摘要
【目的】观察心康方治疗气虚血瘀水停证射血分数保留的心力衰竭(HFpEF)的临床疗效。【方法】将100例符合纳入标准的气虚血瘀水停证HFpEF患者随机分为试验组和对照组,每组各50例。对照组给予西医规范化治疗,试验组在西医规范化治疗的基础上加用心康方治疗,4周为1个疗程,连续治疗2个疗程。分别于入组前、入组后第4周和第8周,观察2组患者治疗前后中医证候评分、明尼苏达心功能不全生活质量量表(MLHFQ)评分、经胸超声心动图各项参数[包括二尖瓣舒张早期血流峰值速度(E)、二尖瓣舒张早期运动速度(e’)及E/e’比值]、血清脑钠肽(BNP)水平和6 min步行试验(6MWT)等的变化情况,并评价其疗效。观察期间若出现急性心衰发作,则退出本研究。【结果】(1)研究过程中,试验组和对照组分别有3例和2例退出,实际纳入研究试验组47例,对照组48例。(2)治疗8周后,试验组总有效率为91.49%,对照组为79.17%,试验组疗效优于对照组(P<0.05)。(3)治疗4周和8周后,2组患者的中医证候评分和MLHFQ评分均较治疗前改善(P<0.05),且试验组对中医证候评分和MLHFQ评分的改善作用均明显优于对照组(P<0.05)。(4)治疗4周和8周后,2组患者6MWT、BNP、E/e’比值均较治疗前改善(P<0.05),且试验组治疗4周后在改善6MWT、E/e’比值方面明显优于对照组(P<0.05);但治疗8周后,2组各项指标比较,差异均无统计学意义(P>0.05)。【结论】使用心康方加减化裁治疗气虚血瘀水停证HFpEF患者,具有较好疗效,可有效改善左心室舒张功能,增加患者活动耐受量,提高患者生活质量。
Objective To observe the clinical efficacy of Xinkang Recipe for the treatment of heart failure with preserved ejection fraction(HFpEF)differentiated as Qi deficiency,blood stasis and fluid retention syndrome.Methods One hundred HFpEF patients with Qi deficiency,blood stasis and fluid retention syndrome were randomly divided into trial group(n=50)and control group(n=50).The two groups were given conventional western medicine treatment,and additionally the trial group was given oral use of Xinkang Recipe.Four weeks constituted one treatment course,and the treatment for the two groups covered 2 courses.Before enrollment,and on the 4 th and 8 th week after enrollment,the scores of traditional Chinese medicine(TCM)symptoms,scores of Minnesota Living with Heart Failure Questionnaire(MLHFQ),transthoracic echocardiography indicators including peak value of early diastolic mitral flow velocity(E),early diastolic mitral annulus velocity(e’)and E/e’ratio,serum brain natriuretic peptide(BNP)level,and distance of 6-minute walking test(6 MWT)in the two groups were compared.After treatment,the clinical efficacy of the two groups was evaluated.The patients should quit the trial once the acute heart failure attacked during the trial.Results(1)During the trial,3 cases from the trial group and 2 cases from the control group quitted,and the final case number of trial group was 47 and that of the control group was 48.(2)After treatment for 8 weeks,the total effective rate of the trial group was 91.49%and that of the control group was 79.17%,the therapeutic efficacy of the trial group being superior to that of the control group(P<0.05).(3)After treatment for 4,8 weeks,TCM symptom scores and MLHFQ scores in the two groups were improved(P<0.05 compared with those before treatment),and the improvement in the trial group was superior to that in the control group(P<0.05).(4)After treatment for 4,8 weeks,distance of 6 MWT,serum BNP level,and E/e’ratio in the two groups were improved(P<0.05 compared with those before treatment),and th
作者
陈丽萍
叶小汉
CHEN Li-Ping;YE Xiao-Han(Dongguan Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine ,Dongguan 523000 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2019年第4期471-475,共5页
Journal of Guangzhou University of Traditional Chinese Medicine
关键词
射血分数保留的心力衰竭
心康方
从肺论治
中医证候评分
MLHFQ评分
超声心动图
6min步行试验
脑钠肽
heart failure with preserved ejection fraction(HFpEF)
Xinkang Recipe
treating based on lung differentiation
traditional Chinese medicine symptom scores
Minnesota Living with Heart Failure Questionnaire(MLHFQ)scoring
echocardiography
6-minute walking test(6MWT)
brain natriuretic peptide(BNP)
