摘要
目的:观察强心方结合西医常规疗法治疗心肾阳虚型慢性心力衰竭(CHF)的临床疗效。方法:将符合纳入标准的82例心肾阳虚型CHF患者随机分为治疗组42例和对照组40例,两组患者均给予西医常规治疗,治疗组患者在西医常规治疗基础上给予强心方加减口服,两组治疗周期均为3个月。比较两组患者的心功能分级改善疗效、中医证候疗效;治疗前后,检测并计算所有患者的左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室射血分数(LVEF)、左室短轴缩短率(FS)、心室舒张末期容量(EDV)、每搏输出量(SV)、心输出量(CO),检测患者的血浆脑钠肽(BNP)、心肌肌钙蛋白1(cTn1)、血清同型半胱氨酸(Hcy)水平,比较两组患者的6 min步行距离(6MWD)。结果:(1)治疗后,治疗组患者的心功能分级改善总有效率为73.81%,对照组为52.50%,治疗组的疗效优于对照组(P<0.05)。(2)治疗后,治疗组患者的中医证候疗效总有效率为78.57%,对照组为50.00%,治疗组的疗效优于对照组(P<0.05)。(3)治疗后,治疗组患者的LVEDD、LVESD较治疗前减小(P<0.05),LVEF、SV较治疗前增加(P<0.05,P<0.01);对照组患者的LVEF较治疗前亦增加(P<0.05);且治疗组患者的LVEDD、LVESD低于对照组(P<0.05,P<0.01),LVEF高于对照组(P<0.01)。(4)治疗后,两组患者的血浆BNP、cTn1及血清Hcy水平较治疗前均显著降低(P<0.01),且治疗组患者的BNP、Hcy水平明显低于对照组(P<0.01)。(5)治疗后,两组患者的6MWD较治疗前均明显延长(P<0.01),且治疗组患者的6MWD较对照组亦明显延长(P<0.05)。结论:与西医常规疗法相比,强心方联合西医常规疗法能够更好地改善心肾阳虚型CHF患者的临床症状和心功能,延缓患者心室重构的进展,调节相关神经内分泌指标水平。
Objective:To observe the clinical efficacy of Qiangxin Recipe combined with conventional western medicine in the treatment of chronic heart failure(CHF)with syndrome of heart and kidney yang deficiency.Methods:A total of 82 CHF patients with syndrome of heart and kidney yang deficiency who met the inclusion criteria were randomly divided into the treatment group(42 cases)and control group(40 cases).The patients in both groups were treated with conventional western medicine,and the patients in the treatment group were orally treated with modified Qiangxin Recipe based on conventional western medicine.The treatment course of the two groups was 3 months.The efficacy of cardiac function classification improvement and Chinese medical syndrome were compared between the two groups.Before and after treatment,the left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular ejection fraction(LVEF),fractional shortening(FS),end diastolic volume(EDV),stroke volume(SV)and cardiac output(CO)were measured and calculated,the levels of plasma brain natriuretic peptide(BNP),cardiac troponin 1(cTn1)and serum homocysteine(Hcy)were detected,and the 6-minute walking distance(6 MWD)of the two groups was compared.Results:(1)After treatment,the total effective rate on cardiac function classification improvement was 73.81%in the treatment group and 52.50%in the control group.The efficacy of the treatment group was better than that of the control group(P<0.05).(2)After treatment,the total effective rate on Chinese medical syndrome was 78.57%in the treatment group and 50.00%in the control group.The efficacy of the treatment group was better than that of the control group(P<0.05).(3)After treatment,the LVEDD and LVESD in the treatment group were reduced compared with those before treatment(P<0.05),and the LVEF and SV were increased compared with those before treatment(P<0.05,P<0.01);the LVEF in the control group was also increased compared with that before treatment(P<0.05).After treatment,the
作者
袁晨越
董耀荣
刘晨萍
YUAN Chenyue;DONG Yaorong;LIU Chenping(Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)
出处
《上海中医药大学学报》
CAS
2021年第4期12-17,共6页
Academic Journal of Shanghai University of Traditional Chinese Medicine
基金
上海市卫健委卫生行业临床研究专项面上项目(201940236)。
关键词
慢性心力衰竭
心肾阳虚型
强心方
中西医结合
chronic heart failure
syndrome of heart and kidney yang deficiency
Qiangxin Recipe
integrated traditional Chinese and western medicine
