本文選題：冠心病(氣滯血瘀型)　切入點(diǎn)：左室舒張功能不全　出處：《廣州中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：左室舒張功能減退,是冠心病早期心肌缺血的表現(xiàn)之一。降低左室舒張末期的壓力,改善左室順應(yīng)性,可預(yù)防冠心病向終末期心力衰竭進(jìn)一步發(fā)展。本研究旨在觀察血府逐瘀湯治療氣滯血瘀型冠心病左室舒張功能減退的臨床療效,并觀察血府逐瘀湯治療氣滯血瘀型冠心病前后超聲心動(dòng)圖中反應(yīng)左室舒張功能指標(biāo)的改變。通過此研究,探索中西醫(yī)結(jié)合在冠心病左室舒張功能減退患者中提供更好的治療方法。方法：本研究采取前瞻性隨機(jī)對(duì)照研究,選取廣州市中醫(yī)醫(yī)院心病科住院診斷為冠心病左室舒張功能減退(氣滯血瘀型)的患者60例,并按隨機(jī)方法分為實(shí)驗(yàn)組30例和對(duì)照組30例。實(shí)驗(yàn)組運(yùn)用血府逐瘀湯加冠心病常規(guī)西醫(yī)治療,對(duì)照組單運(yùn)用冠心病常規(guī)西醫(yī)治療。治療14天后觀察兩組臨床療效,并對(duì)照治療前后患者超聲心動(dòng)圖左室舒張功能指標(biāo)(E、A、E/A)的改變。結(jié)果：1.治療組與對(duì)照組的一般資料(包括年齡、性別),治療前左室舒張功能指標(biāo)E、A、E/A及中醫(yī)癥候積分比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。2.左室舒張功能比較,治療組在治療后E、A、E/A比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。對(duì)照組在治療后A比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05),而E、E/A比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組在治療后E、A、E/A比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3.中醫(yī)證候積分比較,治療前兩組中醫(yī)癥候積分比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。治療前后兩組中醫(yī)癥候積分分別比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后兩組中醫(yī)癥候積分比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。4.兩組中醫(yī)癥候療效比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：1.兩組患者性別構(gòu)成、年齡比較均無顯著性差異,具有可比性。2.兩組患者治療前后E、E/A比較均有顯著性差異,表明兩組治療方案均能提高E峰、改善左室舒張功能。兩組患者治療后E、A、E/A比較均有顯著性差異,表明治療組比對(duì)照組在改善左室舒張功能不全方面效果更佳。3.兩組患者治療前后中醫(yī)證候積分比較均有顯著性差異,表明兩組治療方案均能減少中醫(yī)證候積分。兩組患者治療后中醫(yī)證候積分比較有顯著性差異,表明治療組比對(duì)照組更能減少中醫(yī)癥候積分。4.兩組患者治療后中醫(yī)癥候療效比較有顯著性差異,表明治療組中醫(yī)癥候療效優(yōu)于對(duì)照組。
[Abstract]:Objective: left ventricular diastolic dysfunction is one of the manifestations of early myocardial ischemia in coronary heart disease. The aim of this study was to observe the clinical effect of Xuefu Zhuyu decoction on left ventricular diastolic dysfunction in patients with coronary heart disease with Qi stagnation and blood stasis. The changes of left ventricular diastolic function in echocardiography before and after Xuefu Zhuyu decoction were observed before and after treatment of coronary heart disease with Qi stagnation and blood stasis. To explore the better treatment of left ventricular diastolic dysfunction in patients with coronary heart disease by combining traditional Chinese and western medicine. Methods: a prospective randomized controlled study was conducted in this study. Sixty patients with coronary heart disease diagnosed as left ventricular diastolic dysfunction (Qi stagnation and blood stasis type) were selected from Department of Heart Disease, Guangzhou traditional Chinese Medicine Hospital. The experimental group was treated with routine western medicine for coronary heart disease with Xuefu Zhuyu decoction, while the control group was only treated with routine western medicine for coronary heart disease. After 14 days of treatment, the clinical effects of the two groups were observed. The changes of left ventricular diastolic function index were compared before and after treatment. Results: 1. The general data of the treatment group and the control group (including age, sex, left ventricular diastolic function index, EtA / A and TCM symptom score) were compared before and after treatment. There was no significant difference in left ventricular diastolic function between the two groups. There was significant difference between the treatment group and the control group after treatment. In the control group, there was no significant difference (P 0.05), but there was no significant difference between the two groups (P < 0.05), but the E / A ratio of the treatment group was higher than that of the control group (P < 0.05), but that of the control group was higher than that of the control group (P < 0.05). The difference was statistically significant (P 0.05). After treatment, the difference between the two groups was statistically significant (P 0.05). There was no significant difference between the two groups before and after treatment. The difference was statistically significant (P 0.05). After treatment, there was a significant difference in the scores of TCM symptoms between the two groups. There was no significant difference in the curative effect of TCM symptoms between the two groups (P 0.05). Conclusion: 1. There is no significant difference in sex composition and age comparison between the two groups. There were significant differences between the two groups before and after treatment, which indicated that both groups could improve E peak and left ventricular diastolic function, and there were significant differences between the two groups after treatment. The results showed that the treatment group was better than the control group in improving left ventricular diastolic dysfunction. There were significant differences between the two groups before and after treatment. The results show that the two treatment schemes can reduce the TCM syndromes integral, and there are significant differences between the two groups after the treatment of TCM syndromes integral. The results showed that the treatment group was more effective than the control group in reducing the TCM symptom score. 4. There was significant difference between the two groups after treatment, which indicated that the treatment group had better curative effect than the control group.
【學(xué)位授予單位】：廣州中醫(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

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