加减补阳还五汤酒水煎法治疗冠心病心绞痛的临床与实验分析-中医内科专业论文.docxVIP

提要 提要 Y 4 0 4‘78 本文旨在发掘提高传统的汤剂制作技术。从临床和实验两方面探讨了加减 补阳还五汤洒煎后治疗冠心病心绞痛的疗效和机理。l临床研究选取气虚血瘀型 冠心病心绞痛患者60例，随机分为2纽，用加减补阳还五汤酒水煎法治疗30 例作为试验组，用常规水煎法治疗30例作为对照组，结果表明：试验组心绞 痛疗效有效率达到90％，对照组有效率达到73 33％，试验组明显优于对照纽。 中药活性成分的检测试验证明：丹参酮IIA等脂溶性成分、黄芪甲苷、和浸 出物均为稀白酒汤剂，水煎汤剂。研究结果说明加减补阳还五汤酒水煎法优于 常规水煎法。 关键词：加减补阳还五汤酒水煎冠心病疗效 Researches Researches On the treatment of CHD-AP by BuYangHuanWu decoction boiled in alcohol through clinic and experiment Author：Wei LingBo Speciality：Cardiovascular diseases Tutor：Professor Ding ShuWen Abstract Objective To detect the efficacy of alcohol served as dilution—media，and to explore mechanism and effection of BuYangHuanWu decoction boiled in alcohol in two aspects ofclinic and experiment． Methods 60 patients who had Coronaryheart disease(CHD)一Angia Pectrosis (AP)were studied．All patients underwent history collection，clinical examination and ECG ，then randomized into two groups．30 patients who treated by BuYangHuan Wu decoction boiled in alcohol were relegated to treat group，others treated by BuYangHuan Wu decoction boiled in pure water were control group． Results In the aspect of tofaI effect of CHD—AP，treatment group’S obvious effectual rate is 90．00％，control group’S obvious effectual rate is 73．33％，the diffience shows remarkable significance．Experiment on filtration of herbs active components demonstrates that Tanshinone 11 A，Astragaloside and others active elements were found more in alcohol than in water． Conclusion The study strongly suggests that BuYangHuanWu decoction boiled in alcohoI iS mole emcient than it was boiled in water． Key words ： BuYangHuan Wu decoction ’Boiled by alcoholand water·CttD -Efficacy． 2 引 引 言 中医的治疗学中，汤剂占有重要的位置，在中药的各种剂型中，汤剂具有 吸收快，疗效迅速，用途广，可随证情加减变化等特点，因而成为临床最常用 的给药手段之一。汤剂古代称汤液，相传为尹伊所作，皇甫谧在《针灸甲乙经》 自序中淀：“尹伊 撰用神农本草为汤液”，可见汤剂早在商时代已开始应用。 因此，如何煎好中药，进一步提高疗效，是一个值得研究的问题，明代李时珍 说：“凡服汤药需品物专精，修治如法，而煎药者鲁莽造次，水火不良，火候 失度，贝Ij药亦无功”，中医治病疗效主要取决于两个主要因素：即辨证、选方 遣药的准确和煎煮药的方法是否得当。应充分注意煎药溶媒的运用与临床疗效 的内在关系，不同的煎药溶媒因其性质的差异，而具有不同的临床作用。因此， 古代的煎药方式是多种多样的，所用溶媒甚丰富，如雨水、