【作者】 徐慧；

【导师】 曹洪欣；

【作者基本信息】 黑龙江中医药大学 ， 中医基础理论， 2007， 博士

【摘要】 本课题将120例冠心病患者分为温阳益心法治疗组和西药对照组，进行随机对照临床研究。分别选取治疗后1个月、3个月、6个月三个时点，对两组患者症状、心电图变化、硝酸甘油停减率、生存质量变化情况、因冠心病再入院次数、药物不良反应等进行观察比较。并运用重复测量多元方差分析，Topsis理想点法等，对温阳益心法治疗冠心病的临床疗效进行综合评价。研究结果表明：1．温阳益心法能够改善冠心病患者临床症状、改善心肌缺血，降低血脂，提高硝酸甘油减停率，提高患者生存质量，且减少冠心病复发，降低患者因冠心病再入院次数。因此，温阳益心法可以从多方面提高冠心病患者的临床疗效。2．通过对各时点的症状总分、血脂和生存质量总分分别进行单变量重复测量多元方差分析，提示温阳益心法治疗组与对照组各变量均具有随观测时点变化的趋势，且组间比较有差异。3．通过对不同时点治疗组和对照组的各指标进行Topsis理想点法综合疗效排序，结果显示治疗组在6个月时，Topsis分数为0.804，最接近1，是最优理想解。说明远期疗效更能体现温阳益心法论治冠心病的优势。通过临床研究，得出如下结论：1．温阳益心法可明显提高冠心病患者临床疗效，且随着用药时间延长，效果更加显著。2．建立包括主观指标、客观指标、生存质量在内的临床疗效评价指标集，并引入时点数据，构建多因素、多时点的综合疗效评价体系，将有助于对中医药临床疗效进行全面评价。更多还原

【Abstract】 The project conducted the study in a random、control sample by dividing 120 coronary heart diseases patients into treating group and control group. We chosen three time 1 month、3 month、6month after the treatment and compare the symptoms、electrocardiogram changes、glonoin reducing rate、life quality、hospitalized times for CHD、adverse reactions to drug of the two groups patients. And making comprehensive assessment of the CHD treatment by warming heart-yang to strengthen the heart by using the statistical measure multivariate analysis of variance、Topsis ideal point method etc.The results indicate that: 1. The method of warming heart-yang to strengthen the heart can improve the clinical symptoms of CHD patients and the myocardial ischemia. It also can reduce blood lipid、increase the glonoin reducing rate and patients life quality. Furthermore, reducing the CHD recur and decreasing the hospitalized times for CHD. Therefore, the method of warming heart-yang to strengthen the heart can increase the clinical effects of CHD patients from many aspects. 2. We analyzed the symptoms marks、blood lipid and life quality points by the method of multivariate analysis of variance. The results indicated all the variable of the treating group and control group have the trend that changing with the observing times, and they have significant difference between the groups. 3. By the method of Topsis ideal point method, the results showed after the 6 months treatment, the Topsis method is 0.804. It is the best ideal solution for nearest to 1. That indicates the effects of long time treatment can show the advantage of warming heart-yang to strengthen the heart to treat the CHD. From the clinical research, we deduced the following conclusion: 1.The method of warming heart-yang to strengthen the heart can improve the clinical effects of the CHD patients obviously and these effects would become more prominent with the treatment elongation. 2. Establishing the clinical effects assessing index system including subjective indicator、objective indicator、life quality, and bringing into time data, constructing comprehensive assessment system including poly-factors、poly-times would benefit to assess the clinical effects of Chinese medicine comprehensively.更多还原