本文選題：冠心病 + 太陰人��； 參考：《延邊大學(xué)》2017年碩士論文

【摘要】：目的通過觀察山藥補肺元湯合熊膽散治療太陰人冠心病心絞痛的臨床研究,探討山藥補肺元湯合熊膽散治療冠心病心絞痛的有效性、安全性,為朝醫(yī)藥在臨床治療冠心病提供更為有效的治療依據(jù)。方法將50例太陰人冠心病穩(wěn)定型心絞痛患者,按其就診順序隨機分為兩組,即治療組、對照組,其中25例治療組服用山藥補肺元湯合熊膽散,其余25例對照組服用瑞舒伐他汀鈣片。所有患者每日給予5%葡萄糖(250草仙)250ml+丹紅注射液40ml,治療組在丹紅注射液基礎(chǔ)上給予山藥補肺元湯合(組成:麥門冬15g、山藥10g、桔梗10g、萊菔子10g、五味子5g、薏苡仁10g。)按每劑600ml水泡半小時,水煎300ml或按院內(nèi)常規(guī)煎服,每日一劑,早晚各一次分服。熊膽散2g(熊膽散每0.5g裝入1個膠囊管中),每晚一次口服,4周為一個療程;對照組給予瑞舒伐他汀鈣片20mg(瑞脂:5mg×14片)每晚頓服,4周為一個療程。結(jié)果1.經(jīng)統(tǒng)計分析后對照組和治療組在性別、病程、年齡及體重指數(shù)這幾個方面比較均無統(tǒng)計學(xué)意義(P0.05),說明可以進(jìn)行比較。2.綜合療效:對照組總有效例數(shù)為17例、總有效率為68%,治療組總有效例數(shù)為21例、總有效率為84%,山藥補肺元湯合熊膽散治療太陰人冠心病穩(wěn)定型心絞痛總體有效率與對照組沒有統(tǒng)計學(xué)差異(P0.05)。3.中醫(yī)臨床癥狀記分:治療組與對照組用藥前的證候記分相比,無統(tǒng)計學(xué)差異(P0.05),說明可以進(jìn)行比較;用藥后熊膽組患者的記分明顯下降,說明山藥補肺元湯合熊膽散能夠有效的改善冠心病穩(wěn)定型心絞痛患者的臨床癥狀;同時說明了在改善中醫(yī)癥狀方面,山藥補肺元湯組的療效明顯優(yōu)于對照組。4.心絞痛記分:治療組與對照組在治療前的心絞痛記分比較,無統(tǒng)計學(xué)差異(P0.05),說明兩組數(shù)據(jù)具有比較性;用藥后治療組患者心絞痛記分有顯著降低,這點可以說明運用山藥補肺元湯合熊膽散可明顯改善患者心絞痛癥狀,同時治療后治療組心絞痛記分明顯低于對照組,進(jìn)一步說明山藥補肺元湯合熊膽散在改善心絞痛癥狀方面更優(yōu)于瑞舒伐他汀鈣片的治療。5.心電圖療效:對照組共有21例患者心電圖異常,用藥后15例患者的心電圖異常導(dǎo)聯(lián)得到有效恢復(fù),總有效率為71%;治療組共有21例患者心電圖異常,用藥后18例患者的心電圖異常導(dǎo)聯(lián)得到有效恢復(fù),總有效率為85%。6.血脂TC、HDL、LDL變化:經(jīng)過治療后對照組和治療組患者體內(nèi)血脂含量均有明顯改變,說明山藥補肺元湯合熊膽散可以明顯降低TC、LDL并增加HDL在患者體內(nèi)的含量。7.所有患者的生命體征、血常規(guī)、尿常規(guī)、肝功能、腎功能、心肌酶、出凝血時間等均未出現(xiàn)明顯異常。結(jié)論1.采用山藥補肺元湯合熊膽散治療太陰人冠心病穩(wěn)定型心絞痛未見毒副反應(yīng)或其他藥源性不良反應(yīng)的發(fā)生,腎功能等未出現(xiàn)明顯異常,治療過程中未發(fā)生任何心血管意外等不良情況,且治療組對山藥補肺元湯合熊膽散的耐受性總體良好。2.臨床上應(yīng)用山藥補肺元湯合熊膽散具有能夠有效改善太陰人冠心病心絞痛患者胸悶、心前區(qū)及上臂、下頜的陣發(fā)性、壓榨性疼痛等臨床癥狀。3.臨床上應(yīng)用山藥補肺元湯合熊膽散治療太陰人冠心病心絞痛患者可使心絞痛的疼痛程度、發(fā)作頻率、持續(xù)時間有效降低。4.臨床上應(yīng)用山藥補肺元湯合熊膽散能夠有效恢復(fù)太陰人冠心病心絞痛患者心電圖各異常導(dǎo)聯(lián)的改變。5.太陰人冠心病心絞痛患者經(jīng)山藥補肺元湯合熊膽散治療后體內(nèi)TC、LDL含量明顯降低,HDL含量有所增加。
[Abstract]:Objective To observe the clinical study of yam tonifying Yuan Tang and bear Dall powder in treating coronary heart disease and angina pectoris in the Tai Yin people, and to explore the effectiveness and safety of yam tonifying Yuan Tang and bear Dall powder in treating coronary heart disease and angina pectoris. In order to provide more effective treatment basis for the treatment of coronary heart disease in the clinic, 50 cases of stable heart disease of coronary heart disease in the Tai Yin people are taken. The pain patients were randomly divided into two groups according to the order of their treatment, that is, the treatment group and the control group, of which 25 cases were treated with yam, tonifying lung yuan soup and bear gall powder, and the rest 25 cases of the control group were taken Rosuvastatin Calcium Tablets. All the patients were given 5% glucose (250 grass immortals) 250ml+ Danhong injection 40ml daily, and the treatment group was supplementing the Danhong Injection on the basis of Danhong injection. Lung Yuan Tang (composition: 15g, 10g, 10g, semen semen 10g, sulforaphane 10g, Schisandra 5g, coix 10g.) for half an hour per dose of 600ml blisters, decoction of 300ml or regular decocting in hospital, one dose per day, every morning and evening. Bear gall powder 2g (bear bile powder per 0.5g loaded in 1 capsules), once a night and 4 weeks as a course of treatment; the control group is given a course of treatment; control group given. Rosuvastatin Calcium Tablets 20mg (Rayleigh: 5mg x 14 tablets) was taken every night and 4 weeks as a course of treatment. Results there was no significant difference between the control group and the treatment group on the gender, course of disease, age and body mass index (P0.05) after statistical analysis (P0.05), which showed that the total effective rate of the control group was 17 cases and the total effective rate was effective. For 68%, the total number of effective cases in the treatment group was 21 cases, the total effective rate was 84%. The total effective rate of yam tonifying lung Yuan Tang and bear gall powder in treating stable angina pectoris of the Tai Yin people was not statistically significant (P0.05).3. clinical symptom score of TCM: there was no statistical difference between the treatment group and the control group before the score of the syndrome (P0.05). It can be compared, after drug use, the score of the bear bile group is obviously decreased. It shows that the yam tonifying Yuan Tang and bear Dall powder can effectively improve the clinical symptoms of the patients with stable angina pectoris. At the same time, the curative effect of the yam Decoction group is better than the control group.4. angina pectoris score: the treatment group and the treatment group are better than the control group. The score of angina pectoris before treatment was not statistically different (P0.05), indicating that the data of two groups were comparative, and the score of angina pectoris in the treatment group was significantly lower after drug use, which could indicate that the use of yam tonifying lung Yuan Tang and bear Dall powder could obviously improve the symptoms of angina pectoris in patients, and the score of angina pectoris in the treatment group was obviously lower. In the control group, it was further explained that yamchi tonifying lung Yuan Tang and bear Dall powder were better than Rosuvastatin Calcium Tablets in the treatment of angina pectoris in the treatment of.5. electrocardiogram. There were 21 patients in the control group with abnormal electrocardiogram, 15 patients with abnormal lead in electrocardiogram were effectively restored, the total effective rate was 71%, and the treatment group had 21 patients' heart. Abnormal electrocardiogram of 18 patients after drug use was effectively recovered, the total effective rate was 85%.6. blood lipid TC, HDL, LDL changes: after treatment, the blood lipid content in the control group and the treatment group were obviously changed, indicating that the yam tonifying lung Yuan Tang and bear gall powder can obviously reduce TC, LDL and increase the HDL content.7. in the patient's body. There was no obvious abnormality in all patients' vital signs, blood routine, urine routine, liver function, renal function, myocardial enzyme, and coagulation time. Conclusion 1. the treatment of stable angina pectoris of coronary heart disease of the Tai Yin people with yam tonifying lung Yuan Tang and bear gall powder has no toxic side reaction or other drug induced adverse reactions, and there are no obvious abnormalities in renal function. No adverse events such as cardiovascular accidents occurred during the treatment, and the treatment group had a good overall tolerance to yam tonifying lung Yuan Tang and bear gall powder in the treatment group. The clinical application of yam tonifying lung Yuan Tang and bear gall powder could effectively improve chest tightness in patients with coronary heart disease, precardiac region and upper arm, paroxysmal paroxysmal and squeezed pain in the.2.. Clinical application of clinical symptom.3. to treat patients with angina pectoris in the treatment of angina pectoris in patients with angina pectoris in the treatment of angina pectoris by yam tonifying lung Yuan Tang and bear gall powder. The clinical application of.4. in the clinical application of yam tonifying lung Yuan Tang and bear gall powder can effectively restore the changes of ECG abnormality lead in patients with angina pectoris of the Tai Yin people .5. the TC and LDL contents in the body of patients with coronary heart disease and angina pectoris were significantly reduced after treatment by yam, Bu Fei Tang and bear gall powder. The content of HDL increased.
【學(xué)位授予單位】：延邊大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259
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本文編號：1965428