【摘要】：目的：觀察通脈養(yǎng)心丸治療冠心病穩(wěn)定型心絞痛(氣陰兩虛型)患者的臨床療效及對BNP、hs-cTnT水平的影響,進一步評價其有效性,并初步探討其對心肌損傷修復(fù)作用的影響,為擴大臨床應(yīng)用提供療效性依據(jù)。方法：選取黑龍江中醫(yī)藥大學(xué)附屬第一醫(yī)院心血管二科和心血管四科門診患者中符合標(biāo)準(zhǔn)及簽署知情同意書的患者20例,采用隨機、雙盲、安慰劑對照的研究方法,將入選患者按1：1隨機分為試驗組和對照組,試驗組予以西醫(yī)標(biāo)準(zhǔn)治療+通脈養(yǎng)心丸,每次40粒,每日2次；對照組予以西醫(yī)標(biāo)準(zhǔn)治療+安慰劑,每次40粒,每日2次；療程均為12周。觀察治療前、治療后的中醫(yī)證候變化、心電圖變化及BNP、hs-cTnT水平的變化。結(jié)果：1.中醫(yī)證候方面：治療后,兩組患者的中醫(yī)證候積分均較治療前明顯下降,組內(nèi)的差異具有統(tǒng)計學(xué)意義(p0.05)；試驗組的總積分下降程度明顯優(yōu)于對照組,兩組間的差異有統(tǒng)計學(xué)意義(p0.05)。治療后,試驗組的中醫(yī)證候總有效率為87.5%,對照組的總有效率為33.3%,兩組間的療效差異具有統(tǒng)計學(xué)意義(p0.05)。2.心電圖方面：治療后,試驗組的心電圖總有效率為75.0%,對照組的心電圖總有效率為33.3%,試驗組明顯優(yōu)于對照組,兩組間的療效差異具有統(tǒng)計學(xué)意義(p0.05)。3.BNP和hs-cTnT方面：治療后,兩組患者的BNP較治療前均未見明顯改變,組內(nèi)的差異無統(tǒng)計學(xué)意義(p0.05),試驗組與對照組相比較,兩組間的差異無統(tǒng)計學(xué)意義(p0.05)。治療后,兩組患者的hs-cTnT較治療前均未見明顯改變,組內(nèi)的差異無統(tǒng)計學(xué)意義(p0.05),試驗組與對照組相比較,兩組間的差異無統(tǒng)計學(xué)意義(p0.05)。結(jié)論：1.通脈養(yǎng)心丸可明顯改善冠心病穩(wěn)定型心絞痛(氣陰兩虛型)患者的中醫(yī)證候。2.通脈養(yǎng)心丸對冠心病穩(wěn)定型心絞痛(氣陰兩虛型)患者心電圖的缺血性改變具有明顯的改善作用。3.通脈養(yǎng)心丸對冠心病穩(wěn)定型心絞痛(氣陰兩虛型)患者的BNP、hs-cTnT的變化未見明顯影響。
[Abstract]:Objective: to observe the clinical effect of Tongmai Yangxin pill (Tongmai Yangxin pill) on stable angina pectoris (deficiency of Qi and Yin) of coronary heart disease (CHD) and its effect on BNP,hs-cTnT level, to further evaluate its effectiveness, and to explore the effect of Tongmai Yangxin pill on the repair of myocardial injury. To provide curative effect basis for expanding clinical application. Methods: twenty outpatients from the second and fourth departments of Cardiovascular Department and Cardiovascular Department of the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine were selected and 20 patients who signed the informed consent were studied by randomized, double-blind, placebo controlled study. The patients were randomly divided into experimental group and control group according to 1:1. The experimental group was treated with western medicine standard Tongmai Yangxin pills, 40 pills each time, twice a day; The control group was treated with western medicine standard placebo, 40 tablets twice a day, the course of treatment was 12 weeks. The changes of TCM syndromes, electrocardiogram and BNP,hs-cTnT level before and after treatment were observed. Results: 1. TCM syndromes: after treatment, the scores of TCM syndromes in the two groups were significantly lower than those before treatment, and the differences in the two groups were statistically significant (p0.05). The decrease of the total score in the test group was significantly better than that in the control group, and the difference between the two groups was statistically significant (p0.05). After treatment, the total effective rate of TCM syndromes in the experimental group was 87.5 and that in the control group was 33.3.The difference between the two groups was statistically significant (p0.05). 2. Electrocardiogram: after treatment, the total effective rate of electrocardiogram in the experimental group was 75.0, and that in the control group was 33.30.The experimental group was obviously superior to the control group. The difference of curative effect between the two groups was statistically significant (p0.05). 3.BNP and hs-cTnT: after treatment, the BNP of the two groups had no significant change compared with that before treatment, and there was no significant difference between the two groups (p0.05). There was no significant difference between the two groups compared with the control group (p 0.05). After treatment, there was no significant change in hs-cTnT between the two groups. There was no significant difference between the two groups (p0. 05), and there was no significant difference between the two groups (p0. 05). Conclusion 1. Tongmai Yangxin pills can obviously improve the TCM syndromes of patients with stable angina pectoris of coronary heart disease (deficiency of Qi and Yin). 2. 2. Tongmai Yangxin pills can improve the ischemic changes of ECG in patients with stable angina pectoris of coronary heart disease (deficiency of both qi and yin). 3. Tongmai Yangxin pill had no obvious effect on BNP,hs-cTnT in patients with stable angina pectoris of coronary heart disease (deficiency of Qi and Yin).
【學(xué)位授予單位】：黑龍江中醫(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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