益脈顆粒對老年氣虛血瘀型穩(wěn)定性心絞痛患者生活質(zhì)量影響的研究
發(fā)布時(shí)間：2018-08-02 18:03
【摘要】：目的:觀察益脈顆粒治療老年氣虛血瘀型穩(wěn)定性心絞痛的臨床療效及對患者生活質(zhì)量的影響,并探討作用機(jī)制,為今后臨床用藥提供依據(jù)。方法:選取符合納入標(biāo)準(zhǔn)的60例患者作為研究對象,將60例患者隨機(jī)分為兩組:觀察組和對照組,每組各30例。觀察組在常規(guī)西藥治療的基礎(chǔ)上給予中藥制劑益脈顆粒,對照組僅給予常規(guī)西藥治療,4個(gè)療程后,對比兩組患者治療前后心電圖療效、中醫(yī)癥候積分、中醫(yī)癥候療效、血脂、血漿纖維蛋白原、左心射血分?jǐn)?shù)、運(yùn)動耐量、生活質(zhì)量及安全性指標(biāo)的變化并進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:1.心電圖療效:治療后兩組間比較,觀察組心電圖總有效率高于對照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。2.中醫(yī)癥候積分:治療前兩組患者中醫(yī)癥候積分比較無明顯差異(P0.05),治療后兩組患者中醫(yī)癥候積分較治療前均顯著降低(P0.01),且觀察組中醫(yī)癥候積分降低明顯優(yōu)于對照組(P0.01)。3.中醫(yī)癥候療效:治療后兩組間比較,觀察組中醫(yī)癥狀改善總有效率高于對照組(P0.05)。4.血脂:治療前兩組患者甘油三酯(TG)、總膽固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)之間比較無明顯差異(P0.05),治療后兩組患者TG、TC、LDL較治療前均顯著降低(P0.01),HDL較治療前顯著升高(P0.01),治療后觀察組TG、TC、LDL、HDL改善均優(yōu)于對照組(P0.05)。5.血漿纖維蛋白原:治療前兩組患者血漿纖維蛋白原(FIB)比較無明顯差異(P0.05),治療后兩組患者FIB較治療前均顯著降低(P0.01),且觀察組降低程度優(yōu)于對照組(P0.05)。6.左心射血分?jǐn)?shù)(LVEF):治療前兩組患者LVEF比較無明顯差異(P0.05),治療后兩組患者LVEF較治療前均顯著升高(P0.01),且觀察組升高程度明顯優(yōu)于對照組(P0.01)。7.運(yùn)動耐量:治療前兩組患者6分鐘步行距離及心肌耗氧量比較無明顯差異(P0.05),治療后兩組患者6分鐘步行距離較治療前顯著增加(P0.01),心肌耗氧量較治療前明顯降低(P0.01),治療后兩組間比較,觀察組6分鐘步行距離及心肌耗氧量改善均優(yōu)于對照組(P0.05)。8.生活質(zhì)量:治療前西雅圖心絞痛量表(SAQ)評分表明治療前兩組患者在軀體活動受限度(PL)、心絞痛穩(wěn)定狀態(tài)(AS)、心絞痛發(fā)作情況(AF)、治療滿意程度(TS)及疾病認(rèn)識程度(DP)等方面比較無明顯差異(P0.05),治療后兩組患者在PL、AS、AF、TS、DP方面評分均較治療前顯著提高(P0.01),且觀察組在PL、AS、AF、TS、DP改善均明顯優(yōu)于對照組(P0.01)。9.安全性指標(biāo):兩組患者治療過程中均未發(fā)生嚴(yán)重不良反應(yīng),三大常規(guī)、肝、腎功能未見明顯異常。結(jié)論:本研究證明益脈顆粒能夠改善老年氣虛血瘀型穩(wěn)定性心絞痛患者的心電圖及中醫(yī)癥候療效,調(diào)節(jié)血脂,降低血漿FIB含量,改善左心射血功能,提高運(yùn)動耐量,提高生活質(zhì)量,并且該藥在實(shí)驗(yàn)過程中并未出現(xiàn)不良反應(yīng),具有較好的安全性。
[Abstract]:Objective: to observe the clinical effect of Yimai granule in treating senile stable angina pectoris with deficiency of qi and blood stasis and its effect on the quality of life, and to explore the mechanism of action. Methods: 60 patients were randomly divided into two groups: observation group (n = 30) and control group (n = 30). The observation group was given traditional Chinese medicine Yimai granule on the basis of routine western medicine treatment, while the control group was only given routine western medicine treatment. After 4 courses of treatment, the electrocardiogram effect, TCM symptom integral, TCM symptom curative effect and blood lipid were compared between the two groups. The changes of plasma fibrinogen, left ventricular ejection fraction, exercise tolerance, quality of life and safety were analyzed statistically. The result is 1: 1. Electrocardiogram efficacy: after treatment between the two groups, the observation group electrocardiogram total effective rate was higher than the control group, the difference was statistically significant (P0.05). 2. TCM symptom integral: there was no significant difference between the two groups before treatment (P0.05). After treatment, the TCM symptom score of the two groups was significantly lower than that before treatment (P0.01), and the TCM symptom integral of the observation group was significantly lower than that of the control group (P0.01). 3. Curative effect of TCM symptom: compared with two groups after treatment, the total effective rate of TCM symptom improvement in observation group was higher than that in control group (P0.05). 4. Serum lipids: there was no significant difference in triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) between the two groups before treatment (P0.05). (P0.01), after treatment, the improvement of TGN TCL HDL in the observation group was better than that in the control group (P0.05). Plasma fibrinogen: there was no significant difference in plasma fibrinogen (FIB) between the two groups before treatment (P0.05). After treatment, the FIB of the two groups was significantly lower than that before treatment (P0.01), and the degree of decrease in the observation group was better than that in the control group (P0.05). 6. Left ventricular ejection fraction (LVEF): there was no significant difference in LVEF between the two groups before treatment (P0.05). After treatment, LVEF in both groups was significantly higher than that before treatment (P0.01), and the degree of increase in the observation group was significantly higher than that in the control group (P0.01) .7. Exercise tolerance: there was no significant difference in 6-minute walking distance and myocardial oxygen consumption between the two groups before treatment (P0.05). After treatment, the 6-minute walking distance was significantly increased (P0.01), and myocardial oxygen consumption was significantly decreased (P0.01). Comparison between the two groups after treatment, The improvement of 6-minute walking distance and myocardial oxygen consumption in the observation group was better than that in the control group (P0.05). Quality of life: before treatment, the (SAQ) score of Seattle angina scale indicated that before treatment, the two groups had satisfactory degree of (TS) and degree of understanding of disease, (DP), etc., in the stable state of (PL), angina pectoris with restricted somatic activity, (AF), treatment of stable state of angina pectoris, etc. There was no significant difference between the two groups (P0.05). After treatment, the scores of the two groups were significantly higher than those before treatment (P0.01), and the improvement of TSDP in the observation group was significantly better than that in the control group (P0.01). Safety index: there were no serious adverse reactions in both groups, and there were no obvious abnormalities in liver and kidney function. Conclusion: this study proves that Yimai granule can improve the effect of electrocardiogram and TCM syndrome in elderly patients with stable angina pectoris of Qi deficiency and blood stasis type, regulate blood lipid, decrease plasma FIB content, improve left ventricular ejection function and improve exercise tolerance. Improve the quality of life, and the drug did not appear in the experimental process of adverse reactions, with good safety.
【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
本文編號：2160239
[Abstract]:Objective: to observe the clinical effect of Yimai granule in treating senile stable angina pectoris with deficiency of qi and blood stasis and its effect on the quality of life, and to explore the mechanism of action. Methods: 60 patients were randomly divided into two groups: observation group (n = 30) and control group (n = 30). The observation group was given traditional Chinese medicine Yimai granule on the basis of routine western medicine treatment, while the control group was only given routine western medicine treatment. After 4 courses of treatment, the electrocardiogram effect, TCM symptom integral, TCM symptom curative effect and blood lipid were compared between the two groups. The changes of plasma fibrinogen, left ventricular ejection fraction, exercise tolerance, quality of life and safety were analyzed statistically. The result is 1: 1. Electrocardiogram efficacy: after treatment between the two groups, the observation group electrocardiogram total effective rate was higher than the control group, the difference was statistically significant (P0.05). 2. TCM symptom integral: there was no significant difference between the two groups before treatment (P0.05). After treatment, the TCM symptom score of the two groups was significantly lower than that before treatment (P0.01), and the TCM symptom integral of the observation group was significantly lower than that of the control group (P0.01). 3. Curative effect of TCM symptom: compared with two groups after treatment, the total effective rate of TCM symptom improvement in observation group was higher than that in control group (P0.05). 4. Serum lipids: there was no significant difference in triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) between the two groups before treatment (P0.05). (P0.01), after treatment, the improvement of TGN TCL HDL in the observation group was better than that in the control group (P0.05). Plasma fibrinogen: there was no significant difference in plasma fibrinogen (FIB) between the two groups before treatment (P0.05). After treatment, the FIB of the two groups was significantly lower than that before treatment (P0.01), and the degree of decrease in the observation group was better than that in the control group (P0.05). 6. Left ventricular ejection fraction (LVEF): there was no significant difference in LVEF between the two groups before treatment (P0.05). After treatment, LVEF in both groups was significantly higher than that before treatment (P0.01), and the degree of increase in the observation group was significantly higher than that in the control group (P0.01) .7. Exercise tolerance: there was no significant difference in 6-minute walking distance and myocardial oxygen consumption between the two groups before treatment (P0.05). After treatment, the 6-minute walking distance was significantly increased (P0.01), and myocardial oxygen consumption was significantly decreased (P0.01). Comparison between the two groups after treatment, The improvement of 6-minute walking distance and myocardial oxygen consumption in the observation group was better than that in the control group (P0.05). Quality of life: before treatment, the (SAQ) score of Seattle angina scale indicated that before treatment, the two groups had satisfactory degree of (TS) and degree of understanding of disease, (DP), etc., in the stable state of (PL), angina pectoris with restricted somatic activity, (AF), treatment of stable state of angina pectoris, etc. There was no significant difference between the two groups (P0.05). After treatment, the scores of the two groups were significantly higher than those before treatment (P0.01), and the improvement of TSDP in the observation group was significantly better than that in the control group (P0.01). Safety index: there were no serious adverse reactions in both groups, and there were no obvious abnormalities in liver and kidney function. Conclusion: this study proves that Yimai granule can improve the effect of electrocardiogram and TCM syndrome in elderly patients with stable angina pectoris of Qi deficiency and blood stasis type, regulate blood lipid, decrease plasma FIB content, improve left ventricular ejection function and improve exercise tolerance. Improve the quality of life, and the drug did not appear in the experimental process of adverse reactions, with good safety.
【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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