【摘要】：目的:本課題通過臨床研究,初步評(píng)價(jià)活血通脈方對(duì)瘀阻心脈型老年房顫的臨床療效及安全性。方法:將符合納入標(biāo)準(zhǔn)的60例已確診為瘀阻心脈型老年房顫患者,隨機(jī)分為兩組:治療組和對(duì)照組各30例。對(duì)照組:晨起口服華法林片3mg,日一次,治療組:在口服華法林的基礎(chǔ)上加服活血通脈方,日一劑。兩組療程均為14天一療程。對(duì)兩組患者治療前后中醫(yī)證候、安全性等相關(guān)指標(biāo)的變化及臨床出血事件進(jìn)行觀察比較并總結(jié)分析。結(jié)果:1.治療一療程后治療組中醫(yī)綜合證候積分低于對(duì)照組,治療組和對(duì)照組的總有效率分別為93.33%、66.67%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2.治療一療程后兩組患者中醫(yī)證候總積分前后進(jìn)行比較均差異有統(tǒng)計(jì)學(xué)意義(P0.01)。3.治療一療程后對(duì)兩組患者治療后的中醫(yī)證候積分進(jìn)行比較差異具有統(tǒng)計(jì)學(xué)意義(P0.05),說明治療后治療組在整體癥狀改善方面明顯優(yōu)于對(duì)照組。4.治療一療程后對(duì)兩組患者各單項(xiàng)癥狀積分均值進(jìn)行比較,治療組在改善心悸、胸悶、氣短、乏力癥狀方面均明顯優(yōu)于對(duì)照組(P0.05)。5.治療一療程后兩組患者治療前和治療后的PT、APTT、INR相比較,均在治療后優(yōu)于治療前(P0.05),治療組在PT、APTT方面優(yōu)于對(duì)照組(P0.05)。6.治療組與對(duì)照組均未發(fā)現(xiàn)明顯的毒副反應(yīng),兩組治療前后,血常規(guī)、尿常規(guī)、糞便常規(guī)加糞便隱血,肝腎功能、心電圖等方面均無顯著差異。兩組患者在觀察期間都沒有出現(xiàn)與房顫相關(guān)性血栓栓塞事件和嚴(yán)重出血事件。結(jié)論:活血通脈方對(duì)老年心房顫動(dòng)(瘀阻心脈型)的治療取得了很好的臨床療效,且安全未出現(xiàn)毒副反應(yīng)。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of Huoxue Tongmai recipe (Huoxue Tongmai recipe) in the treatment of senile atrial fibrillation with stasis and blockage of heart vein by clinical study. Methods: 60 elderly patients with atrial fibrillation were divided into two groups randomly: treatment group (n = 30) and control group (n = 30). Control group: warfarin tablets 3 mg, once a day, treatment group: on the basis of oral warfarin plus Huoxue Tongmai prescription, a daily dose. The course of treatment in both groups was 14 days a course. Two groups of patients before and after treatment of TCM syndrome, safety and other related indicators of changes and clinical bleeding events were observed and compared and summarized and analyzed. Results: 1. The total effective rate of the treatment group and the control group were 93.33% and 66.67%, respectively. The difference between the two groups was statistically significant (P0.05). 2. The total effective rate of the treatment group and the control group were 93.33% and 66.67% respectively (P0.05). After one course of treatment, the total scores of TCM syndromes between the two groups were significantly different before and after treatment (P0.01). After one course of treatment, the scores of TCM syndromes between the two groups were significantly different (P0.05), indicating that the overall symptoms of the treatment group were significantly better than that of the control group. 4. After one course of treatment, the mean scores of each single symptom in the two groups were compared. The treatment group was better than the control group in improving palpitation, chest tightness, shortness of breath and fatigue symptoms (P0.05). After one course of treatment, the PT,APTT,INR of the two groups was better than that of the control group before and after treatment (P0.05), and the treatment group was superior to the control group in PT,APTT (P0.05). No obvious toxic and side effects were found between the two groups. There were no significant differences in blood routine, urine routine, stool routine plus fecal occult blood, liver and kidney function and electrocardiogram between the two groups before and after treatment. No atrial fibrillation-associated thromboembolism and severe bleeding were observed in both groups. Conclusion: Huoxue Tongmai recipe has achieved good clinical effect in the treatment of senile atrial fibrillation (stagnation of heart vein type), and there is no toxic and side effect.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

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