桑芪首烏膏方對老年高血壓患者中醫(yī)體質(zhì)干預(yù)的臨床研究
發(fā)布時間：2018-09-07 16:33
【摘要】：目的:通過研究老年高血壓(肝腎不足,心脾失養(yǎng)證)患者的中醫(yī)體質(zhì)分布情況;觀察名老中醫(yī)陸家龍教授經(jīng)驗方“桑芪首烏膏方”對老年高血壓(肝腎不足,心脾失養(yǎng)證)患者的中醫(yī)證候及體質(zhì)狀態(tài)的干預(yù)作用;進一步探討辨病、辨證、辨體相結(jié)合防治老年高血壓診療模式的意義,為中醫(yī)體質(zhì)學(xué)研究中“體質(zhì)可調(diào)論”奠定理論基礎(chǔ)。方法:將符合納入標準的200例老年高血壓患者進行信息采集,填寫《中醫(yī)體質(zhì)分類與判定表》,按《中醫(yī)體質(zhì)分類與判定》標準進行體質(zhì)判定,采用隨機、對照研究方法,分為治療組100例和對照組100例,對照組采用常規(guī)口服降壓藥治療,并囑低鹽飲食、戒煙、限酒等改變不良生活方式;治療組在對照組治療的基礎(chǔ)上加用桑芪首烏膏方,療程均為28天;治療后再次填寫《中醫(yī)體質(zhì)分類與判定表》。整理前后兩次數(shù)據(jù),建立數(shù)據(jù)庫,對兩組患者治療前后的中醫(yī)證候總積分、中醫(yī)體質(zhì)轉(zhuǎn)化分的變化、血壓值、安全性指標進行對比分析。結(jié)果:1.最終病例187例,其中治療組95例,對照組92例。兩組患者在性別、年齡、病程、體質(zhì)類型分布及治療前的血壓、中醫(yī)證候總積分、中醫(yī)體質(zhì)轉(zhuǎn)化分等方面差異無統(tǒng)計學(xué)意義;2.中醫(yī)體質(zhì)分布情況顯示:187例老年高血壓(肝腎不足,心脾失養(yǎng)證)患者的中醫(yī)體質(zhì)分布為:氣虛質(zhì)32.1%、平和質(zhì)19.3%、陽虛質(zhì)16.0%、陰虛質(zhì)12.3%、痰濕質(zhì)9.6%、濕熱質(zhì)3.7%、氣郁質(zhì)3.2%、血瘀質(zhì)2.1%、特稟質(zhì)1.6%。3.“桑芪首烏膏方”治療老年高血壓臨床中醫(yī)證候總積分、治療總有效率對比研究:3.1中醫(yī)證候總積分比較治療組和對照組治療前后中醫(yī)證候總積分自身對照比較,差異均有統(tǒng)計學(xué)意義(P0.01);兩組治療28天后中醫(yī)證候總積分組間比較,治療組明顯優(yōu)于對照組(P0.01);3.2治療總有效率比較治療組總有效率為89.5%,對照組總有效率為41.3%,提示治療組的療效明顯優(yōu)于對照組(P0.01);4.中醫(yī)體質(zhì)轉(zhuǎn)化分比較治療組治療前后平和質(zhì)、氣虛質(zhì)、陽虛質(zhì)、陰虛質(zhì)、痰濕質(zhì)、氣郁質(zhì)的體質(zhì)轉(zhuǎn)化分自身對照比較,差異均有統(tǒng)計學(xué)意義(P0.05),濕熱質(zhì)的體質(zhì)轉(zhuǎn)化分差異無統(tǒng)計學(xué)意義(P0.05);對照組治療前后平和質(zhì)、氣虛質(zhì)、陽虛質(zhì)、陰虛質(zhì)、痰濕質(zhì)、濕熱質(zhì)、氣郁質(zhì)的體質(zhì)轉(zhuǎn)化分自身對照比較,差異均無統(tǒng)計學(xué)意義(P0.05);兩組患者治療后組間比較,氣虛質(zhì)的體質(zhì)轉(zhuǎn)化分差異有統(tǒng)計學(xué)意義(P0.05),平和質(zhì)、陽虛質(zhì)、陰虛質(zhì)、痰濕質(zhì)、濕熱質(zhì)、氣郁質(zhì)的體質(zhì)轉(zhuǎn)化分差異無統(tǒng)計學(xué)意義(P0.05)。5.血壓值比較兩組治療前后收縮壓、舒張壓組內(nèi)比較均無統(tǒng)計差異(P0.05);兩組治療后收縮壓、舒張壓組間比較無統(tǒng)計差異(P0.05);6.安全性指標比較兩組患者治療前后血常規(guī)、尿常規(guī)、大便常規(guī)+潛血、肝功能、腎功能、心電圖比較,差異無統(tǒng)計學(xué)意義。結(jié)論:老年高血壓(肝腎不足,心脾失養(yǎng)證)患者的體質(zhì)分布以氣虛質(zhì)、陽虛質(zhì)、陰虛質(zhì)多見,符合“以虛為主”的體質(zhì)特點;桑芪首烏膏方能有效改善老年高血壓患者的臨床癥狀,起到改善老年高血壓患者中醫(yī)體質(zhì)狀態(tài)的作用,在治療中未出現(xiàn)明顯不良反應(yīng)及毒副作用,臨床安全有效,值得進一步推廣和應(yīng)用。
[Abstract]:Objective: To study the distribution of constitution of traditional Chinese medicine (TCM) in elderly patients with hypertension (liver and kidney insufficiency, heart and spleen dystrophy syndrome), observe the intervention effect of Sangqi Shouwu paste, a famous and old TCM professor Lu Jialong's empirical prescription, on the TCM syndrome and constitution of elderly patients with hypertension (liver and kidney insufficiency, heart and spleen dystrophy syndrome). Methods: 200 elderly hypertensive patients who met the inclusion criteria were collected information, filled in the "Classification and Judgment Form of Traditional Chinese Medicine Constitution" and judged according to the "Classification and Judgment of Traditional Chinese Medicine Constitution" criteria. The treatment group was given Sangqi Shouwu ointment on the basis of the treatment of the control group, and the treatment course was 28 days. The total score of TCM syndromes, changes of TCM constitution transformation, blood pressure and safety index were compared and analyzed before and after treatment. Results: 1. 187 cases were final, 95 cases in treatment group and 92 cases in control group. There was no significant difference in blood pressure, total score of TCM syndromes and constitution transformation score of TCM before treatment. 2. The distribution of TCM constitution in 187 elderly patients with hypertension (deficiency of liver and kidney, heart and spleen dystrophy syndrome) was 32.1%, 19.3%, 16.0%, 12.3%, 9.6% of phlegm and dampness, 3.7% of dampness and heat. Qi stagnation 3.2%, blood stasis 2.1%, special temperament 1.6%. 3. "Sangqi Shouwu Plaster" in the treatment of senile hypertension clinical TCM syndrome total score, treatment of total effective rate comparative study: 3.1 TCM syndrome total score compared with the treatment group and control group before and after treatment TCM syndrome total score self-control comparison, the difference was statistically significant (P 0.01); After 8 days, the total score of TCM syndromes in the treatment group was significantly better than that in the control group (P 0.01); the total effective rate was 89.5% in the treatment group and 41.3% in the control group, suggesting that the curative effect of the treatment group was significantly better than that of the control group (P 0.01); 4. The Constitutional Transformation scores of Yin-deficiency, phlegm-dampness and Qi-depression had statistical significance (P There was no significant difference between the two groups (P 0.05). There was no significant difference in blood pressure between the two groups before and after treatment. There was no significant difference in systolic blood pressure and diastolic blood pressure between the two groups. There was no significant difference in systolic blood pressure and diastolic blood pressure between the two groups (P 0.05). 6. Safety indexes were compared between the two groups before and after treatment, including blood routine, urine routine, stool routine + Occult blood, liver function, renal function, electrocardiogram. Conclusion: There was no significant difference in elderly patients with hypertension (liver and kidney insufficiency, heart and spleen dystrophy syndrome). Sangqi Shouwu ointment can effectively improve the clinical symptoms of senile hypertension patients and improve the constitutional state of senile hypertension patients. There are no obvious adverse reactions and toxic side effects in the treatment. It should be further promoted and applied.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259
本文編號：2228806
[Abstract]:Objective: To study the distribution of constitution of traditional Chinese medicine (TCM) in elderly patients with hypertension (liver and kidney insufficiency, heart and spleen dystrophy syndrome), observe the intervention effect of Sangqi Shouwu paste, a famous and old TCM professor Lu Jialong's empirical prescription, on the TCM syndrome and constitution of elderly patients with hypertension (liver and kidney insufficiency, heart and spleen dystrophy syndrome). Methods: 200 elderly hypertensive patients who met the inclusion criteria were collected information, filled in the "Classification and Judgment Form of Traditional Chinese Medicine Constitution" and judged according to the "Classification and Judgment of Traditional Chinese Medicine Constitution" criteria. The treatment group was given Sangqi Shouwu ointment on the basis of the treatment of the control group, and the treatment course was 28 days. The total score of TCM syndromes, changes of TCM constitution transformation, blood pressure and safety index were compared and analyzed before and after treatment. Results: 1. 187 cases were final, 95 cases in treatment group and 92 cases in control group. There was no significant difference in blood pressure, total score of TCM syndromes and constitution transformation score of TCM before treatment. 2. The distribution of TCM constitution in 187 elderly patients with hypertension (deficiency of liver and kidney, heart and spleen dystrophy syndrome) was 32.1%, 19.3%, 16.0%, 12.3%, 9.6% of phlegm and dampness, 3.7% of dampness and heat. Qi stagnation 3.2%, blood stasis 2.1%, special temperament 1.6%. 3. "Sangqi Shouwu Plaster" in the treatment of senile hypertension clinical TCM syndrome total score, treatment of total effective rate comparative study: 3.1 TCM syndrome total score compared with the treatment group and control group before and after treatment TCM syndrome total score self-control comparison, the difference was statistically significant (P 0.01); After 8 days, the total score of TCM syndromes in the treatment group was significantly better than that in the control group (P 0.01); the total effective rate was 89.5% in the treatment group and 41.3% in the control group, suggesting that the curative effect of the treatment group was significantly better than that of the control group (P 0.01); 4. The Constitutional Transformation scores of Yin-deficiency, phlegm-dampness and Qi-depression had statistical significance (P There was no significant difference between the two groups (P 0.05). There was no significant difference in blood pressure between the two groups before and after treatment. There was no significant difference in systolic blood pressure and diastolic blood pressure between the two groups. There was no significant difference in systolic blood pressure and diastolic blood pressure between the two groups (P 0.05). 6. Safety indexes were compared between the two groups before and after treatment, including blood routine, urine routine, stool routine + Occult blood, liver function, renal function, electrocardiogram. Conclusion: There was no significant difference in elderly patients with hypertension (liver and kidney insufficiency, heart and spleen dystrophy syndrome). Sangqi Shouwu ointment can effectively improve the clinical symptoms of senile hypertension patients and improve the constitutional state of senile hypertension patients. There are no obvious adverse reactions and toxic side effects in the treatment. It should be further promoted and applied.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259
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