摘要
目的观察督脉灸联合益气温阳活血利水方治疗阳气亏虚、血瘀水停型慢性心力衰竭(CHF)患者的临床疗效。方法将94例阳气亏虚、血瘀水停型CHF患者按照随机数字表法分为2组,在均予西医常规二级预防治疗基础上,对照组46例予益气温阳活血利水方治疗,治疗组48例在对照组基础上联合督脉灸治疗。2组均治疗8周后统计疗效,比较2组治疗前后中医症状(包括心悸、胸痛、气短、下肢水肿、神疲乏力、畏寒肢冷、咳嗽、腹胀及尿少)评分、炎症因子[包括白细胞介素6(IL-6)、IL-10及肿瘤坏死因子α(TNF-α)]及心功能指标[包括血清脑钠肽(BNP)及N末端B型利钠肽原(NT-proBNP)]水平变化情况。结果治疗组总有效率91.67%(44/48),对照组总有效率76.09%(35/46),治疗组总有效率高于对照组(P<0.05)。与本组治疗前比较,2组治疗后中医症状心悸、胸痛、气短、下肢水肿、神疲乏力、畏寒肢冷、咳嗽、腹胀、尿少评分及总分均降低(P<0.05),且治疗组治疗后中医症状心悸、胸痛、气短、下肢水肿、神疲乏力、畏寒肢冷评分及总分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后血清炎症因子IL-6及TNF-α水平均降低(P<0.05),IL-10水平均升高(P<0.05),且治疗组治疗后IL-6及TNF-α水平均低于对照组(P<0.05),IL-10水平高于对照组(P<0.05)。与本组治疗前比较,2组治疗后血清BNP及NT-proBNP水平均降低(P<0.05),且治疗组治疗后血清BNP及NT-proBNP水平均低于对照组(P<0.05)。结论督脉灸联合益气温阳活血利水方治疗阳气亏虚、血瘀水停型CHF患者疗效确切,可有效改善患者中医症状,控制病情进展,其作用机制与调节炎症因子水平,抑制炎性反应,下调BNP及NT-proBNP表达,提高心功能有关。
Objective To observe the clinical efficacy of Du Mai moxibustion combined with Yiqi Wenyang Huoxue Lishui Formula for patients with chronic heart failure(CHF)of Yang deficiency,blood stasis and water retention.Methods A total of 94 CHF patients(Yang deficiency,blood stasis and water retention)were randomly assigned into the treatment group(n=48)and the control group(n=46).All patients were managed by conventional Western medicine+Yiqi Wenyang Huoxue Lishui Formula,and those in the treatment group were additionally treated with Du Mai moxibustion.After 8 weeks of treatment,the traditional Chinese medicine(TCM)symptoms scores(palpitation,chest pain,shortness of breath,lower limb edema,fatigue,chills,cough,abdominal distension and oliguria),inflammatory factors including interleukin-6(IL-6),IL-10 and tumor necrosis factor-α(TNF-α),and cardiac function indexes including serum brain natriuretic peptide(BNP)and N-terminal pro-B-type natriuretic peptide(NT-proBNP)were included as comparisons between the two groups.Results The total effective rate in the treatment group was significantly higher than that in the control group(91.67%[44/48]vs 76.09%[35/46],P<0.05).After treatment,the each dimension scores and total score of TCM symptoms in the two groups decreased(P<0.05),and which in the treatment group were significantly lower than in the control group(P<0.05).The levels of IL-6 and TNF-αin the two groups decreased significantly(P<0.05),and the levels of IL-10 increased significantly(P<0.05).The difference was significant in the levels of IL-6,TNF-α,IL-10 between the treatment group and the control group(all P<0.05).The levels of serum BNP and NT-proBNP in the two groups were significantly decreased(P<0.05),and the decrease was more obvious in the treatment group(P<0.05).Conclusion CHF patients(Yang deficiency,blood stasis and water retention),Du Mai moxibustion combined with Yiqi Wenyang Huoxue Lishui Formula has a definite curative effect.It can effectively improve TCM symptoms and control the disease progress.Its
作者
夏梅华
刘金良
魏艳伟
兰泽毅
袁银娜
XIA Meihua;LIU Jinliang;WEI Yanwei;LAN Zeyi;YUAN Yinna(Department of Cardiology,Hengshui Hospital of Traditional Chinese Medicine,Hengshui,Hebei 053000)
出处
《河北中医》
2023年第10期1703-1706,1711,共5页
Hebei Journal of Traditional Chinese Medicine
基金
河北省中医药管理局2018年度中医药类科研计划项目(编号:2018555)。
关键词
心力衰竭
中药疗法
灸法
督脉
辨证论治
Heart failure
Chinese medicine therapy
Moxibustion
Du Mai
Dialectical theory
