益气振心汤改善慢性心力衰竭心功能及逆转心室重构临床观察
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R541.6+1

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浙江省中医药科技计划舟山专项(2014ZSZX01)


Clinical Observation of Yiqi Zhenxin Tang for Improving Function of Chronic Heart Failure and Reversion of Ventricular Remodeling
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    摘要:

    目的:观察益气振心汤在逆转心室重构改善心功能方面的临床疗效。方法:通过编号、随机数字生成的方法将慢性心力衰竭患者按照升序分为2组各50例。对照组参照《中国心力衰竭诊断和治疗指南2014》的治疗原则,给予抗心力衰竭的系统治疗;治疗组在对照组治疗方案的基础上加用益气振心汤治疗,治疗时间为3月。观察评估2组治疗前后心室重构、心功能相关指标以及中医临床症状积分、生活质量的变化及不良反应。结果:心功能疗效总有效率治疗组80.0%,对照组72.0%;中医证候疗效总有效率治疗组84.0%,对照组76.0%,2组心功能疗效及中医证候疗效分别比较,差异均有统计学意义(P<0.05,P<0.01)。与治疗前比较,2组心超测定左室收缩末期内径(LVSD)、左室射血分数(LVEF) 指标均有所改善,人脑钠前肽(pro-BNP)均下降,6 min步行距离均延长,尼苏达心力衰竭生活质量积分均降低,差异均有统计学意义(P<0.05,P<0.01);治疗组左室舒张末期内径(LVDD)、左房内径(LAD) 亦有所改善,差异均有统计学意义(P<0.05)。治疗后,与对照组比较,治疗组LVSD、LVDD、LAD、LVEF改善均优于对照组,pro-BNP下降更明显,6 min步行距离更长,尼苏达心力衰竭生活质量积分降低更明显,中医证候积分更低,差异均有统计学意义(P<0.01)。100例患者均纳入研究,共出现不良反应6例,均不影响数据完整性。2组在血、尿、粪常规、肝功能、肾功能、电解质等方面比较,差异均无统计学意义(P>0.05)。结论:益气振心汤联合系统性抗心力衰竭治疗,能明显改善心脏功能,在逆转心室重构方面更具优势。

    Abstract:

    Objective: To observe the clinical effect of Yiqi Zhenxin tang on reversion of ventricular remodeling for improving heart function.Methods:According to the method of numbering and random number generation,patients with chronic heart failure were divided into two groups,50 cases in each group.The control group was given systemic treatment of heart failure in terms of therapeutic principles of China Heart Failure Diagnosis and Treatment Guide(2014 Edition),while the treatment group was additionally given Yiqi Zhenxin tang for treatment,the treatment being three months.Observed and evaluated the ventricular remodeling,indexes pertaining to heart function,scores of Chinese medicine clinical symptom,and changes of quality of life as well as adverse reaction.Results:The total effective rate of heart function effect was 80.0%in the treatment group and 72.0%in the control group;the total effective rate of Chinese medicine syndrome effect was 84.0%in the treatment group and 76.0%in the control group,differences being significant(P<0.05,P<0.01).Comparing with those before treatment, left ventricular ejection fraction(LVSD), left ventricular end-systolic diameter(LVEF)detected by echocardiography in both groups were improved,while pro-brain natriuretic peptide(pro-BNP)was decreased;the 6-minute walk distance was prolonged;and scores of heart failure and quality of life of Nisuda were all decreased,differences being significant(P<0.05,P<0.01).Left ventricular end-diastolic diameter(LVDD)and left atrial diameter(LAD)were also improved,differences being significant(P < 0.05).After treatment,comparing with those in the control group,the improvements of LVSD,LVDD,LAD,and LVEF in the treatment group were all better;the reduction of pro-BNP was more obvious;the 6-minute walk distance was longer;the reduction of scores of heart failure and quality of life of Nisuda were more obvious;Chinese medicine syndrome scores were lower,differences being significant(P < 0.05).100 cases of patients were included in this study,and there were 6 cases of adverse reaction,which did not affect the data integrity.There were no significant differences being found in the comparison of blood,urine,stool for routine,liver function,kidney function,and electrolyte as well as other indexes between two groups(P>0.05).Conclusion:Yiqi Zhenxin tang combined with systemic heart failure treatment can effectively improve heart function and has more advantages in reversing ventricular remodeling.

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李飞泽,陈琳,龚炳,李洁,康法宝,刘中良.益气振心汤改善慢性心力衰竭心功能及逆转心室重构临床观察[J].新中医,2018,50(3):41-45

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  • 在线发布日期: 2018-03-04
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