镇悸养心汤加减治疗冠心病室性期前收缩气血两虚证的临床观察与研究
|
摘要
目的:观察镇悸养心汤加减对冠心病室性期前收缩(中医辨证属气血两虚证)的疗效,并与稳心颗粒做对照。
方法:将60名患者随机分为治疗组和对照组,治疗组口服镇悸养心汤加减每日一剂,水煎取汁300ml,早晚分服:对照组口服稳心颗粒(山东步长制药有限公司生产)每次1袋,日三次,冲服。观察并记录两组患者症状、体征、心电图及早搏次数变化情况。治疗4周为一个疗程。观察结束后将数据进行统计分析,计数资料用x~2检验,计量资料用t检验。
结果:1.临床综合疗效比较:治疗组总有效率86.67%,对照组总有效率66.67%,经统计学分析有差异(P＜0.05),治疗组优于对照组。2.中医证候疗效比较:治疗组总有效率96.67%,对照组总有效率76.67%,经统计学分析有差异(P＜0.05),治疗组优于对照组。3.单个症状疗效比较:在对于心悸、胸闷气短、乏力、失眠多梦、头晕眼花症状改善方面(P＜0.05),治疗组疗效优于对照组。而对于神疲懒言、自汗、面色淡白症状的改善方面(P＞0.05),两组无明显差异。4.心电图疗效比较:治疗组有效率46.67%,对照组有效率53.33%,经统计学分析无差异(P＞0.05),两组药物对心电图的改变相似。5.24小时动态心电图疗效比较:治疗组总有效率83.33%;对照组总有效率56.67%。经统计学分析有差异(P＜0.05),治疗组优于对照组。6.室早次数(次/24小时)疗效比较:两组药物治疗前后比较均能减少室早次数,两组治疗前后室早次数差值比较,经统计学分析有差异(P＜0.05),治疗组优于对照组。7.不良反应:治疗组和对照组均无明显不良反应。
结论:镇悸养心汤加减治疗冠心病室性期前收缩疗效确切、安全,优于稳心颗粒组。
Objective: To observe the curative effect of ZhenJiYangXin soup to add and subtract in treating premature ventricular beats of coronary heart disease , and compare with Wenxin grains.
Methods: To averagely randomize sixty patients to treatment group and control group. The treatment group was treated with ZhenJiYangXin soup one dose daily, decocted in water for oral dose, and taken orally after breakfast and supper respectively. and control group Wenxin grains 1bag, t.i.d. Observe and record all the patients symptoms,the various syndromes,ECG and premature ventricular beats times. One period of treatment is four weeks.After four weeks, we analyse the data.
Results: 1. Clinical comprehensive curative effect comparison: The treatment group's total effective rate was 86.67% , and the control group's total effective rate was 66.67% . Analyzing the efficacy statistically of the two groups, there were significant differences (P < 0.05).The treatment group is better than the control group . 2.Assess the efficiency of the various symptoms: In the treatment group, whose overall effective rate was 96.67%, In the control group, whose overall effective rate was 76.67%. Analyzing the validity statistically of the two groups, there were significant differences (P < 0.05). The treatment group is better than the control group . 3.curative effect comparison of single symptom: The treatment group is better than the control group in improvement of palpitation, dyspnea and stuffy, tired, insomnia and dizziness. But there were no obvious differences in improvement of exhausted spirits, sweat and pale. 4. efficiecy of the ECG comparison: In the treatment group, whose overall effective rate was 46.67%, In the control group, whose overall effective rate was 53.33%, Analyzing the efficacy statistically of the two groups, there were no significant differences (P > 0.05). 5. AECG curative effect comparison: The treatment group's total effective rate was 83.33% , and the control group's total effective rate was 56.67% . Analyzing the efficacy statistically of the two groups, there were significant differences (P < 0.05).The treatment group is better than the control group . 6.premature ventricular beats times (time/24 hours) curative effect comparison: All the two groups can reduce numbers of premature ventricular beats afer treatment ,but the treatment group is better than control group through comparison. 7.adverse reaction:There were no distinct adverse reaction in the both groups.
Conclusion: The efficiency of ZhenJiYangXin soup to add and subtract in treating premature ventricular beats of coronary heart disease was exact and safe,better than Wenxingrains.
方法:将60名患者随机分为治疗组和对照组,治疗组口服镇悸养心汤加减每日一剂,水煎取汁300ml,早晚分服:对照组口服稳心颗粒(山东步长制药有限公司生产)每次1袋,日三次,冲服。观察并记录两组患者症状、体征、心电图及早搏次数变化情况。治疗4周为一个疗程。观察结束后将数据进行统计分析,计数资料用x~2检验,计量资料用t检验。
结果:1.临床综合疗效比较:治疗组总有效率86.67%,对照组总有效率66.67%,经统计学分析有差异(P＜0.05),治疗组优于对照组。2.中医证候疗效比较:治疗组总有效率96.67%,对照组总有效率76.67%,经统计学分析有差异(P＜0.05),治疗组优于对照组。3.单个症状疗效比较:在对于心悸、胸闷气短、乏力、失眠多梦、头晕眼花症状改善方面(P＜0.05),治疗组疗效优于对照组。而对于神疲懒言、自汗、面色淡白症状的改善方面(P＞0.05),两组无明显差异。4.心电图疗效比较:治疗组有效率46.67%,对照组有效率53.33%,经统计学分析无差异(P＞0.05),两组药物对心电图的改变相似。5.24小时动态心电图疗效比较:治疗组总有效率83.33%;对照组总有效率56.67%。经统计学分析有差异(P＜0.05),治疗组优于对照组。6.室早次数(次/24小时)疗效比较:两组药物治疗前后比较均能减少室早次数,两组治疗前后室早次数差值比较,经统计学分析有差异(P＜0.05),治疗组优于对照组。7.不良反应:治疗组和对照组均无明显不良反应。
结论:镇悸养心汤加减治疗冠心病室性期前收缩疗效确切、安全,优于稳心颗粒组。
Objective: To observe the curative effect of ZhenJiYangXin soup to add and subtract in treating premature ventricular beats of coronary heart disease , and compare with Wenxin grains.
Methods: To averagely randomize sixty patients to treatment group and control group. The treatment group was treated with ZhenJiYangXin soup one dose daily, decocted in water for oral dose, and taken orally after breakfast and supper respectively. and control group Wenxin grains 1bag, t.i.d. Observe and record all the patients symptoms,the various syndromes,ECG and premature ventricular beats times. One period of treatment is four weeks.After four weeks, we analyse the data.
Results: 1. Clinical comprehensive curative effect comparison: The treatment group's total effective rate was 86.67% , and the control group's total effective rate was 66.67% . Analyzing the efficacy statistically of the two groups, there were significant differences (P < 0.05).The treatment group is better than the control group . 2.Assess the efficiency of the various symptoms: In the treatment group, whose overall effective rate was 96.67%, In the control group, whose overall effective rate was 76.67%. Analyzing the validity statistically of the two groups, there were significant differences (P < 0.05). The treatment group is better than the control group . 3.curative effect comparison of single symptom: The treatment group is better than the control group in improvement of palpitation, dyspnea and stuffy, tired, insomnia and dizziness. But there were no obvious differences in improvement of exhausted spirits, sweat and pale. 4. efficiecy of the ECG comparison: In the treatment group, whose overall effective rate was 46.67%, In the control group, whose overall effective rate was 53.33%, Analyzing the efficacy statistically of the two groups, there were no significant differences (P > 0.05). 5. AECG curative effect comparison: The treatment group's total effective rate was 83.33% , and the control group's total effective rate was 56.67% . Analyzing the efficacy statistically of the two groups, there were significant differences (P < 0.05).The treatment group is better than the control group . 6.premature ventricular beats times (time/24 hours) curative effect comparison: All the two groups can reduce numbers of premature ventricular beats afer treatment ,but the treatment group is better than control group through comparison. 7.adverse reaction:There were no distinct adverse reaction in the both groups.
Conclusion: The efficiency of ZhenJiYangXin soup to add and subtract in treating premature ventricular beats of coronary heart disease was exact and safe,better than Wenxingrains.
引文
[1]孙思邈,备急千金要方。人民卫生出版社,1998
[2]严用和,济生方。人民卫生出版社,1956,227
[3]郑寿全,医法圆通。中国中医药出版社,1993,258
[4]黄帝内经素问。人民卫生出版社,1963
[5]陈延之,小品方。中国中医药出版社,1995,790
[6]巢元方,诸病源候论。辽宁科学技术出版社,1997
[7]窦材,扁鹊心书。中医古籍出版社,1992,176
[8]王怀隐等,太平圣惠方。人民卫生出版社,1958
[9]赵佶,圣济总录。人民卫生出版社,1982
[10]刘完素,素问玄机原病式。人民卫生出版社,1998,139
[11]李杲,脾胃论,东垣医集。人民卫生出版社,1993,34
[12]张介宾,景岳全书。人民卫生出版社,1991,368,399
[13]王清任,医林改错。上海科学技术出版社,1966,34
[14]陈士铎,辨证录。人民卫生出版社,1989,358-359
[15]李用粹,证治汇补。上海卫生出版社,1959,213-215
[16]张锡纯,医学衷中参西录。河北科技出版社,1985,214,354-355
[17]高世拭,素问直解。科学技术文献出版社,1982,284
[18]难经。人民卫生出版社,1956,14,35
[19]李培生等,伤寒论讲义。上海科学技术出版社,1985
[20]皇甫谧,针灸甲乙经。人民卫生出版社,1996
[21]葛洪,肘后备急方。人民卫生出版社,1963,56
[22]张从正,儒门事亲。人民卫生出版社,1994,213-214
[23]李杲,内外伤辨惑,东垣医集。人民卫生出版社,1993,17
[24]朱震亨,丹溪心法,丹溪医集。人民卫生出版社,1993,126
[25]朱震亨,丹溪手镜,丹溪医集。人民卫生出版社,1993,95
[26]张介宾,景岳全书。人民卫生出版社,1991,368,399
[27]沈金鳌,杂病源流犀烛。中国中医药出版社,1994,110,107-108
[28]高鼓峰,四明心法。人民卫生出版社,1991,142
[29]陈士铎,石室秘录。北京科技出版社,1984,422
[30]叶桂,临证指南医案。上海科学技术出版社,1959
[31]王清任,医林改错。上海科学技术出版社,1966,34
[32]王振涛,吴鸿从“痰”、“热”、“瘀”论治快速性心律失常经验.江苏中医药杂志,2004,25(6):23-24
[33]周次清治疗心律失常经验总结.山东中医杂志,2002,21(8);500-501
[34]丁元庆,卢尚岭治疗室性早搏经验谈.上海中中医杂志,1997,1:9
[35]丁书文.治疗心律失常十二法.山东中医杂志,1990,9(5):2-4
[36]包培荣.论治心律失常学术思想.辽宁中医杂志,1995,22(4):155-157
[37]殷照红,陈国瑶,陈伯勤老中医治疗心律失常的经验.广西中医药,1993,16(1):
[38]邓铁涛著.邓铁涛医案.北京:人民卫生出版社,1995,18
[39]刘淑清.中西医结合治疗早博32例明.安徽中医学院学报,1998,17(4):2021
[40]何东霞.中医辨证治疗心律失常体会[J].河北中医,2000,22(4):280-281
[41]周世熊.调和五脏法治疗心律失常[J].江西中医药,1995,26(6):2223
[42]周永康.辨证分型治疗心律失常体会.实用中医药杂志,2004,20(3):161
[43]吴治恒,张晓岚等.桂枝甘草龙骨牡蛎汤加减治疗心律失常100例.中国民族民间医药杂志,2002(55):84-85.
[44]岳建平.炙甘草汤治疗虚证室性早搏60例[J].国医论坛.1996,11(2):14
[45]祝光礼,钱宝庆,李玲英,等.逍遥散为主方治疗室性早搏32例.中国中西医结合杂志,1999,19(8):498
[46]李相中,刘维,李敏霞,等.酸枣仁汤加味治疗室性早搏.河南中医,2001,21(4):26
[47]贾斌.益气养阴汤加减治疗心律失常40例J四川中医,2002,20(2):35
[48]林慧娟,王翠萍,郭伟星,等.心疾宁胶囊治疗快速型心律失常100例临床研究[J].山东中医杂志,1996,15(8):347-349.
[49]李卫青.苦参复脉汤治疗虚证快速型心律失常85例临床观察[J].新中医,1997,29:79-80.
[50]张榴修,张华,张荣珍.起律汤治疗心律失常32例观察.中国中医急症.1995,4(4) 190.
[51]陈振云.心宝治疗病窦综合征87例.中西医结合杂志,1990,10(9):529.
[52]高忠范,高明莉,邹存信.金水宝治疗心动过缓100例.中医药学报,1997,(5)8.
[2]严用和,济生方。人民卫生出版社,1956,227
[3]郑寿全,医法圆通。中国中医药出版社,1993,258
[4]黄帝内经素问。人民卫生出版社,1963
[5]陈延之,小品方。中国中医药出版社,1995,790
[6]巢元方,诸病源候论。辽宁科学技术出版社,1997
[7]窦材,扁鹊心书。中医古籍出版社,1992,176
[8]王怀隐等,太平圣惠方。人民卫生出版社,1958
[9]赵佶,圣济总录。人民卫生出版社,1982
[10]刘完素,素问玄机原病式。人民卫生出版社,1998,139
[11]李杲,脾胃论,东垣医集。人民卫生出版社,1993,34
[12]张介宾,景岳全书。人民卫生出版社,1991,368,399
[13]王清任,医林改错。上海科学技术出版社,1966,34
[14]陈士铎,辨证录。人民卫生出版社,1989,358-359
[15]李用粹,证治汇补。上海卫生出版社,1959,213-215
[16]张锡纯,医学衷中参西录。河北科技出版社,1985,214,354-355
[17]高世拭,素问直解。科学技术文献出版社,1982,284
[18]难经。人民卫生出版社,1956,14,35
[19]李培生等,伤寒论讲义。上海科学技术出版社,1985
[20]皇甫谧,针灸甲乙经。人民卫生出版社,1996
[21]葛洪,肘后备急方。人民卫生出版社,1963,56
[22]张从正,儒门事亲。人民卫生出版社,1994,213-214
[23]李杲,内外伤辨惑,东垣医集。人民卫生出版社,1993,17
[24]朱震亨,丹溪心法,丹溪医集。人民卫生出版社,1993,126
[25]朱震亨,丹溪手镜,丹溪医集。人民卫生出版社,1993,95
[26]张介宾,景岳全书。人民卫生出版社,1991,368,399
[27]沈金鳌,杂病源流犀烛。中国中医药出版社,1994,110,107-108
[28]高鼓峰,四明心法。人民卫生出版社,1991,142
[29]陈士铎,石室秘录。北京科技出版社,1984,422
[30]叶桂,临证指南医案。上海科学技术出版社,1959
[31]王清任,医林改错。上海科学技术出版社,1966,34
[32]王振涛,吴鸿从“痰”、“热”、“瘀”论治快速性心律失常经验.江苏中医药杂志,2004,25(6):23-24
[33]周次清治疗心律失常经验总结.山东中医杂志,2002,21(8);500-501
[34]丁元庆,卢尚岭治疗室性早搏经验谈.上海中中医杂志,1997,1:9
[35]丁书文.治疗心律失常十二法.山东中医杂志,1990,9(5):2-4
[36]包培荣.论治心律失常学术思想.辽宁中医杂志,1995,22(4):155-157
[37]殷照红,陈国瑶,陈伯勤老中医治疗心律失常的经验.广西中医药,1993,16(1):
[38]邓铁涛著.邓铁涛医案.北京:人民卫生出版社,1995,18
[39]刘淑清.中西医结合治疗早博32例明.安徽中医学院学报,1998,17(4):2021
[40]何东霞.中医辨证治疗心律失常体会[J].河北中医,2000,22(4):280-281
[41]周世熊.调和五脏法治疗心律失常[J].江西中医药,1995,26(6):2223
[42]周永康.辨证分型治疗心律失常体会.实用中医药杂志,2004,20(3):161
[43]吴治恒,张晓岚等.桂枝甘草龙骨牡蛎汤加减治疗心律失常100例.中国民族民间医药杂志,2002(55):84-85.
[44]岳建平.炙甘草汤治疗虚证室性早搏60例[J].国医论坛.1996,11(2):14
[45]祝光礼,钱宝庆,李玲英,等.逍遥散为主方治疗室性早搏32例.中国中西医结合杂志,1999,19(8):498
[46]李相中,刘维,李敏霞,等.酸枣仁汤加味治疗室性早搏.河南中医,2001,21(4):26
[47]贾斌.益气养阴汤加减治疗心律失常40例J四川中医,2002,20(2):35
[48]林慧娟,王翠萍,郭伟星,等.心疾宁胶囊治疗快速型心律失常100例临床研究[J].山东中医杂志,1996,15(8):347-349.
[49]李卫青.苦参复脉汤治疗虚证快速型心律失常85例临床观察[J].新中医,1997,29:79-80.
[50]张榴修,张华,张荣珍.起律汤治疗心律失常32例观察.中国中医急症.1995,4(4) 190.
[51]陈振云.心宝治疗病窦综合征87例.中西医结合杂志,1990,10(9):529.
[52]高忠范,高明莉,邹存信.金水宝治疗心动过缓100例.中医药学报,1997,(5)8.