三拗汤合瓜蒌薤白半夏汤加味治疗慢性肺源性心脏病随机平行对照研究  

A Randomized Controlled Trial of Gualou Xiebai Decoction in Treatment of Chronic Pulmonary Heart Disease combined Sanniu Decoction

作　　者：蔡茂玉 

机构地区：[1]四川省达州市大竹县中医院心内科,四川大竹635100

出　　处：《实用中医内科杂志》2016年第4期29-32,共4页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察三拗汤合瓜蒌薤白半夏汤加味治疗慢性肺源性心脏病疗效。[方法]使用随机平行对照方法,将110例住院患者按就诊顺序编号方法简单随机分为两组。对照组55例抗感染、畅通呼吸道、纠正酸碱失衡、纠正电解紊乱、改善心肺功能等;常用：双氢克尿噻,25mg/次,3次/d,饭后口服;螺内酯,40mg/次,2次/d,饭后口服;硝酸甘油,0.25～0.5mg/次,舌下含服,根据病程适量选择使用频率;核酸酪素,10m L/次,3次/d;肝素,20000～40000U＋1000m L氯化钠,持续静滴,滴注前先静脉注射5000U作为首次剂量,1次/d;青霉素,50～250万U/次,4次/d,静滴;注意不良反应和并发症,积极预防。治疗组55例三拗汤合瓜蒌薤白半夏汤加味（甘草、杏仁、麻黄、瓜蒌各30g,薤白18g,半夏12g,茯苓15g,远志10g,太子参、醪糟各30g）研为粗末,药物浸泡30min,水煎450m L,150m L/次,3次/d,饭前服用,2d 1剂;双下肢水肿加泽泻、金钱草、木通利水渗湿;浓稠痰加白术、川贝、枇杷,散寒化痰、温肺止咳;舌苔黄腻加郁金;血液黏稠加当归、决明子、银杏叶补血行气、扩张血管。连续治疗4周为1疗程。观测临床症状、不良反应。连续治疗3疗程,判定疗效。[结果]治疗组显效30例,有效22例,无效3例,总有效率94.55%。对照组显效16例,有效27例,无效12例,总有效率78.18%。治疗组疗效优于对照组（P〈0.05）。[结论]三拗汤合瓜蒌薤白半夏汤加味治疗慢性肺源性心脏病,疗效满意,无严重不良反应,值得推广。[Objective]To observe three decoction combined Gualou Xiebai Banxia decoction in the treatment of chronic pulmonary heart disease.[Methods] 110 cases of hospitalized patients were randomly divided into two groups according to the random parallel control method. As before, sodium chloride, select the appropriate amount of course; control group 55 cases of anti infection, respiratory flow, correcting acidbase imbalance, correct electrolyte disorder, improve heart and lung function, etc. are commonly used： dihydro chlorothiazide, 25mg/time, 3 times/d, after oral administration of spironolactone, 40mg/time, 2 times/d, after oral administration of nitroglycerin, 0.25～0.5mg, tongue sublingual, according to frequency of use; nucleic acid casein 10 m L/time, 3 times/d; heparin, 20000 to 40000U＋1000m L intravenous drops drip intravenous injection of 5000 U first dose, 1 times/d; penicillin, 50～250 million U/times, 4 times/d, intravenous drip; pay attention to the adverse reactions and complications, and actively prevent. Treatment group 55 cases of Sanao Decoction of Trichosanthes kirilowii Allium white Pinellia decoction（licorice root, almond, ephedra, snakegourd fruit 30 g, bulbus Allii Macrostemi 18 g, 12 g of the tuber of pinellia, Poria 15 g, Radix Polygalae 10 g, Radix Pseudostellariae, fermented glutinous rice 30 g. Licorice root, almond, ephedra） research for thick end, drug soaked for 30 min, water to cook 450 m L, 150 m L/time, 3 times/d, before meals, two days a agent; double lower limbs edema and Oriental waterplantain rhizome, Herba Lysimachiae, Mutong and water dampness; thick phlegm and Rhizoma Atractylodis Macrocephalae, Chuanbei loquat, scattered cold phlegm, warm the lung cough, yellow tongue greasy add turmeric, thick blood plus angelica, cassia seed, Ginkgo biloba blood blood gas, dilation of blood vessels. Continuous treatment for 4 weeks for 1 courses. Observation of clinical symptoms and adverse reactions. Continuous treatment for 3 courses of treatment, to determine efficacy.[Results] i

关 键 词：慢性肺源性心脏病 水肿 喘证 双氢克尿噻 螺内酯 核酸酪素 肝素 青霉素 三拗汤 瓜蒌薤白半夏汤 支持治疗 中医药治疗 随机平行对照研究 

分 类 号：R289.5[医药卫生—方剂学]