摘要
[目的]观察辨证分型治疗老年心脑血管疾病疗效。[方法]使用随机平行对照方法,将112例住院患者按病志号抽签方法简单随机分两组随机分为两组。对照组56例非洛地平,5mg/次,1次/d;强心剂、利尿剂、降压药、抗血栓药物、血管紧张素转换酶抑制剂以及血管紧张素Ⅱ受体阻断剂等对症治疗。治疗组56例高血压-天麻钩藤饮(桃仁、杜仲各12g,赤芍、天麻各15g,川芎10g,玄参8g,红花3g,水蛭5g,大黄6g,丹参20g;头痛加菊花10g,钩藤12g;便秘加熟地生8g,何首乌12g;心烦口渴加黄柏10g,知母12g;畏寒肢冷加仙茅6g,附子10g);冠心病-补气活血方(桃仁、红花、党参、川芎各10g,当归15g,丹参20g,枳实12g,黄芪30g;阳虚加桂枝10g,杜仲12g;阴虚加玉竹、麦冬各10g;痰浊加胆南星10g,半夏12g);心力衰竭(①气虚血瘀——补阳还五汤,赤芍、川芎、甘草、当归、丹参10g,黄芪12g,红花6g,红参8g,茯苓15g;②脾肾阳虚——真武汤加减,白术6g,芍药、茯苓各8g,附子^(炮,去皮,破八片)9g,生姜(切)12g;③气阴两虚——益气养阴汤,郁金、甘草~炙6g,白芍、麦冬各8g,党参、生姜、茯苓各10g,黄芪、生地、桂枝、大枣各12g),1剂/d,水煎300mL,早、晚各1次口服。连续治疗15d为1疗程。观测临床表现、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组显效38例,有效14例,无效4例,总有效率92.86%;对照组显效19例,有效26例,无效11例,总有效率80.36%;治疗组疗效优于对照组(P<0.05)。不良反应对照组18例,治疗组2例,未影响继续观察。[结论]辨证分型治疗老年心脑血管疾病,疗效满意,无严重不良反应,值得推广。
[Objective]To observe the effect of syndrome differentiation on the treatment of senile cardiovascular and cerebrovascular diseases.[Methods]A randomized parallel control method was used to randomly divide 112 hospitalized patients into two groups according to the simple and random method.56 patients in the control group were felodipine,5 mg/time,once daily/d;symptomatic treatment of cardiotonic,diuretic,antihypertensive,antithrombotic,angiotensin converting enzyme inhibitor and angiotensin II receptor blocker.Treatment group 56 cases of hypertension-Tianma Gouteng drink(Peach kernel,Eucommia each 12 g,red peony,Tianma 15 g,Chuanxiong 10 g,Scrophulariaceae 8 g,safflower 3 g,leeches5 g,rhubarb 6 g,Salvia 20 g;headache plus chrysanthemum 10 g,Uncaria 12 g;constipation plus cooked ground 8 g,Polygonum multiflorum 12 g;upset thirst plus yellow cypress 10 g,Zhimu 12 g;chilly limb cold plus Curculigo 6 g,aconite 10 g);coronary heart disease-qi and blood circulation(peach kernel,safflower,Dangshen,Chuanxiong 10 g,Angelica 15 g,Salvia 20 g,Poria 12 g,Astragalus 30 g;Yangxu plus Guizhi 10 g,Eucommia 12 g;Yin deficiency plus Yuzhu,Ophiopogon 10 g;Turbidity plus gallbladder Nanxing 10 g,Pinellia 12 g Heart failure(1 qi deficiency and blood stasis-Bu Yang Huan Wu Tang,Chishao,Chuanxiong,Licorice,Angelica,Salvia miltiorrhiza 10 g,Astragalus 12 g,Safflower 6 g,Red Ginseng 8 g,Lycium 15 g;2 Spleen and Kidney Yang Deficiency-Zhenwu Tang addition and subtraction,Atractylodes 6 g,peony,sputum8 g,aconite,peeled,broken eight 9 g,ginger(cut)12 g;3 qi and yin deficiency-Yiqi Yangyin soup,turmeric,licorice炙6 g,White peony root,Ophiopogon japonicus 8 g,Codonopsis pilosula,ginger,medlar each 10 g,Astragalus,raw land,cassia twig,jujube each 12 g),1 dose/d,decoction 300 mL,morning and evening Take1 time each time.Continuous treatment for 15 days is a course of treatment.Observe clinical manifestations and adverse reactions.Continuous treatment for 2 courses,to determine the efficacy.[Results]38 cases were effective in the treatment group,14 cases were effective,4 cases were ineffective,and the total effective rate was 92.86%.The control group was effective in 19 cases,effective in 26 cases,ineffective in 11 cases,and the total effective rate was 80.36%.The therapeutic effect was better than the control group(P<0.05).There were 18 cases of adverse reaction control group and 2 cases of treatment group,which did not affect the continued observation.[Conclusion]Syndrome differentiation and treatment of senile cardiovascular and cerebrovascular diseases with satisfactory results and no serious adverse reactions are worth promoting.
作者
董兴美
DONG Xingmei(Xinxiang Mayor,Yixian Hospital of Traditional Chinese Medicine,Xinxiang 453400,Henan,China)
出处
《实用中医内科杂志》
2019年第1期20-22,62,共4页
Journal of Practical Traditional Chinese Internal Medicine
关键词
心脑血管疾病
辨证分型
老年
高血压
冠心病
心力衰竭
天麻钩藤饮
补气活血方
补阳还五汤
真武汤
益气养阴汤
非洛地平
中医药治疗
随机平行对照研究
cardio-cerebral vascular disease
syndrome differentiation
old age
hypertension
coronary heart disease
heart failure
Tianma Gouteng drink
Buqi Huoxue Recipe
Buyang Huanwu Decoction
Zhenwu Decoction
Yiqi Yangyin Decoction
Chinese medicine treatment
randomized parallel controlled study
