本文選題：溫陽利水 + 慢性收縮性心力衰竭��； 參考：《山東中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:1.運用系統(tǒng)評價中Meta分析對溫陽利水法治療慢性收縮性心力衰竭的臨床療效和安全性進(jìn)行評估;2.借助中醫(yī)傳承輔助系統(tǒng),挖掘溫陽利水法治療慢性收縮性心力衰竭的用藥及組方規(guī)律。方法:1.檢索近20年來已發(fā)表在國內(nèi)外醫(yī)學(xué)期刊上采用溫陽利水法治療慢性收縮性心力衰竭的隨機(jī)對照試驗研究,利用RevMan5.3軟件對符合標(biāo)準(zhǔn)的研究進(jìn)行異質(zhì)性檢驗、Meta分析、倒漏斗圖與敏感性分析等;2.借助中醫(yī)傳承輔助系統(tǒng)對文獻(xiàn)和臨床資料中采用溫陽利水法治療慢性收縮性心力衰竭的處方進(jìn)行篩選、錄入,進(jìn)行相關(guān)性數(shù)據(jù)分析,從中得出溫陽利水法治療慢性收縮性心力衰竭的方劑配伍規(guī)律。結(jié)果:1.本研究共35項隨機(jī)對照臨床試驗符合標(biāo)準(zhǔn),患者共3252例。(1)對9個研究結(jié)果的總體效應(yīng)進(jìn)行Meta分析結(jié)果為:研究結(jié)果指標(biāo)的相對合并效應(yīng)量OR值均不等于1或MD值均不等于0,且合并后的總體P值均小于0.05,說明配合溫陽利水法治療慢性收縮性心力衰竭與單純西藥治療比較均有統(tǒng)計學(xué)意義;(2)5個研究結(jié)果指標(biāo)(心功能療效、中醫(yī)證候療效、Lee氏心衰積分評價心衰的有效率,6MWT,LVEF)經(jīng)治療后治療組的改善明顯優(yōu)于對照組;4個研究結(jié)果指標(biāo)(中醫(yī)證候積分、BNP、LVEDD、生活質(zhì)量評分)經(jīng)治療后治療組變化明顯低于對照組。2.借助中醫(yī)傳統(tǒng)輔助平臺系統(tǒng)(V2.5),對符合的111個處方進(jìn)行相關(guān)分析,確定使用頻次較高的藥物、核心組合28對,候選新方6首,揭示其用藥的規(guī)律。結(jié)論:1.溫陽利水法治療慢性收縮性心力衰竭良好的臨床療效和安全性得到證實;2.對符合的處方進(jìn)行統(tǒng)計分析,得出常用藥物核心組合,候選新方,對臨床辨證指導(dǎo)選藥具有深遠(yuǎn)意義。
[Abstract]:Purpose 1. To evaluate the clinical efficacy and safety of Wenyangli water therapy in the treatment of chronic systolic heart failure (CHF) by meta-analysis in systematic evaluation. With the aid of traditional Chinese Medicine (TCM) inheriting auxiliary system, we excavate the law of treatment of chronic systolic heart failure by warming yang and water therapy. Method 1: 1. A randomized controlled trial study on the treatment of chronic systolic heart failure (CHF) with wenyangli method in medical journals at home and abroad in the past 20 years was searched. A meta-analysis of heterogeneity test was performed using RevMan5.3 software. Inverted funnel diagram and sensitivity analysis. With the help of traditional Chinese Medicine (TCM) inheritance Assistant system, the prescriptions for the treatment of chronic systolic heart failure (CHF) were screened, inputted and analyzed by using WYLW in the literature and clinical data. From the conclusion of Wenyang-Lishui method for the treatment of chronic systolic heart failure prescription compatibility rule. The result is 1: 1. A total of 35 randomized controlled clinical trials were conducted in this study. There were 3252 patients. (1) the results of meta-analysis of the total effects of 9 study results were as follows: the OR value of the relative combined effect was not equal to 1 or the MD value was not equal to 0, and the total P value of the combined study was less than 0.05, said. There was significant difference between the treatment of chronic systolic heart failure and that of western medicine alone. The curative effect of TCM Syndrome and the effective rate of evaluating Heart failure by Lee's Heart failure score) after treatment, the improvement of the treatment group is obviously better than that of the control group, and the changes of the treatment group after treatment with four indexes (TCM syndrome integral and BNPLVEDD-quality of life score) are obviously better than those in the control group. It was significantly lower than that of control group. With the help of traditional Chinese Medicine assisted platform system (V2.5), 111 prescriptions in accordance with the relevant analysis, the use of high-frequency drugs, core combination of 28 pairs, 6 candidates, to reveal the law of its drug use. Conclusion 1. The clinical efficacy and safety of warming yang and water therapy in the treatment of chronic systolic heart failure have been proved to be 2. 2%. According to the statistical analysis of prescriptions, the core combination of commonly used drugs and the candidates for new prescriptions are obtained, which is of far-reaching significance to the clinical guidance of drug selection based on syndrome differentiation.
【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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