【摘要】：目的:觀察參桂護(hù)心湯化裁治療射血分?jǐn)?shù)保留心力衰竭(HFpEF)(心陽(yáng)不振型)患者的臨床療效,為中醫(yī)臨床治療提供一定的思路。方法:入選患者為2016年1月～2016年12月期間在黑龍江中醫(yī)藥大學(xué)附屬第一醫(yī)院心內(nèi)科門(mén)診就診的心陽(yáng)不振型射血分?jǐn)?shù)保留心力衰竭患者64例,運(yùn)用隨機(jī)方法分入治療組以及對(duì)照組,每組32例。對(duì)照組應(yīng)用常規(guī)西藥治療,治療組則在對(duì)照組治療基礎(chǔ)上聯(lián)合參桂護(hù)心湯化裁進(jìn)行治療,療程為8周。其中治療組30例完成研究觀察,對(duì)照組29例完成研究觀察。比較治療前后心功能分級(jí)、中醫(yī)證候積分、血BNP、Hcy水平以及超聲心動(dòng)圖指標(biāo)(e',E/e',LVMI)。結(jié)果:(1)心功能分級(jí)療效:對(duì)照組總體有效率為65.52%,治療組總體有效率為86.67%;2組間進(jìn)行比較,具有顯著統(tǒng)計(jì)學(xué)差異(P0.05),治療組改善心功能分級(jí)的療效優(yōu)于對(duì)照組。(2)中醫(yī)證候積分:經(jīng)治療后2組積分均下降(P0.01),治療組比對(duì)照組降低積分更明顯,具有顯著統(tǒng)計(jì)學(xué)差異(P0.05)。對(duì)照組總有效率為65.52%,治療組總有效率為90.00%;組間比較具有極顯著統(tǒng)計(jì)學(xué)差異(P0.01),治療組改善中醫(yī)證候的效果更優(yōu)。(3)Hcy及BNP水平:經(jīng)治療后2組Hcy及BNP水平均較前下降(P0.01),組間比較,治療組降低Hcy及BNP水平的效果更優(yōu),具有極顯著統(tǒng)計(jì)學(xué)差異(P0.01)。(4)超聲心動(dòng)圖指標(biāo):2組治療前后e',E/e',LVMI進(jìn)行比較,指標(biāo)均有改善(P0.01),對(duì)治療后e'及E/e'進(jìn)行組間比較,具有顯著統(tǒng)計(jì)學(xué)差異(P0.05),對(duì)治療后LVMI進(jìn)行組間比較,無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),總體來(lái)說(shuō),治療組改善心臟舒張功能的效果更佳。結(jié)論:(1)參桂護(hù)心湯化裁可改善HFpEF(心陽(yáng)不振型)患者的心衰臨床癥狀及中醫(yī)證候。(2)參桂護(hù)心湯化裁可降低HFpEF(心陽(yáng)不振型)患者的Hcy及BNP水平。(3)參桂護(hù)心湯化裁可改善HFpEF(心陽(yáng)不振型)患者的心臟舒張功能。
[Abstract]:Objective: to observe the clinical effect of Shengui Huaxin decoction in the treatment of (HFpEF) (patients with heart failure with ejection fraction retention (EF), and to provide some ideas for the clinical treatment of traditional Chinese medicine (TCM). Methods: from January 2016 to December 2016, 64 patients with heart failure were enrolled in the outpatient Department of Cardiology, the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine. The patients in each group were randomly divided into treatment group (n = 32) and control group (n = 32). The control group was treated with conventional western medicine, while the treatment group was treated with Shengui Huaxin decoction on the basis of the control group. The course of treatment was 8 weeks. Among them, 30 cases in the treatment group and 29 cases in the control group completed the study observation. The cardiac function grade, TCM syndrome score, blood BNP,Hcy level and echocardiography indexes were compared before and after treatment. Results: (1) the overall effective rate was 65.52% in the control group and 86.67% in the treatment group. There was significant difference between the two groups (P 0.05). The curative effect of the treatment group on improving cardiac function grade was better than that of the control group. (2) TCM syndrome score: after treatment, the scores of the two groups decreased (P 0.01). Compared with the control group, the treatment group decreased the score more significantly, with significant difference (P 0.05). The total effective rate was 65.52% in the control group and 90.00% in the treatment group. There was significant difference between the two groups (P 0.01), and the effect of the treatment group on improving TCM syndromes was better. (3) the levels of Hcy and BNP: after treatment, the levels of Hcy and BNP in the two groups were lower than those before treatment (P 0.01), and the levels of Hcy and BNP in the treatment group were lower than those before treatment. The effect of reducing Hcy and BNP levels in the treatment group was better than that in the treatment group, and there was significant difference between the two groups (P 0.01). (4). Before and after treatment, the indexes of E, E and LVMI in the two groups were improved (P 0.01), and there was a significant difference between the two groups before and after treatment (P 0.01). There was significant difference between the two groups after treatment (P 0.05). There was no significant difference in LVMI between the two groups after treatment (P 0.05). In general, there was no significant difference between the two groups (P 0.05), and there was no significant difference between the two groups after treatment (P 0.05). The effect of treatment group on improving cardiac diastolic function was better. Conclusion: (1) Shengui Huaxin decoction can improve the clinical symptoms and TCM syndromes of HFpEF patients with heart failure. (2) Shengui Huxin decoction can reduce the levels of Hcy and BNP in HFpEF patients. (2) Shengui Huxin decoction can reduce the levels of Hcy and BNP in patients with Xinyang. ( 3) Shengui Huxin decoction can improve the diastolic function of HFpEF patients.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 左易霞;范晉奇;殷躍輝;;射血分?jǐn)?shù)保留的心力衰竭新進(jìn)展[J];心血管病學(xué)進(jìn)展;2017年01期

2 趙芳;王杰敏;楊秀花;王杰超;盧旭東;郭曉平;;依那普利或卡托普利聯(lián)合螺內(nèi)酯治療舒張性心力衰竭的臨床對(duì)照研究[J];中西醫(yī)結(jié)合心腦血管病雜志;2016年24期

3 魏琳萍;;芪藶強(qiáng)心膠囊聯(lián)合曲美他嗪片治療冠心病舒張性心力衰竭的療效研究[J];中華全科醫(yī)學(xué);2016年12期

4 柴坷;王華;楊杰孚;;射血分?jǐn)?shù)保留性心力衰竭的病理生理機(jī)制和治療進(jìn)展[J];中國(guó)循環(huán)雜志;2016年09期

5 韓永燕;劉永建;南榮霞;王維展;肖青勉;;丹參川芎嗪注射液聯(lián)合貝那普利治療射血分?jǐn)?shù)保留的心力衰竭療效觀察[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2016年16期

6 李緒玲;仉曉紅;李虹;尉若川;;超聲心動(dòng)圖參數(shù)對(duì)單純左室舒張性心衰的療效觀察[J];醫(yī)學(xué)影像學(xué)雜志;2016年05期

7 高淑賢;賈辛未;趙文萍;;射血分?jǐn)?shù)保留心力衰竭診療進(jìn)展[J];醫(yī)學(xué)研究與教育;2016年02期

8 李春雷;劉培晶;;舒張性心力衰竭左房容積指數(shù)和血清腦鈉肽的相關(guān)性研究[J];中國(guó)循證心血管醫(yī)學(xué)雜志;2016年01期

9 黃黎英;章琴鶯;包斐豐;朱小紅;滿景華;;黃芪生脈飲與倍他樂(lè)克聯(lián)合治療舒張性心力衰竭臨床觀察[J];新中醫(yī);2016年01期

10 李娟;王如鋒;楊莉;王崢濤;;三七皂苷類成分及對(duì)心血管作用的研究進(jìn)展[J];中國(guó)中藥雜志;2015年17期

，

本文編號(hào)：2481265