摘要
目的:探讨温润通降法对慢性充血性心力衰竭(CHF)患者的临床疗效。方法:将本院心病科住院的125例CHF患者随机分为常规治疗组(62例)与温润通降法组(63例,给予常规+温润通降法治疗)。治疗3个月,对比两组治疗前后中医证候积分、中医疗效、心功能分级、6min步行距离(6MWD)、N末端脑钠肽前体(NT-proBNP)、内皮素-1(ET-1)及超声心动图相关指标变化情况,并记录不良反应及治疗后6个月主要不良心血管事件(MACE)发生情况。结果:治疗3个月后,与常规治疗组比较,温润通降法组中医证候积分[(4.19±0.58)分比(3.22±0.54)分]、心功能Ⅲ+Ⅳ级占比(35.00%比18.03%)均显著降低,中医有效率(80.00%比93.44%)及临床有效率(75.00%比90.16%)均显著提高,P<0.05或<0.01;与常规治疗组比较,温润通降法组治疗1、3个月后的6MWD、左室射血分数(LVEF)均显著增加,左室舒张期末内径(LVEDd)、左心房内径(LAD)及NT-proBNP、ET-1水平均显著减少,P均<0.01;温润通降法组随访期间总MACE发生率显著低于常规治疗组(11.48%比31.67%,P=0.007),两组总不良反应发生率比较无显著差异(P=0.335)。结论:在常规治疗基础上,对CHF患者加用温润通降法治疗,可显著促进临床症状好转,改善心功能,提高疗效,且具有一定安全性。
Objective:To explore clinical therapeutic effect of Wenruntongjiang(WRTJ) method on patients with chronic congestive heart failure(CHF).Methods:A total of 125 CHF patients hospitalized in our department were randomly divided into routine treatment group(n=62) and WRTJ group(n=63, received routine + WRTJ treatment). After three-month treatment, traditional Chinese medicine(TCM) syndrome score, TCM therapeutic effect, cardiac function class, 6 min walking distance(6 MWD), levels of N terminal pro brain natriuretic peptide(NT-proBNP) and endothelin(ET)-1 and related indexes of echocardiography(ECG) were compared between two groups before and after treatment, adverse reactions and incidence of major adverse cardiovascular events(MACE) within six months after treatment were recorded.Results:Compared with routine treatment group after three-month treatment, there were significant reductions in TCM syndrome score [(4.19±0.58) scores vs.(3.22±0.54) scores], percentage of cardiac function class III+IV(35.00% vs. 18.03%), and significant rise in TCM effective rate(80.00% vs. 93.44%) and clinical effective rate(75.00% vs. 90.16%) in WRTJ group, P<0.05 or <0.01;compared with routine treatment group, there were significant rise in 6 MWD and LVEF, and significant reductions in left ventricular end-diastolic dimension(LVEDd), left atrial diameter(LAD) and NT-proBNP and ET-1 levels in WRTJ group after one and three-month treatment, P<0.01 all;total incidence rate of MACE in WRTJ group during follow-up was significantly lower than that of routine treatment group,(11.48% vs. 31.67%,P=0.007). There was no significant difference in total incidence rate of adverse reactions between two groups, P=0.335.Conclusion: Wenruntongjiang method based on routine treatment can significantly promote the improvement of clinical symptoms, improve heart function and therapeutic effect with certain safety in CHF patients.
作者
贾运时
刘琪
马秀娟
宋温婷
付玉娜
JIA Yun-shi;LIU Qi;MA Xiu-juan;SONG Wen-ting;FU Yu-na(Department of Cardiology,Traditional Chinese Medicine Hospital of Shijiangzhuang City,Shijiangzhuang,Hebei,050051,China)
出处
《心血管康复医学杂志》
CAS
2023年第1期34-39,共6页
Chinese Journal of Cardiovascular Rehabilitation Medicine
基金
河北省中医药管理局资助项目(2019441)。
关键词
心力衰竭
中医疗法
治疗结果
Heart failure
TCM Therapy
Treatment outcome
