【作者】 周焱萍；

【导师】 司晓晨；

【作者基本信息】 南京中医药大学 ， 中医学， 2011， 硕士

【摘要】 目的：观察苓桂术甘汤合瓜蒌薤白半夏汤加减治疗慢性充血性心力衰竭气虚痰阻证的临床效果,根据实验数据分析探讨其疗效,以更好地指导临床治疗。方法：1.观察方法：根据对“慢性充血性心理衰竭中医临床研究,制定补气化痰法在慢性充血性心力衰竭的治疗调查表,内容包括患者姓名、性别、年龄、疾病诊断、临床表现、中医辨证、治法方药、西药用法共8项内容。根据病历资料,对基础心脏病的诊断、慢性充血性心力衰竭的诊断、心功能分级与中医辨证等进行诊断与辨证。2.治疗方法：将40例确诊为慢性充血性心力衰竭的患者进行中医辨证分型及心功能分级在西药常规治疗的基础上,加用补气化痰的中药,150m1/次,每日2次。中药制剂由江苏省中医院煎药房生产。西药常规治疗具体药物及剂量为：呋塞米20-40mg,每日1-3次；螺内酯20-40mg,每日1-3次；盐酸贝那普利5-10mg,每日1-2次,美托洛尔缓释片27.5mg-47.5mg,每日2次,地高辛0.125mg,每日1次。必要时可酌情应用速尿、西地兰、酚妥拉明、单硝酸异山梨酯等药物,以及对症支持治疗,不用任何中药煎剂。2组均观察治疗14d。3.统计方法：统计全部病例进行分析,观察疗效,用SPSS17.0统计软件进行统计学处理。计数资料用X2检验,计量资料组间比较用t检验。结果：治疗组在西医基础治疗的基础上加用补气化痰法,可明显改善治疗组心功能情况,总有效率为95%,显效率40%,对照组总有效率为75%,显效率25%。治疗组与对照组相比,左室射血分数及心搏出量的改善程度比对照组高,BNP水平比对照组明显降低,有显著性差异(P<0.05)。结论：1.运用补气化痰法治疗气虚痰阻型心衰比单用西药治疗效果明显。更多还原

【Abstract】 Objective:To observ the clinical effect of mixture of LingGuiZhuGan formula and GuaLouXieBaiBanXia formula for chronic congestive heart failure of QiXuTanZu syndrome,according to the experimental data to analysis its effect, to better guide clinical treatment.Methods:1. Observation method:according to cardiovascular and chronic congestive heart failure of TCM clinical research,draft the treatment questionnaire of BuQiHuaTan methods for chronic congestive heart failure, including patient’s name, sex, age, disease diagnosis, clinical manifestation, TCM syndrome differentiation, treatment of formulas, western medicine usage eight content. According to the medical records of basic heart disease, the diagnosis, congestive heart failure diagnosis, cardiac function such as grading and TCM syndrome differentiation diagnosis and syndrome differentiation.2. Treatment method:40 cases of chronic heart failure patients diagnosed TCM syndrome differentiations grading and cardiac function in western medicine based on routine therapy, add with the Chinese traditional medicine of BuQiHuaTan 150ml/times,2 times a day. TCM hospital by jiangsu province JianYao room production. Western medicine treatment of specific drugs and regular dose is of drugs frusemide 20～40mg,1～3 times ter day;Screw Irolang 20～40mg,1～3 times ter day; Benazepril 5～10mg,1～2 times ter day, digoxin 0.125 mg,1 times ter day. When necessary, can use Frusemide, Cedi-lanid, Regilin drugs andlsosorbide Mononitrate etc, Symptomatic treatment without any treatment of symptomatic support traditional Chinese medicine decoction. Two groups are observed treatment for 14 days.3. Statistical methods:statistical analysis, observe all cases SPSS17.0 statistical software with curative effect, the statistical processing.Counting material use X 2 inspection, measuring data set with t test is compared between.Results:Group based in western medicine treatment combined with the basis of BuQiHuaTan method can obviously improve the cardiac function,the total effective rate of 95%, significant efficiency 40%, control the total effective rate was 75%, significant efficiency by 25%. Compared with control group, left ventricular ejection fraction and heartbeat out amount of improve degree high than the control group, BNP levels significantly lower than the control group, there are significant difference (P<0.05).Conclusion: 1.It is more effective by use method of BuQiHuaTan decotion than western medicine therapy alone in chronic congestive heart failure.更多还原