本文選題：生脈散合炙甘草湯 + 室性早搏��； 參考：《湖北中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:觀察生脈散合炙甘草加減治療室性早搏患者的臨床療效及安全性,為臨床治療提供依據(jù)。方法:選取自2014年1月至2015年1月利川市中醫(yī)院心血管內(nèi)科住院部及門(mén)診符合室性早搏診斷標(biāo)準(zhǔn)和中醫(yī)心悸氣陰兩虛證患者60例。采用隨機(jī)對(duì)照分組的方法將其分為治療組和對(duì)照組,每組30例。治療組:口服生脈散合炙甘草湯加減治療,150ml/次,2次/日,早晚餐后各溫服。對(duì)照組:口服酒石酸美托洛爾(倍他樂(lè)克)治療,25mg/次,2次/日。療程均為4周。治療過(guò)程中根據(jù)各組患者心率、血壓及癥狀來(lái)調(diào)節(jié)用量以及觀察治療前后兩組患者中醫(yī)癥狀,24小時(shí)動(dòng)態(tài)心電圖早搏次數(shù),收集數(shù)據(jù)并進(jìn)行統(tǒng)計(jì)學(xué)分析,判斷兩組治療療效及安全性。結(jié)果:1.證候積分方面:治療組中醫(yī)證候療效顯效率63.3%,有效率36.7%,無(wú)效率0%,總有效率100%;而對(duì)照組顯效率20%,有效率66.7%,無(wú)效率4%,總有效率86.7%;經(jīng)秩和檢驗(yàn)分析P=0.000,P0.05,說(shuō)明治療組與對(duì)照組在證候積分方面存在明顯差異,治療組療效優(yōu)于對(duì)照組。2.早搏次數(shù)方面:治療組動(dòng)態(tài)心電圖療效顯效率13.3%,有效率60%,無(wú)效率26.7%,總有效率73.33%;而對(duì)照組顯效率3.3%,有效率16.7%,無(wú)效率80%,總有效率20%;經(jīng)秩和檢驗(yàn)分析P=0.000,P0.05,說(shuō)明治療組與對(duì)照組在早搏改善情況存在明顯差異,治療組療效優(yōu)于對(duì)照組。3.中醫(yī)癥狀改善方面:治療組及對(duì)照組都能有效改善早搏中醫(yī)癥狀,但兩組治療前后有明顯差異(P0.05),治療組明顯優(yōu)于對(duì)照組。治療組比對(duì)照組在心悸不寧、倦怠乏力、不寐多夢(mèng)等癥狀改善更明顯,兩組在素體虛弱、面色蒼白、耳鳴腰酸等癥狀改善方面無(wú)明顯差異(P0.05)。4.安全性方面:兩組患者在治療前后安全性指標(biāo),如血常規(guī)、大便常規(guī)、尿常規(guī)、肝功能、腎功能均在正常范圍之內(nèi),均未出現(xiàn)明顯不良反應(yīng)。結(jié)論:1.生脈散合炙甘草湯加減能顯著改善中醫(yī)證型屬氣陰兩虛證室性早搏的癥狀,對(duì)心悸不寧、不寐多夢(mèng)等癥狀改善尤為明顯。2.生脈散合炙甘草湯加減能明顯減少24小時(shí)動(dòng)態(tài)心電圖室性早搏次數(shù)。3.生脈散合炙甘草湯加減在治療早搏過(guò)程中未出現(xiàn)明顯不良反應(yīng),說(shuō)明其安全有效。
[Abstract]:Objective: to observe the efficacy and safety of Shengmaisan combined with liquorice plus subtraction in the treatment of ventricular premature beats. Methods: from January 2014 to January 2015, 60 patients with Qi-Yin deficiency syndrome of heart palpitations and heart palpitations were selected from inpatient department and outpatient department of Department of Cardiovascular Medicine, Lichuan traditional Chinese Medicine Hospital, in accordance with the diagnostic criteria of ventricular premature beats and TCM palpitations. They were divided into treatment group and control group with 30 cases in each group. Treatment group: oral Shengmaisan combined with Radix Glycyrrhiza decoction for the treatment of 150 ml / time twice a day, morning and evening after the meal each warm. Control group: metoprolol tartrate (betaloc) was given orally for 25 mg / d. The course of treatment was 4 weeks. In the course of treatment, according to the heart rate, blood pressure and symptoms of the patients in each group, the dosage was adjusted and the 24 hour ambulatory electrocardiogram beat times of the two groups were observed before and after treatment, and the data were collected and analyzed statistically. The efficacy and safety of the two groups were evaluated. The result is 1: 1. Syndromes integral: in the treatment group, the effective rate of TCM syndromes was 63.3%, the effective rate was 36.7%, the effective rate was 0%, the total effective rate was 100; in the control group, the effective rate was 20%, the effective rate was 66.7%, the inefficiency rate was 4%, and the total effective rate was 86.7%; the rank sum test was used to analyze P0.000P0.05, indicating the treatment group and the control group. There were significant differences in syndromes integral between the two groups. The curative effect of the treatment group was better than that of the control group. In terms of the number of times of premature beats: in the treatment group, the markedly effective rate of ambulatory electrocardiogram was 13.3, the effective rate was 60, the effective rate was 26.7, the total effective rate was 73.33; in the control group, the markedly effective rate was 3.3, the effective rate was 16.7. the effective rate was 80 and the total effective rate was 20g; the rank sum test was used to analyze P0. 000 and P0. 05, indicating that the treatment group and the treatment group were correct. There was significant difference in the improvement of premature beats in the radiation group. The curative effect of the treatment group was better than that of the control group. The improvement of TCM symptoms: both the treatment group and the control group can effectively improve the TCM symptoms of premature beats, but there is a significant difference between the two groups before and after treatment, the treatment group is obviously better than the control group. Compared with the control group, the symptoms of palpitations, fatigue, insomnia and many dreams were improved more obviously in the treatment group than in the control group, but there was no significant difference between the two groups in the improvement of symptoms such as physical weakness, pale complexion, tinnitus, lumbar acid and so on. Safety: the two groups of patients before and after the treatment of safety indicators, such as blood routine, stool routine, urine routine, liver function, renal function are within the normal range, no significant adverse reactions. Conclusion 1. Shengmaisan combined with Radix Glycyrrhiza decoction can significantly improve the symptoms of ventricular premature beats of qi and yin deficiency syndrome in TCM syndrome, especially in the symptoms of heart palpitations, insomnia and many dreams. Shengmaisan combined with Radix Glycyrrhiza decoction can significantly reduce 24-hour ambulatory electrocardiogram ventricular premature beat times. 3. There was no obvious adverse reaction in the treatment of premature beats by Shengmaisan and ZhiLicao decoction, which indicated that it was safe and effective.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R259

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