發(fā)布時(shí)間：2018-05-31 15:47

  本文選題：高血壓 + 疏肝降火顆粒��； 參考：《河南中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的通過疏肝降火顆粒干預(yù)肝郁火旺型高血壓病患者,觀察治療前后實(shí)驗(yàn)組與對照組中醫(yī)證候積分、24動態(tài)血壓及綜合醫(yī)院焦慮抑郁量表的積分的變化。評價(jià)疏肝降火顆粒在干預(yù)高血壓病肝郁火旺型臨床療效。方法受試對象為2014.4~2015.10在河南中醫(yī)藥大學(xué)第三附屬院心血管科門診及病房診斷為高血壓病肝郁火旺型60例患者,按照患者就診序號采用隨機(jī)數(shù)字表法,分為實(shí)驗(yàn)組30例和對照組30例,實(shí)驗(yàn)組給予疏肝降火顆粒(每日1付,分2次,早晚沖服)+苯磺酸氨氯地平片(絡(luò)活喜,5mg/片,1片/日)治療,對照組給予苯磺酸氨氯地平片,5mg/片,1片/日)治療。藥物均由河南中醫(yī)藥大學(xué)第三附屬醫(yī)院藥劑科統(tǒng)一提供,觀察8周后患者的中醫(yī)證候積分、24h ABPM及醫(yī)院綜合焦慮抑郁量表積分的變化情況。收集數(shù)據(jù)采用SPSS19.0軟件統(tǒng)計(jì)分析。結(jié)果實(shí)驗(yàn)組與對照組治療前一般資料及觀察指標(biāo)相比較均滿足(P0.05),無統(tǒng)計(jì)學(xué)差異,具有可比性。治療前中醫(yī)證候積分、24h SBP、24h DBP、dSBP、d-DBP、n-SBP、n-DBP、SCV、DCV及綜合醫(yī)院焦慮抑郁量表的積分等資料統(tǒng)計(jì)學(xué)上均無明顯差異,具有可比性。兩組治療后中醫(yī)癥狀積分及中醫(yī)證候總療效均較治療前顯著下降,有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組治療后降壓總療效較治療前有改善,實(shí)驗(yàn)組有效率為90.00%,對照組總有效率為73.30%。經(jīng)統(tǒng)計(jì)分析兩組間(P0.05),表明實(shí)驗(yàn)組在改善高血壓病患者的中醫(yī)證候顯著優(yōu)于對照組;在改善(24h SBP、24h DBP、d-SBP、d-DBP、nSBP、n-DBP)方面實(shí)驗(yàn)組顯著優(yōu)于對照組,經(jīng)統(tǒng)計(jì)分析兩組間(P0.05);實(shí)驗(yàn)組能顯著改善血壓變異性,經(jīng)統(tǒng)計(jì)分析(P0.05),對照組對血壓變異性改善不明顯,經(jīng)統(tǒng)計(jì)分析(P0.05);治療后焦慮抑郁分布及積分較治療前均有顯著改善,經(jīng)統(tǒng)計(jì)分析(P0.05),實(shí)驗(yàn)組在改善焦慮抑郁方面顯著優(yōu)于對照組。結(jié)論根據(jù)觀察結(jié)果顯示疏肝降火顆粒聯(lián)合苯磺酸氨氯地平片明顯改善肝郁火旺型高血壓病患者的中醫(yī)證候、24h ABPM及焦慮抑郁情緒的作用,同時(shí)發(fā)現(xiàn)肝郁火旺型高血壓病患者在一定程度上伴有焦慮抑郁的狀態(tài),且焦慮狀態(tài)居多,及時(shí)控制血壓能有效的減少焦慮抑郁的發(fā)生,其從疏肝降火、息風(fēng)止眩入手,降低患者24h ABPM及改善患者焦慮抑郁情緒的作用,但中藥聯(lián)合西藥在治療高血壓病患者血壓和改善焦慮抑郁的情緒優(yōu)于單純西藥。驗(yàn)證了疏肝降火顆粒治療高血壓病伴焦慮抑郁的臨床療效,為高血壓病的治療提供新的思路。
[Abstract]:Objective to observe the changes of ambulatory blood pressure (ABBP) in experimental group and control group before and after treatment with Shugan Jianghuo granule (Shugan Jianghuo granule) and the scores of anxiety and depression scale in general hospital before and after treatment. Objective: to evaluate the clinical effect of Shugan Jianghuo granule (Shugan Jianghuo granule) in treating essential hypertension with stagnation of liver and fire. Methods Sixty patients with essential hypertension, liver stagnation and fire flourishing type were diagnosed in the Department of Cardiovascular Department and ward of the third affiliated Hospital of Henan University of traditional Chinese Medicine on October 10, 2014. According to the number of the patients, the random digital table method was used. Three groups were divided into experimental group (30 cases) and control group (30 cases). The experimental group was treated with Shugan Jianghuo granule (1 daily, divided into 2 times, taken sooner or later) amlodipine benzenesulfonic acid tablets (5 mg / tablet / day). The control group was treated with amlodipine benzenesulfonate (5 mg / d). All drugs were provided by the Pharmacy Department of the third affiliated Hospital of Henan University of traditional Chinese Medicine. The changes of TCM syndromes score 24 h ABPM and hospital comprehensive anxiety and depression scale were observed after 8 weeks. The data were collected and analyzed by SPSS19.0 software. Results the comparison of general data and observation index before treatment between the experimental group and the control group had no statistical difference and was comparable. Before treatment, there was no statistical difference in the score of TCM syndromes (24 h SBP) and 24 h DBP (dSBPn) -DBP (n-SBP) -DBP (n-DBP), SCVV (DCV), and the scores of anxiety and depression scale (SAS) in general hospital, which were comparable to each other. After treatment, the scores of TCM symptoms and the total curative effect of TCM syndromes in both groups were significantly lower than those before treatment, with statistical significance (P 0.05). The total effect of hypotension in the two groups was improved after treatment. The effective rate was 90.00in the experimental group and 73.30g in the control group. The statistical analysis showed that the experimental group was significantly better than the control group in improving the TCM syndromes of hypertensive patients, and in improving the 24h DBPnPnSBPnSBPnSBPnDBPn in the experimental group, the experimental group was significantly better than the control group in improving the symptoms of hypertension, and in improving the 24h SBP of the control group, the experimental group was significantly better than the control group. After statistical analysis, the blood pressure variability was significantly improved in the experimental group, but not in the control group, and the distribution of anxiety and depression and the score in the control group were significantly improved compared with those before treatment. By statistical analysis, the experimental group was significantly better than the control group in improving anxiety and depression. Conclusion according to the observation results, Shugan Jianghuo granule combined with amlodipine benzenesulfonic acid tablets can obviously improve the effect of TCM syndromes 24 h ABPM and anxiety and depression in patients with liver depression. At the same time, it was found that the patients with hypertension of liver depression and fire were accompanied with anxiety and depression to a certain extent, and the anxiety state was the most. Timely control of blood pressure could effectively reduce the occurrence of anxiety and depression, which began from soothing the liver and lowering the fire and stopping the dizziness and dizziness of the wind. The effects of Chinese medicine combined with western medicine on blood pressure and anxiety and depression in patients with hypertension were better than those of western medicine alone. The clinical efficacy of Shugan Jianghuo granule in the treatment of hypertension with anxiety and depression was verified and a new idea was provided for the treatment of hypertension.
【學(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259

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