中藥復(fù)方對緩慢性心律失常患者血流動力學(xué)影響及生活質(zhì)量評價
發(fā)布時間：2018-10-08 08:57
【摘要】：目的:通過前瞻性隊列研究的方法,基于溫補心腎、活血化瘀治療緩慢性心律失常,對中藥復(fù)方治療緩慢性心律失常的效療進(jìn)行觀察分析,探討其療效,及應(yīng)用超聲評價口服中藥復(fù)方后血流動力學(xué)的改變,應(yīng)用簡明健康狀況調(diào)查問卷(SF-36量表)評價其生活療量的改變。材料與方法:于2015年12月至2016年02月期間通過醫(yī)院招募受試者,其中緩慢性心律失常(未接受治療)患者40例(隊列一),起搏器植入術(shù)后患者80例,隨機分成兩組,每組40例(隊列二、隊列三)。其中隊列一與隊列三給予參仙升脈口服液,療程為4周。三組均需記錄患者的年齡、性別及是否伴有腦血管病、冠心病、糖尿病等基線水平。通過簡明健康狀況調(diào)查問卷(SF-36量表)問卷對生活質(zhì)量改善評分。測定治療前后兩組患者的收縮末期容積(LVESV)、左室舒張末期容積(LVEDV)、左室射血分?jǐn)?shù)(LVEF)、每搏輸出量(SV)、每分輸出量(CO)及縮期峰值血流速度(AV)觀察其變化,觀察臨床癥狀改善情況。通過統(tǒng)計學(xué)方法分析三組在年齡、性別、是否伴有腦血管病、冠心病、糖尿病等基線水平上是否存在差異性,三組在治療前后血流動力學(xué)改變對比,治療前后臨床癥狀改善情況對比。結(jié)果:治療組及對照組在年齡、性別、是否伴有腦血管病、冠心病、糖尿病等基線水平的病例數(shù)上統(tǒng)計學(xué)無差異(P0.05)。隊列一治療0周和4周的生活質(zhì)量及超聲指標(biāo)均有明顯改變且具有統(tǒng)計學(xué)意義(P0.05);隊列二與隊列三在治療0周時生活質(zhì)量及超聲無明顯差異不具有統(tǒng)計學(xué)意義(P0.05);隊列三治療0周和4周的生活質(zhì)量及超聲指標(biāo)均有明顯改變且具有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:心腎陽虛、血脈瘀阻是緩慢性心律失常的主要病機特點及證候特征,通過簡明健康狀況調(diào)查問卷(SF-36量表)分析比較發(fā)現(xiàn)中藥聯(lián)合起搏器組的生活質(zhì)量改善情況優(yōu)于起搏器組。中藥復(fù)方治療緩慢性心律失常療效顯著可改善患者臨床癥狀及血流動力學(xué)是未達(dá)到起搏器治療標(biāo)準(zhǔn)或不愿安裝起搏器的緩慢性心律失常首選治療藥物。目前對于起搏器術(shù)后聯(lián)合中藥治療的研究較少,本研究證明參仙升脈口服液對于接受起搏器治療后患者的臨床癥狀及血流動力學(xué)有優(yōu)化作用。
[Abstract]:Objective: based on the prospective cohort study, based on warming the heart and kidney, activating blood circulation and removing blood stasis to treat bradyarrhythmia, we observed and analyzed the effect of traditional Chinese medicine on treating bradyarrhythmia, and discussed its curative effect. The changes of hemodynamics after oral Chinese medicine compound were evaluated by ultrasound, and the changes of life therapy quantity were evaluated by the brief health status questionnaire (SF-36). Materials and methods: from December 2015 to February 2016, 40 patients with bradyarrhythmia (untreated) and 80 patients with pacemaker implantation were randomly divided into two groups. There were 40 cases in each group (queue two, three). Queue 1 and queue 3 were given Shenxian Shengmai oral liquid for 4 weeks. Age, sex and baseline levels of cerebrovascular disease, coronary heart disease and diabetes were recorded in all three groups. The quality of life (QOL) was evaluated by the brief Health status questionnaire (SF-36). End systolic volume (LVESV),) left ventricular end-diastolic volume (LVEDV),) left ventricular ejection fraction (LVEF),) left ventricular ejection fraction (CO) and peak systolic velocity (AV) were measured before and after treatment. The differences in baseline levels of age, sex, cerebrovascular disease, coronary heart disease and diabetes were analyzed by statistical method. The hemodynamic changes of the three groups before and after treatment were compared. Comparison of the improvement of clinical symptoms before and after treatment. Results: there was no statistical difference between the treatment group and the control group in terms of age, sex, whether accompanied by cerebrovascular disease, coronary heart disease, diabetes and other baseline cases (P0.05). The quality of life and ultrasound were significantly changed at 0 and 4 weeks after cohort 1 treatment (P0.05), but there was no significant difference in QOL and ultrasound between cohort 2 and cohort 3 at 0 weeks (P0.05). The quality of life and ultrasound were significantly changed at 0 and 4 weeks after treatment (P0.05). Conclusion: deficiency of heart and kidney yang and blood stasis are the main pathogenesis and syndromes of bradyarrhythmia. The quality of life in the pacemaker group was better than that in the pacemaker group through the brief health status questionnaire (SF-36). The curative effect of traditional Chinese medicine on bradyarrhythmia can improve the clinical symptoms and hemodynamics of patients. It is the first choice to treat slow arrhythmias that do not meet the standard of pacemaker therapy or do not want to install pacemakers. At present, there is little research on pacemaker combined with traditional Chinese medicine treatment. This study proves that Shenxianshengmai oral liquid can optimize the clinical symptoms and hemodynamics of patients after pacemaker therapy.
【學(xué)位授予單位】：遼寧中醫(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：2256174
[Abstract]:Objective: based on the prospective cohort study, based on warming the heart and kidney, activating blood circulation and removing blood stasis to treat bradyarrhythmia, we observed and analyzed the effect of traditional Chinese medicine on treating bradyarrhythmia, and discussed its curative effect. The changes of hemodynamics after oral Chinese medicine compound were evaluated by ultrasound, and the changes of life therapy quantity were evaluated by the brief health status questionnaire (SF-36). Materials and methods: from December 2015 to February 2016, 40 patients with bradyarrhythmia (untreated) and 80 patients with pacemaker implantation were randomly divided into two groups. There were 40 cases in each group (queue two, three). Queue 1 and queue 3 were given Shenxian Shengmai oral liquid for 4 weeks. Age, sex and baseline levels of cerebrovascular disease, coronary heart disease and diabetes were recorded in all three groups. The quality of life (QOL) was evaluated by the brief Health status questionnaire (SF-36). End systolic volume (LVESV),) left ventricular end-diastolic volume (LVEDV),) left ventricular ejection fraction (LVEF),) left ventricular ejection fraction (CO) and peak systolic velocity (AV) were measured before and after treatment. The differences in baseline levels of age, sex, cerebrovascular disease, coronary heart disease and diabetes were analyzed by statistical method. The hemodynamic changes of the three groups before and after treatment were compared. Comparison of the improvement of clinical symptoms before and after treatment. Results: there was no statistical difference between the treatment group and the control group in terms of age, sex, whether accompanied by cerebrovascular disease, coronary heart disease, diabetes and other baseline cases (P0.05). The quality of life and ultrasound were significantly changed at 0 and 4 weeks after cohort 1 treatment (P0.05), but there was no significant difference in QOL and ultrasound between cohort 2 and cohort 3 at 0 weeks (P0.05). The quality of life and ultrasound were significantly changed at 0 and 4 weeks after treatment (P0.05). Conclusion: deficiency of heart and kidney yang and blood stasis are the main pathogenesis and syndromes of bradyarrhythmia. The quality of life in the pacemaker group was better than that in the pacemaker group through the brief health status questionnaire (SF-36). The curative effect of traditional Chinese medicine on bradyarrhythmia can improve the clinical symptoms and hemodynamics of patients. It is the first choice to treat slow arrhythmias that do not meet the standard of pacemaker therapy or do not want to install pacemakers. At present, there is little research on pacemaker combined with traditional Chinese medicine treatment. This study proves that Shenxianshengmai oral liquid can optimize the clinical symptoms and hemodynamics of patients after pacemaker therapy.
【學(xué)位授予單位】：遼寧中醫(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：2256174
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