【作者】 胡雯青；

【导师】 陈宏珪；

【作者基本信息】 广州中医药大学 ， 中西医结合临床， 2005， 硕士

【摘要】 研究背景:透过文献研究得知充血性心力衰竭(CHF)是所有不同种类心脏病的主要并发症,是临床常见的危重症,是多数器质性心脏病几乎不可避免的结局,发病率逐年增加。充血性心力衰竭不仅威胁人类生命,还造成极高的经济成本,带给个人家庭及社会相当大的负担。 研究目的:温阳利水法治疗充血性心力衰竭的临床疗效。 研究方法:广州中医药大学第一附属医院门诊和病房病人。针对符合充血性心力衰竭诊断标准的患者50例。随机分为治疗组30例,对照组20例,两组均运用抗心衰西药治疗,基础疾病治疗用药继续使用,治疗组中药使用五苓散加减,对照组中药使用安慰剂。 研究结果:入选治疗组30例病人,12例心功能Ⅳ级,16例为Ⅲ级,2例为Ⅱ级,温阳利水法治疗14天后,10例进步2级,18例进步1级以上,无变化的2例;对照组20例病人,7例心功能Ⅳ级,10例为Ⅲ级,3例为Ⅱ级,治疗后5例进步2级,13例进步1级以上,无变化的2例。心功能分级疗效方面治疗组总有效率为93.3.%,对照组总有效率为90%,两组总有效率之比较,结果p>0.05,说明治疗组与对照组的临床疗效对比疗效相当。但两组患者自觉症状有效率比较,心悸、气促、乏力、胸闷、形寒肢冷等症状及体征紫绀,p<0.01,有极显著差异,治疗组明显优于对照组。治疗组患者体征前后对比,舒张压、心率、脉搏,p<0.01,有极显著差异;呼吸、收缩压,p<0.05,有显著性差异;但体重、LVEF无显著差异;水肿、肝脏情况、颈静脉怒张,p<0.05,差异有显著性。 结论:温阳利水法治疗充血性心力衰竭有一定疗效,尤其对于控制症状,心率、脉搏、呼吸频率降低,均有显著的疗效。更多还原

【Abstract】 Theory background: CHF is the major complication of all different kinds of heart disease via document research. It’s a common clinical dangerous disease which inevitably ends up majority organic heart disease. And the incidence of it increases year by year. CHF not only threatens human life but also causes high economy cost that brings great burden to individual family and whole society.Objective: The clinical curative effect of warming Yang and diuretic treatment for CHF. Measures: 50 patients who fit the CHF diagnosis standard from outpatient service and ward of the First Affiliated Hospital of Guangzhou University of TCM. They are divided by random into two groups which have 30 cases in remedy group and 20 cases in contrast group. Both groups are treated by anti-heart failure western medicine and basis disease remedy continues. Remedy group uses Chinese medicine- Wu-Ling-San, when the contrast group uses that of the placebo.Results: 30 cases in remedy group, 12 cases heart function are IV degree, 16 cases are III degree, and 2 cases are II degree. After treated by warming Yang and diuretic for 14 days, 10 cases made progress 2 degree, 18 cases made progressed 1 degree at least, 2 cases unchanged. 20 cases in contrast group, 7 cases heart function are IV degree, 10 cases are III degree, and 3 cases are II degree. After treated, 8 cases made progress 2 degree, 10 cases made progress 1 degree at least, 2 cases unchanged. Overall efficiency of heart function classified curative effect in remedy group is 93.3% while the contrast group is 90%. The comparison of overall efficiency in two groups the result is p>0.05. This shows that the curative effect in two groups is similar. But after comparing subjective symptoms in two groups, there are remarkable differences in symptoms of palpitations, short of breath, lack of strength, stuffy chest, feeling cold, etc; also symptoms of anoxia; p<0.01. Remedy group is obviously superior to contrast group. After comparing, body symptoms in remedy group, there are remarkable difference in diastolic pressure, heart rate, and breath; p<0.01. Those have obvious difference in systolic pressure, and breath; p<0.05. But there is no obvious difference in body weight and LVEF. There are obvious更多还原