Jing Fang for clinical observation, and Western medicine combined with the classics as the observation group. The curative effect of the observation group was higher than that of the simple group, which showed that the Meridian prescription played a positive role in the treatment of heart failure, and improved the clinical efficacy. To explore the simple principles of treating heart failure in different stages, including the early active treatment of primary disease, the middle stage of the emphasis on tonifying deficiency and strengthening the spirit, and the later period of strengthening and dispelling evil spirits, and exploring the dialectical key points of Meridian prescription in treating chronic heart failure, including differentiation of etiology, In order to improve the clinical curative effect, the five parts of differentiating disease position, disease differentiation, yin and yang, and deficiency and reality are explored respectively in order to improve the clinical effect by using the method of meridian prescription.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

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