本文選題：系統性硬化 + 寒濕痹阻型��； 參考：《云南中醫(yī)學院》2017年碩士論文

【摘要】：目的:探討以附子桂枝合劑為代表方的溫陽通絡法治療證屬寒濕痹阻型系統性硬化的立論依據及臨床療效,采取隨機對照分析研究,運用統計學方法,歸納、總結溫陽通絡法治療系統性硬化的療效及安全性。方法:采用隨機對照試驗,將符合納入標準的60例寒濕痹阻型系統性硬化患者,隨機分為治療組30例和對照組30例。治療組予口服附子桂枝合劑聯合青霉胺片,對照組予口服青霉胺片。12周為一個療程。觀察兩組患者治療前、治療后皮膚硬度、甲襞微循環(huán)檢測結果、中醫(yī)證候積分、血沉、C-反應蛋白等療效性指標。并觀察治療前、治療后兩組患者血、尿、便常規(guī)化驗、肝腎功能、心電圖檢查等安全性指標。結果:1.從中醫(yī)病因病機出發(fā)探討溫陽通絡法治療系統性硬化(寒濕痹阻型)的立論依據及可行性;基于文獻研究,提取有效治法方藥,探討附子桂枝合劑的主要組成藥物、配伍規(guī)律及治療系統性硬化的可行性。2.療程結束后,兩組中醫(yī)證候比較,治療組中醫(yī)證候療效總有效率為93.34%,對照組為80%,兩組比較,差異有統計學意義(P0.05)。3.治療組甲襞微循環(huán)檢測結果有效率為90%,對照組為66.67%,兩組比較,差異有統計學意義(P0.05)。4.療程結束后,治療組和對照組皮膚硬化分級比較,存在顯著性差異(P0.05),治療組明顯優(yōu)于對照組。5.療程結束后,治療組和對照組改善ESR、CRP比較,差異存在統計學意義(P0.05),治療組優(yōu)于對照組。6.研究過程中,兩組患者血常規(guī)、肝腎功等均未出現明顯異常。結論:1.以附子桂枝合劑為代表方的溫陽通絡法是治療寒濕痹阻型系統性硬化安全有效的方法。2.附子桂枝合劑能明顯改善寒濕痹阻型系統性硬化的臨床癥狀,且未發(fā)現明顯毒副作用,是安全有效的藥物,值得臨床應用及推廣。
[Abstract]:Objective: to explore the theoretical basis and clinical effect of wenyang Tongluo method in treating systemic sclerosis of cold and dampness obstruction type with Fuzi Guizhi mixture as the representative prescription. To summarize the efficacy and safety of warming yang and clearing collaterals in the treatment of systemic sclerosis. Methods: 60 patients with systemic sclerosis of cold and dampness obstruction were randomly divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated with aconite Guizhi mixture combined with penicillamine tablet, and the control group was treated with penicillamine tablet for 12 weeks. The skin hardness, nailfold microcirculation, TCM syndromes score, erythrocyte sedimentation rate (ESR) and C-reactive protein were observed before and after treatment in the two groups. The safety indexes such as blood, urine, stool routine test, liver and kidney function, electrocardiogram were observed before and after treatment. The result is 1: 1. From the etiology and pathogenesis of traditional Chinese medicine, to discuss the theoretical basis and feasibility of warming Yang Tongluo method in treating systemic sclerosis (cold and dampness arthralgia obstruction type), based on the literature study, to extract effective prescription drugs, and to discuss the main components of Fuzi Guizhi mixture. Compatibility Law and the Feasibility of treating systemic sclerosis. After the end of the course of treatment, the two groups of TCM syndrome comparison, the treatment group TCM syndromes total effective rate of 93.34 and the control group is 80, the difference between the two groups, the difference was statistically significant (P 0.05). 3. The effective rate of nailfold microcirculation in the treatment group was 90 and that in the control group was 66.67. The difference between the two groups was statistically significant (P 0.05). After the course of treatment, there was a significant difference between the treatment group and the control group in skin sclerosis grade (P 0.05), and the treatment group was significantly better than the control group (P 0.05). After the course of treatment, the treatment group and the control group improved ESR-CRP, the difference was statistically significant (P 0.05), the treatment group was better than the control group. 6. In the course of the study, there were no significant abnormalities in blood routine, liver and kidney function in both groups. Conclusion 1. The Wenyang Tongluo method, which is represented by Fuzi Guizhi mixture, is a safe and effective method for the treatment of systemic sclerosis of cold and dampness obstruction type. Fuzi Guizhi mixture can obviously improve the clinical symptoms of systemic sclerosis of cold and dampness obstruction type, and no obvious toxic side effects have been found. It is a safe and effective drug and is worthy of clinical application and popularization.
【學位授予單位】：云南中醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R259

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