文档介绍：成都中医药大学硕士学位论文
摘要
目的:在前期工作基础上,通过对肺心病急性发作期中西医结合综合治
疗方案的随机、对照试验研究,评价该方案的临床疗效,从而制订一个既能提高
临床疗效又适合中国国情的,肺心病急性发作期中西医结合综合治疗优化方案。
研究方法:以肺心病急性发作期中医辨证属痰浊蕴肺、肺气郁闭患者为
对象,随机分为治疗组(中西医结合综合治疗)和对照组(西医常规治疗)。治
疗组采用中西医结合综合方案治疗,即在西医常规治疗基础上加以中药治疗,基
本证型为痰浊蕴肺、肺气郁闭,以宣肺平喘,化痰止咳为治法,方用三拗汤、瓜
蒌薤白半夏汤及桔梗汤合方。对照组采用西医常规治疗,并同时服用中药安慰剂。
西医常规治疗包括控制性氧疗,积极抗感染,保持呼吸道通畅,改善通气、纠正
缺氧和二氧化碳潴留,纠正电解质紊乱及酸碱失衡,降低肺动脉压,纠正心衰,
营养支持,预防及处理各种并发症。两组均治疗天。观察疗效性指标为:总
体疗效、中医主症及次症积分、西医体征积分、白细胞总数及中性分类、血气分
析等。
结果:两组天病死率无差异,但和对照组比较,治疗组能提高临床综
合疗效,在部分中医主症、次症、西医体征以及血液白细胞及中性粒细胞分类异
常等方面治疗组与对照组比较有统计学意义,能更迅速地纠正低氧血症和高碳酸
血症,能改善肺功能,治疗组的电解质紊乱发生率比对照组低,不良反应比对照
组低,两组治疗后安全性分析无明显异常。
结论:与西医综合治疗方案比较,中西医结合综合治疗方案具有降低
病死率,提高临床综合疗效,改善症状、体征,中西医结合综合治疗方案副作用
少,不良反应轻,耐受性好;中西医结合综合治疗方案可以减少低钾血症发生,
从而减少酸碱失衡发生。
关键词:肺心病急性发作期中西医结合综合治疗方案临床
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成都中医药大学硕士学位论文
ABSTRACT
Objective: To evaluate the effectiveness prehensive treatment of
Traditional Chinese bining with Western Medicine for SPHD during
acute period through radom, comparative experiment research, based on earlier stage
work. And this research attempts to formulate prehensive treatment of
Traditional Chinese Medicine with Western Medicine for SPHD during acute period,
which can not only enhance clinical curative effect, but also fit for Chinese conditions.
Methods: The patients suffering from SPHD during acute period and
differentiation for phlegm remaining in lung and obstruction of lung qi are randomely
divided into treatment group (prehensive treatment of Traditional
Chinese Medicine with Western Medicine)and control group(receiving conventional
treatment of Western Medicine). The treatment group receives Traditional Chinese
Medicine adding to conventional treatment of Western Medicine. The basic syndrome
is obstruction of phlegm stagnating in lung, so the treatment principle is dispersing
lung-qi and relieving asthma, resolving phlegm to stop coughing. The formulas are San
ao decoction, Kuo lou xie bai ban xia decoction and Jie geng decoction. If th