本文選題：中醫(yī) + 治未病��； 參考：《浙江中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的探究與分析中醫(yī)"治未病"干預(yù)1級高血壓病的效果。方法選取我院自2014年6月至2016年6月收治的1級高血壓病患者180例,對該組患者進(jìn)行體質(zhì)辨識后,根據(jù)六種體質(zhì)(平和質(zhì)、氣虛質(zhì)、陰虛質(zhì)、陽虛質(zhì)、痰濕質(zhì)、濕熱質(zhì))分類,然后采用隨機數(shù)字表法分為干預(yù)組和對照組,每組各90例,對照組在生化指標(biāo)正常、無器質(zhì)性病變的前提下,僅給予健康生活方式指導(dǎo),包括飲食控制、適當(dāng)鍛煉,以及保持足夠的睡眠時間等。觀察組在對照組基礎(chǔ)上實施中醫(yī)"治未病"干預(yù),給予有效的生活方式干預(yù)聯(lián)合藥物干預(yù)方案。對比兩組治療前后自我管理能力、證候療效、血壓變化、體質(zhì)量相關(guān)指標(biāo)、血脂指標(biāo)變化、日常生活質(zhì)量及中醫(yī)體質(zhì)變化。結(jié)果(1)兩組患者治療前相比戒煙戒酒、堅持運動、健康飲食、監(jiān)測血壓患者所占比例無明顯差異(P0.05)。兩組患者治療后與治療前相比戒煙戒酒、堅持運動、健康飲食、監(jiān)測血壓患者所占比例明顯升高,觀察組治療后與對照組治療后相比戒煙戒酒、堅持運動、健康飲食、監(jiān)測血壓患者所占比例升高更加顯著,差異具有統(tǒng)計學(xué)意義(P0.05)。(2)對照組治療后證候療效為76.67%,觀察組治療后證候療效為92.22%,觀察組治療后證候療效明顯高于對照組治療后證候療效,差異具有統(tǒng)計學(xué)意義(P0.05)。(3)兩組患者治療前相比收縮壓及舒張壓無明顯差異(P0.05)。對照組治療1個月后、治療3個月后與治療前相比,收縮壓及舒張壓雖有所降低,但無明顯差異(P0.05)。觀察組治療1個月后與治療前相比收縮壓與舒張壓均降低,治療3個月后與治療1個月后相比收縮壓與舒張壓均降低,差異具有統(tǒng)計學(xué)意義(P0.05)。觀察組治療后1個月后、治療后3個月的收縮壓及舒張壓與對照組治療后1個月后、治療后3個月分別相比降低更加顯著,差異具有統(tǒng)計學(xué)意義(P0.05)。(4)兩組患者治療前相比體重、體重指數(shù)、腰圍、臀圍及腰臀比無明顯差異(P0.05)。對照組治療后與治療前相比體重、體重指數(shù)、腰圍、臀圍及腰臀比雖有所降低,但無明顯差異(P0.05)。觀察組治療后與治療前相比體重、體重指數(shù)、腰圍、臀圍及腰臀比均降低,觀察組治療后與對照組治療后相比體重、體重指數(shù)、腰圍、臀圍及腰臀比降低更加顯著,差異具有統(tǒng)計學(xué)意義(P0.05)。(5)兩組患者治療后與治療前相比TC、TG及LDL-C水平降低,HDL-C水平升高,觀察組治療后與對照組治療后相比TC、TG及LDL-C水平降低,HDL-C水平升高更加顯著,差異具有統(tǒng)計學(xué)意義(P0.05)。(6)兩組患者治療前相比健康感覺、軀體感覺、睡眠狀態(tài)、生活滿足感以及認(rèn)知功能評分無明顯差異(P0.05)。兩組患者治療后與治療前相比健康感覺、軀體感覺、睡眠狀態(tài)、生活滿足感以及認(rèn)知功能評分均升高,觀察組治療后與對照組治療后相比健康感覺、軀體感覺、睡眠狀態(tài)、生活滿足感以及認(rèn)知功能評分升高更加顯著,差異具有統(tǒng)計學(xué)意義(P0.05)。(7)兩組患者治療前后中醫(yī)體質(zhì)量表中平和質(zhì)、氣虛質(zhì)、陰虛質(zhì)、陽虛質(zhì)、痰濕質(zhì)、濕熱質(zhì)得分相比無明顯差異(P0.05)。對照組治療后與治療前相比中醫(yī)體質(zhì)量表中平和質(zhì)、氣虛質(zhì)、陰虛質(zhì)、陽虛質(zhì)、痰濕質(zhì)、濕熱質(zhì)得分無明顯差異(P0.05)。觀察組治療后與治療前相比中醫(yī)體質(zhì)量表中平和質(zhì)、氣虛質(zhì)、陰虛質(zhì)、陽虛質(zhì)、痰濕質(zhì)、濕熱質(zhì)得分均降低,觀察組治療后與對照組治療后相比中醫(yī)體質(zhì)量表中平和質(zhì)、氣虛質(zhì)、陰虛質(zhì)、陽虛質(zhì)、痰濕質(zhì)、濕熱質(zhì)得分降低更加顯著,差異具有統(tǒng)計學(xué)意義(P0.05)。結(jié)論中醫(yī)"治未病"干預(yù)1級高血壓病的效果突出,不僅可提高患者的自我管理能力,改善血脂指標(biāo),提高生活質(zhì)量,改善中醫(yī)體質(zhì),期間未出現(xiàn)不良反應(yīng),安全性較高。
[Abstract]:Objective to explore and analyze the effect of "treating no disease" on the intervention of 1 grade hypertension. Methods 180 cases of 1 grade hypertension patients were selected from June 2014 to June 2016 in our hospital. After physical identification, the group was classified according to six physique (flat and quality, Qi deficiency, yin deficiency, yang deficiency, phlegm wet quality, damp heat quality), and then the random number was used. The method was divided into the intervention group and the control group, with 90 cases in each group. The control group only given the healthy lifestyle guidance, including diet control, proper exercise, and enough sleep time on the premise of normal biochemical indexes and no organic pathological changes. The observation group carried out the intervention of "treating no disease" on the basis of the control group and gave effective life. In the two groups, the self-management ability, the syndrome effect, the blood pressure change, the body mass index, the blood lipid index, the daily life quality and the physique of traditional Chinese medicine were compared before and after the treatment. The results were (1) the proportion of the two groups was less than the smoking and abstinence, the strong exercise, the healthy diet, and the monitoring of the blood pressure. There was significant difference (P0.05). After treatment, the two groups were compared with before treatment to quit smoking and abstinence, adhere to exercise, healthy diet, and monitor blood pressure, the proportion of patients in the observation group was significantly higher than that of the control group after treatment. The proportion of patients who were kept exercise, healthy diet and monitoring blood pressure increased significantly, and the difference was statistically significant. (P0.05) (2) the effect of the syndrome after treatment was 76.67% in the control group and 92.22% in the observation group after treatment. The curative effect of the observation group was significantly higher than that of the control group after treatment. The difference was statistically significant (P0.05). (3) there was no significant difference in systolic pressure and diastolic pressure in the two groups before treatment (P0.05). After 1 months of treatment, the control group was treated, After 3 months of treatment, the systolic pressure and diastolic pressure decreased, but there was no significant difference (P0.05). The systolic and diastolic pressure of the observation group decreased after 1 months of treatment, and the systolic pressure and diastolic pressure decreased after 3 months of treatment and 1 months after treatment. The difference was statistically significant (P0.05). 1 after treatment, the observation group was 1 after treatment. After 3 months after treatment, the systolic pressure and diastolic pressure of the 3 months after treatment were significantly higher than that of the control group after 1 months after treatment. The difference was statistically significant (P0.05). (4) there was no significant difference in body weight, body mass index, waist circumference, hip circumference and waist hip ratio before treatment (P0.05). The control group was compared with before treatment. Body weight, body mass index, waist circumference, hip circumference and waist to hip ratio were lower, but there was no significant difference (P0.05). The body weight, body mass index, waist circumference, hip circumference and waist hip ratio decreased after treatment. The body weight index, waist circumference, hip circumference and waist to hip ratio decreased more significantly after treatment. Statistical significance (P0.05) (5) two groups of patients after treatment compared with before treatment TC, TG and LDL-C level decreased, HDL-C level increased, the observation group after treatment compared with the control group TC, TG and LDL-C level decreased, the level of HDL-C increased more significantly, the difference was statistically significant (P0.05). (6) two groups of patients compared to healthy feeling, somatosensory before treatment. There was no significant difference in sleep state, life satisfaction and cognitive function score (P0.05). The two groups of patients with healthy feeling, somatosensory, sleep state, life satisfaction and cognitive function score increased after treatment. The observation group was compared with the control group after treatment of healthy feeling, somatosensory, sleep state, and full life. The score of foot and cognitive function increased significantly (P0.05). (7) there was no significant difference between the two groups of patients before and after the treatment of the body mass scale, Qi deficiency, yin deficiency, yin deficiency, Yang deficiency, phlegm wet quality and humid heat (P0.05). Quality, yin deficiency, Yang deficiency, phlegm, wet heat and heat quality had no significant difference (P0.05). After treatment, the observation group was compared with the quality of body mass, Qi deficiency, yin deficiency, yin deficiency, Yang deficiency, phlegm wet quality and damp heat quality. After treatment, the observation group was compared with the control group in the middle level of the body mass, Qi deficiency and yin deficiency. The score of Yang deficiency, phlegm, wet heat and heat quality decreased more significantly, and the difference was statistically significant (P0.05). Conclusion the effect of "treatment without disease" in the intervention of grade 1 hypertension is prominent. It can not only improve the self management ability of the patients, improve the blood lipid index, improve the quality of life, improve the physique of traditional Chinese medicine, but have no adverse reaction and high safety during the period.

【學(xué)位授予單位】：浙江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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