發(fā)布時(shí)間：2018-05-10 13:13

  本文選題：耳穴壓豆 + 痰瘀雙解方��； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:利用中醫(yī)中藥內(nèi)外兼治策略,采用耳穴壓豆疏通經(jīng)絡(luò),改善自主神經(jīng)功能的機(jī)理,配合痰瘀雙解方治療冠心病(心絞痛)合并抑郁癥,通過(guò)衛(wèi)生技術(shù)評(píng)估方法,探討該治療方案的安全性和有效性,為冠心病(心絞痛)合并抑郁癥的中醫(yī)治療提供新的思路和方法,為各層次決策者合理使用冠心病(心絞痛)合并抑郁癥的臨床治療方案提供科學(xué)信息和決策依據(jù)。方法:采用隨機(jī)、對(duì)照的研究方法,遵循循證醫(yī)學(xué)的研究原則,將符合診斷、納入和排除標(biāo)準(zhǔn)的患者按照SPSS19.0計(jì)算的隨機(jī)數(shù)字表法分為對(duì)照組和試驗(yàn)組。對(duì)照組采用氯吡格雷以抗血小板,阿托伐他汀降脂,β受體阻滯劑,硝酸酯類(lèi)藥物擴(kuò)冠等治療。每晚予阿普唑侖0.4 mg睡前2h口服抗抑郁等西藥治療。試驗(yàn)組在對(duì)照組的基礎(chǔ)上聯(lián)合使用耳穴壓豆及中藥痰瘀雙解方8周,以心絞痛評(píng)分量表及漢密爾頓抑郁量表-17評(píng)分為療效評(píng)價(jià)指標(biāo),以血尿常規(guī)及肝腎功能為安全性觀察指標(biāo),評(píng)價(jià)耳穴壓豆聯(lián)合痰瘀雙解方在冠心病心絞痛合并抑郁癥中應(yīng)用的療效性及安全性。統(tǒng)計(jì)學(xué)分析應(yīng)用統(tǒng)計(jì)軟件SPSS19.0,計(jì)量資料為正態(tài)分布的予t檢驗(yàn),不符合的予非參數(shù)檢驗(yàn),針對(duì)計(jì)數(shù)資料予卡方檢驗(yàn),對(duì)于等級(jí)資料予秩和檢驗(yàn)。檢驗(yàn)符合P0.05為統(tǒng)計(jì)學(xué)上顯著差異。結(jié)果:1.基本資料分析:共計(jì)納入60例,其中試驗(yàn)組及對(duì)照組各30例,兩組之間年齡進(jìn)行t檢驗(yàn)(P=0.795),性別構(gòu)成進(jìn)行卡方檢驗(yàn)(P=0.980),兩組間統(tǒng)計(jì)學(xué)上無(wú)顯著差異(P0.05),具可比性。2.療效性評(píng)價(jià):兩組間治療前心絞痛量表評(píng)分、漢密爾頓抑郁量表分值對(duì)比,統(tǒng)計(jì)學(xué)上無(wú)差異(P0.05),(同組治療前后有顯著差異P0.05),且試驗(yàn)組好于對(duì)照組,顯著差異(P0.05);試驗(yàn)組總有效率好于對(duì)照組,具顯著差異(P0.05)。3.安全性評(píng)價(jià):(1)兩組在治療后復(fù)查肝腎功能,未發(fā)現(xiàn)血常規(guī)及肝腎功能指標(biāo)較前有明顯異常;(2)兩組在服藥過(guò)程中未出現(xiàn)嚴(yán)重不良反應(yīng),安全性分級(jí)兩組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1.耳穴壓豆聯(lián)合痰瘀雙解方在冠心病心絞痛合并抑郁癥的治療中可有效降低患者的心絞痛量表評(píng)分及漢密爾頓抑郁量表-17評(píng)分,具有良好的療效性。2.耳穴壓豆聯(lián)合痰瘀雙解方在冠心病心絞痛合并抑郁癥的治療中未對(duì)肝腎功能、凝血功能造成不良影響,未出現(xiàn)嚴(yán)重不良反應(yīng),具有良好的安全性。
[Abstract]:Objective: to improve the mechanism of autonomic nervous function by using the internal and external treatment strategy of traditional Chinese medicine (TCM), to improve the mechanism of improving autonomic nervous function by using the ear point pressing beans and dredging the meridian, and to treat coronary heart disease (angina pectoris) with depression by means of health technique evaluation method. To explore the safety and effectiveness of the treatment scheme, and to provide a new way of thinking and method for the treatment of coronary heart disease (angina pectoris) with depression. To provide scientific information and decision basis for the rational use of clinical treatment of coronary heart disease (angina pectoris) with depression. Methods: according to the principle of evidence-based medicine, the patients who met the criteria of diagnosis, inclusion and exclusion were divided into control group and experimental group according to the random digital table method calculated by SPSS19.0. The control group was treated with clopidogrel as antiplatelet, Atto vastatin, 尾 receptor blocker, nitrate ester drugs and so on. Alprazolam 0.4 mg 2 h before bedtime oral antidepressant and other western medicine treatment. On the basis of the control group, the experimental group was treated with auricular acupoint pressure bean and traditional Chinese medicine phlegm and blood stasis for 8 weeks. The scores of angina pectoris and Hamilton depression scale -17 were taken as the therapeutic evaluation index, and the routine blood and urine routine and liver and kidney function were used as safety observation indexes. Objective: to evaluate the efficacy and safety of auricular acupoint combined with phlegm and blood stasis decoction in angina pectoris of coronary heart disease combined with depression. Statistical software SPSS 19.0 was used for statistical analysis. The metrological data were pre-t test for normal distribution, non-parametric test for nonconformance, chi-square test for counting data and rank sum test for rank data. The statistical difference was statistically significant (P 0.05). The result is 1: 1. Analysis of basic data: a total of 60 cases were included, including 30 cases in the test group and 30 cases in the control group. The age of the two groups was examined by t test (P < 0. 795), and the sex composition by chi-square test (P < 0. 980). There was no significant statistical difference between the two groups (P 0. 05), which was comparable. Evaluation of curative effect: there was no statistical difference in the scores of angina pectoris scale and Hamilton depression scale between the two groups before and after treatment (P 0.05), and the trial group was better than the control group. The total effective rate of the experimental group was better than that of the control group, with significant difference (P0.05. 3). Safety evaluation: 1) after treatment, there was no obvious abnormal blood routine and liver and kidney function indexes in the two groups. There was no serious adverse reaction in the course of taking medicine, and there was no significant difference in safety grading between the two groups (P 0.05). Conclusion 1. In the treatment of coronary heart disease angina pectoris complicated with depression, auricular acupoint pressure bean combined with phlegm and double release prescription can effectively reduce the angina pectoris scale score and Hamilton depression scale -17 score, which has good curative effect. 2. In the treatment of coronary heart disease angina pectoris combined with depression, auricular acupoint pressure bean combined with phlegm and blood stasis double solution prescription did not cause adverse effects on liver and kidney function and coagulation function, and had no serious adverse reactions, so it had good safety.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R259;R277.7

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