本文選題：慢性心力衰竭 + 強(qiáng)心膠囊　； 參考：《云南中醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:觀察強(qiáng)心膠囊對(duì)陽虛痰瘀互結(jié)型老年慢性心衰BNP的影響及臨床療效。方法:將60例中醫(yī)辨證為陽虛痰瘀互結(jié)型的老年慢性心衰患者隨機(jī)分為治療組和對(duì)照組,每組病例數(shù)為30例。對(duì)照組采用根據(jù)2014年《中國心力衰竭診斷和治療指南》制定的常規(guī)西藥組治療,治療組則在常規(guī)西藥組基礎(chǔ)上加用強(qiáng)心膠囊治療。兩組療程均為14天。療程結(jié)束后對(duì)兩組患者進(jìn)行治療前、治療后血漿BNP水平、心功能分級(jí)療效、6min步行試驗(yàn)、中醫(yī)癥候療效、中醫(yī)單項(xiàng)癥候積分、明尼蘇達(dá)心力衰竭生活質(zhì)量評(píng)分方面的觀察比較。結(jié)果:1.血漿BNP水平的比較:治療組和對(duì)照組病例治療后血漿BNP值分別為338.41±156.51pg/ml和455.29±266.02pg/ml,兩組之間比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);治療組治療后血漿BNP值下降510.15±353.07pg/ml,對(duì)照組治療后血漿BNP值下降404.22±310.98pg/ml,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后較治療前血漿BNP水平的降低方面,治療組優(yōu)于對(duì)照組;2.心功能分級(jí)療效、6min步行試驗(yàn)、明尼蘇達(dá)心力衰竭生活質(zhì)量評(píng)分的比較:兩組病例治療后較治療前,在心功能分級(jí)療效、6min步行試驗(yàn)、明尼蘇達(dá)心力衰竭生活質(zhì)量評(píng)分方面均有改善(P0.05),治療組的改善情況優(yōu)于對(duì)照組;3.中醫(yī)癥候積分比較:治療組治療后中醫(yī)癥候療效積分、中醫(yī)癥候單項(xiàng)積分均較本組治療前下降(P0.05),且治療組治療后患者心悸、乏力、氣短、動(dòng)則氣喘、畏寒肢冷、咯痰、面浮肢腫、脘腹脹滿、咯痰、煩躁不安、汗出、尿少伴胸腹水、頭暈?zāi)垦�、面色晦暗、皮膚瘀斑、口干癥狀的中醫(yī)癥候療效積分、中醫(yī)癥候單項(xiàng)積分低于對(duì)照組(P0.05);4.兩組病例安全性指標(biāo)評(píng)價(jià):一般生命體征(如血壓、心率等),尿、糞常規(guī),血常規(guī)(HGB、RBC、WBC),肝腎功(ALT、AST,UREA、SCR),電解質(zhì)(Na、K、Cl),心肌酶(CK、CK-MB、LDH、)及肌鈣蛋白(c Tn T),血脂(TC、TG、LDL-C、HDL-C),心電圖ST-T改變,胸片心胸比等(P0.05),差異無統(tǒng)計(jì)學(xué)意義。結(jié)論:治療組在降低老年慢性心衰患者血漿BNP水平,改善心功能,增加6分鐘步行距離,改善生活質(zhì)量,改善心悸、乏力、氣短、動(dòng)則氣喘、咯痰、面浮肢腫、畏寒肢冷等中醫(yī)癥狀方面均優(yōu)于對(duì)照組�？梢�,強(qiáng)心膠囊治療陽虛水瘀互結(jié)型老年慢性心力衰竭的臨床療效確切,其對(duì)降低血漿BNP水平的效果較為明顯,提示強(qiáng)心膠囊可能有抑制血漿BNP的釋放的作用,從而抑制神經(jīng)內(nèi)分泌系統(tǒng)的過度激活,阻礙心室重構(gòu)的發(fā)展進(jìn)程,進(jìn)而達(dá)到治療老年慢性心衰的目的。
[Abstract]:Objective: to observe the effect and clinical effect of Qiangxin capsule (QXC) on senile chronic heart failure (BNP) with Yang deficiency and phlegm stasis.Methods: 60 elderly patients with chronic heart failure were randomly divided into treatment group and control group with 30 cases in each group.The control group was treated with conventional western medicine according to the guidelines for the diagnosis and treatment of Heart failure in China in 2014, while the treatment group was treated with Qiangxin capsule on the basis of routine western medicine.The course of treatment was 14 days in both groups.Before and after the treatment, the plasma BNP level, cardiac function grading efficacy, 6 minutes walking test, TCM symptom effect, TCM single symptom score and Minnesota heart failure quality of life score were observed and compared.The result is 1: 1.Comparison of plasma BNP levels: plasma BNP levels were 338.41 鹵156.51pg/ml and 455.29 鹵266.02 PG / ml in the treatment group and control group, respectively.The plasma BNP decreased by 510.15 鹵353.07pg / ml in the treatment group and 404.22 鹵310.98pg / ml by the control group (P 0.05).The decrease of plasma BNP level after treatment was better in the treatment group than in the control group.Comparison of cardiac function grading efficacy with 6-minute walking test and Minnesota heart failure quality of life score: patients in the two groups had 6 min walking test after treatment and 6 min walking test before and after treatment.The score of quality of life in Minnesota heart failure was improved (P 0.05), and the improvement in the treatment group was better than that in the control group (P 0.05).Comparison of TCM symptom score: treatment group after treatment TCM symptom curative effect integral, TCM symptom single integral compared with this group before treatment decreased P0.05A, and treatment group after treatment patients palpitation, fatigue, shortness of breath, movement is asthma, cold cold limbs, phlegm, phlegm, the treatment group after the treatment of patients with palpitation, fatigue, shortness of breath, movement, cold limbs, phlegm,Facial floating limb swelling, abdominal distention, phlegm, fidgety, sweating, dizziness, dizziness, dark complexion, skin ecchymosis, dry mouth symptom, TCM symptom single score were lower than that of control group (P 0.05).The evaluation of general vital signs (such as blood pressure, heart rate, urine, fecal routine, routine blood routine, blood routine test, liver and kidney function, ALTASTASTUREAEAA SCRN, electrolytes, Nactinia, CK-MBLDHH) and cardiac troponin C Tn Tn, serum lipids, TGG, HDL-C, changes of ST-T in electrocardiogram (ECG), the changes of ST-T in ECG, and the changes of ST-T in electrocardiogram (ECG), the changes of ST-T, and the changes of ST-T in the two groups were also analyzed, and the results showed that there were no significant differences between the two groups in terms of safety index (such as blood pressure, heart rate, urine and feces).The chest radiographs had no significant difference (P 0.05).Conclusion: the treatment group can reduce plasma BNP level, improve cardiac function, increase walking distance for 6 minutes, improve life quality, improve palpitation, fatigue, shortness of breath, dyspnea, sputum and floating limb swelling in elderly patients with chronic heart failure.Cold limbs and other TCM symptoms were better than the control group.It can be seen that Qiangxin capsule is effective in the treatment of senile chronic heart failure with Yang deficiency and blood stasis, and it has obvious effect on reducing plasma BNP level, suggesting that Qiangxin capsule may have the effect of inhibiting the release of plasma BNP.Thus inhibit the excessive activation of the neuroendocrine system, block the development of ventricular remodeling, and then achieve the purpose of treatment of chronic heart failure in the elderly.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 李曉;童曉云;倪凱;楊建紅;侯肖霖;胡孝剛;;強(qiáng)心膠囊對(duì)心衰大鼠血流動(dòng)力學(xué)及MAPK信號(hào)通路的影響[J];云南中醫(yī)中藥雜志;2015年01期

2 楊建紅;李曉;胡孝剛;侯肖霖;陳劍;王雅莉;;強(qiáng)心膠囊對(duì)慢性心力衰竭大鼠心臟超聲及血清BNP水平的影響[J];云南中醫(yī)中藥雜志;2014年10期

3 顧正;;中藥黃芪的心血管藥理作用和臨床應(yīng)用研究分析[J];中西醫(yī)結(jié)合心血管病電子雜志;2014年10期

4 王冰瑤;吳曉燕;樊官偉;;丹參素保護(hù)心血管系統(tǒng)的藥理作用機(jī)制研究進(jìn)展[J];中草藥;2014年17期

5 劉曉雷;董興寶;;β受體阻滯劑對(duì)心力衰竭合并糖尿病患者血糖代謝的影響[J];實(shí)用醫(yī)藥雜志;2014年06期

6 金雪娟;周京敏;葛均波;;心力衰竭流行病學(xué)的研究進(jìn)展[J];中國臨床醫(yī)學(xué);2013年06期

7 魯美麗;王洪新;張靜;楊娟;;人參皂苷Rg1對(duì)脂多糖誘導(dǎo)心肌細(xì)胞肥大的保護(hù)作用[J];中藥藥理與臨床;2013年06期

8 謝志泉;;老年心力衰竭流行病學(xué)與病理生理特點(diǎn)[J];中華臨床醫(yī)師雜志(電子版);2013年11期

9 韓治偉;劉曉飛;王勇;;正確解讀BNP和NT-proBNP[J];中日友好醫(yī)院學(xué)報(bào);2013年02期

10 姜文大;粱靈君;顧潔瑩;王洪新;;人參皂苷Rg1對(duì)腹主動(dòng)脈縮窄致大鼠心肌肥厚和TLR4的影響[J];中藥藥理與臨床;2013年01期

，

本文編號(hào)：1754923