本文選題：化痰活血通脈湯　切入點(diǎn)：冠心病　出處：《成都中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：本研究旨在觀察化痰活血通脈湯治療冠心病穩(wěn)定型心絞痛(痰瘀互結(jié)型)的臨床療效并探討其作用機(jī)理。方法：納入2015年3月至2016年2月成都中醫(yī)藥大學(xué)附屬醫(yī)院心血管內(nèi)科門(mén)診和住院部收集的70例西醫(yī)符合冠心病穩(wěn)定型心絞痛診斷、中醫(yī)符合胸痹(痰瘀互結(jié)型)的患者,采用隨機(jī)數(shù)字查表法將70例病人按1：1隨機(jī)分為治療組和對(duì)照組,每組35例。兩組患者同時(shí)給予西藥基礎(chǔ)治療(拜阿司匹林100mg口服一天一次,單硝酸異山梨酯緩釋片60mg口服一天一次,美托洛爾緩釋片23.75mg一天一次,阿托伐他汀鈣片20mg晚上口服一天一次),治療組在對(duì)照組西藥治療的基礎(chǔ)上加服化痰活血通脈湯劑。4周后對(duì)兩組患者在治療前后的中醫(yī)證候療效、心絞痛程度、心電圖療效、血脂、炎癥反應(yīng)指標(biāo)(CRP)、血液流變學(xué)等指標(biāo)進(jìn)行比較。結(jié)果：治療組冠心病心絞痛的總有效率為97.1%,中醫(yī)證候總有效率為94.3%,心電圖療效總有效率為85.7%；對(duì)照組冠心病心絞痛的總有效率為90.0%,中醫(yī)證候總有效率為86.7%,心電圖療效總有效率為76.7%。兩組治療后均能改善或消除心絞痛表現(xiàn)及臨床癥狀,減少中醫(yī)證候積分,改善心電圖ST段及T波異常情況,但比較兩組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。兩組治療后均能明顯改善血液流變學(xué)各項(xiàng)指標(biāo),其中治療組在改善全血粘度、紅細(xì)胞聚集指數(shù)等方面優(yōu)于對(duì)照組(P0.05)；同時(shí),兩組均可顯著改善血脂代謝情況,在降低甘油三酯(TG)方面,治療組明顯優(yōu)于對(duì)照組(P0.05)。提示：化痰活血通脈湯治療冠心病穩(wěn)定型心絞痛(痰瘀互結(jié)型)療效優(yōu)于對(duì)照組,觀察期間兩組均未發(fā)現(xiàn)明顯不良反應(yīng)。結(jié)論：臨床觀察示,化痰活血通脈湯治療痰瘀互結(jié)型冠心病穩(wěn)定型心絞痛有較好的療效,未見(jiàn)明顯不良反應(yīng)。
[Abstract]:Objective: to observe the clinical effect of Huatan Huoxue Tongmai decoction (Huatan Huoxue Tongmai decoction) in the treatment of stable angina pectoris (phlegm and blood stasis type) of coronary heart disease. Methods: from March 2015 to February 2016, Chengdu University of traditional Chinese Medicine was included in the study. Seventy cases of western medicine collected from the outpatient and inpatient departments of the Department of Cardiovascular Medicine of affiliated Hospital were in accordance with the diagnosis of stable angina pectoris of coronary heart disease. In accordance with chest obstruction (phlegm and blood stasis), 70 patients were randomly divided into treatment group and control group by 1:1. 35 patients in each group were treated with basic western medicine (Aspirin 100mg once a day, isosorbide mononitrate sustained release tablet 60mg once a day, metoprolol sustained release tablet 23.75mg once a day. Atto vastatin calcium tablet 20mg was given orally once a day in the evening. The treatment group was treated with Huatan Huoxue Tongmai decoction for 4 weeks on the basis of western medicine in the control group. After the treatment, the TCM syndromes, the degree of angina pectoris, and the electrocardiogram of the two groups were treated. Blood lipid, Results: the total effective rate of angina pectoris of coronary heart disease in the treatment group was 97.1, the total effective rate of TCM syndrome was 94.3 and the total effective rate of electrocardiogram was 85.7 in the control group. The total effective rate was 90.0, the total effective rate of TCM syndrome was 86.7, the total effective rate of electrocardiogram was 76.70.After treatment, both groups could improve or eliminate the symptoms of angina pectoris and clinical symptoms. To reduce TCM syndromes integral and improve St segment and T wave abnormality of electrocardiogram, but there was no significant difference between the two groups (P 0.05). All the indexes of hemorheology were significantly improved in the treatment group, and the whole blood viscosity was improved in the treatment group. The erythrocyte aggregation index was better than that of the control group (P 0.05), and both groups could significantly improve the metabolism of blood lipids and reduce the TGs of triglyceride. The therapeutic effect of Huatan Huoxue Tongmai decoction in treating stable angina pectoris of coronary heart disease (phlegm and blood stasis type) was better than that in control group, and no obvious adverse reactions were found in both groups during the observation period. Conclusion: clinical observation shows that the therapeutic effect of Huatan Huoxue Tongmai decoction is better than that of control group. Huatan Huoxue Tongmai decoction (Huatan Huoxue Tongmai decoction) has good curative effect on stable angina pectoris of coronary heart disease.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R259

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