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芪附溫陽湯治療擴(kuò)張型心肌病的臨床療效評價

發(fā)布時間:2018-06-14 12:04

  本文選題:芪附溫陽湯 + 擴(kuò)張型心肌病; 參考:《山東中醫(yī)藥大學(xué)》2016年碩士論文


【摘要】:目的:本課題旨在探索芪附溫陽湯配合常規(guī)西藥治療擴(kuò)張型心肌病與單純常規(guī)西藥治療相比較臨床療效有無差異,評價芪附溫陽湯治療擴(kuò)張型心肌病的臨床療效并探索其作用機(jī)理,為其指導(dǎo)擴(kuò)張型心肌病的診療提供一定的臨床依據(jù)。方法:選取50例擴(kuò)張型心肌病心腎陽虛證型患者,隨機(jī)分為對照組和治療組。對照組采取西藥常規(guī)治療,治療組在西藥常規(guī)治療基礎(chǔ)上配合芪附溫陽湯。以8周為1個療程,記錄患者治療前后的中醫(yī)癥候積分、心功能分級(NYHA分級法)、血清N末端腦鈉尿肽原(NT-proBNP)、左心室舒張末期內(nèi)徑(LVEDD)、左心室射血分?jǐn)?shù)(LVEF)、明尼蘇達(dá)心力衰竭患者生活質(zhì)量評分,并應(yīng)用“SPSS17.0”統(tǒng)計(jì)軟件對其進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:(1)治療組心功能分級療效總有效率為88%,對照組總有效率60%,采用秩和檢驗(yàn)對兩組有效率進(jìn)行比較,治療組療效優(yōu)于對照組(P0.05)。(2)治療后兩組患者中醫(yī)癥候積分、NT-proBNP、LVEF、明尼蘇達(dá)心力衰竭患者生活質(zhì)量評分與治療前比較均有顯著性差異(P0.01),對兩組進(jìn)行組間比較,治療組優(yōu)于對照組(P0.05)。(3)治療后兩組患者LVEDD與治療前比較有顯著性差異(P0.01),對兩組進(jìn)行組間比較,治療組與對照組無統(tǒng)計(jì)學(xué)差異(P0.05)。(4)兩組患者治療前后安全性指標(biāo)均無明顯異常變化(P0.05)。結(jié)論:芪附溫陽湯對擴(kuò)張型心肌病心腎陽虛型患者的中醫(yī)癥候積分、心功能分級、NT-proBNP、左心室射血分?jǐn)?shù)、明尼蘇達(dá)心力衰竭患者生活質(zhì)量評分均具有明顯改善作用;對肝腎功能無明顯影響,安全性良好。
[Abstract]:Objective: to explore the clinical effect of Qifu Wenyang decoction combined with conventional western medicine in the treatment of dilated cardiomyopathy. To evaluate the clinical effect of Qifuwenyang decoction in the treatment of dilated cardiomyopathy and to explore its mechanism, and to provide some clinical basis for guiding the diagnosis and treatment of dilated cardiomyopathy. Methods: 50 cases of dilated cardiomyopathy with deficiency of heart and kidney yang were randomly divided into control group and treatment group. The control group was treated with routine western medicine, and the treatment group was treated with Qifu Wenyang decoction on the basis of routine western medicine treatment. Taking 8 weeks as a course of treatment, the scores of TCM symptoms before and after treatment were recorded. NYHA classification of cardiac function, NT-proBNPN, LVEDDD, LVEFN, LVEFV, and quality of life of patients with heart failure in Minnesota were analyzed with SPSS 17.0 statistical software. Results the total effective rate of heart function grading in the treatment group was 88 and that in the control group was 60. The effective rate of the two groups was compared by rank sum test. The curative effect of the treatment group was better than that of the control group (P 0.05, P 0.05, P < 0.05). After the treatment, the score of TCM symptom and the score of quality of life of the patients with Minnesota heart failure were significantly higher than those of the control group (P 0.01), and the difference between the two groups was also significant (P 0.01), and there were significant differences between the two groups in the score of quality of life of the patients with heart failure in Minnesota. There was significant difference in LVEDD between the two groups after treatment and before treatment. There was no significant difference between the treatment group and the control group in the safety indexes of the two groups before and after treatment. Conclusion: Qifuwenyang decoction can significantly improve the scores of TCM symptoms, cardiac function grading and NT-proBNPs, left ventricular ejection fraction (LVEF), and Minnesota heart failure patients' quality of life (QOL) in patients with heart and kidney yang deficiency of dilated cardiomyopathy. It has no obvious effect on liver and kidney function and is safe.
【學(xué)位授予單位】:山東中醫(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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