中药联合针刺治疗气虚血瘀证慢性心力衰竭(心功能分级Ⅱ级)的临床疗效  

Clinical efficacy of traditional Chinese medicine combined with acupuncture on chronic heart failure(cardiac function grade Ⅱ)with Qi deficiency and blood stasis syndrome

作　　者：贺卫 朱慧英 丁嘉怡 吴文昊 秦莹 HE Wei;ZHU Huiying;DING Jiayi;WU Wenhao;QIN Ying(Department of Cardiology,Shanghai Pudong New Area Hospital of Traditional Chinese Medicine,Shanghai 201299,China)

机构地区：[1]上海市浦东新区中医医院心内科,上海201299

出　　处：《上海中医药大学学报》2022年第S01期76-79,83,共5页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：上海市浦东新区卫计委重点专病建设主攻项目(PWZzb2017-29)

摘　　要：目的:观察中药联合针刺结合西医常规疗法治疗气虚血瘀证慢性心力衰竭(心功能Ⅱ级)的临床疗效。方法:纳入72例慢性心力衰竭(心功能Ⅱ级)患者,随机分为治疗组与对照组,每组各36例。对照组患者予西医基础治疗,治疗组患者在对照组基础上加用中药内服联合针刺治疗,两组疗程均为4周。评价两组的临床疗效;治疗前后,计算两组患者的左室射血分数(LVEF),检测并比较两组患者的血清N末端脑钠肽前体(NT-proBNP)、转化生长因子-β_(1)(TGF-β_(1))、结缔组织生长因子(CTGF)、Ⅰ型前胶原(PCⅠ)、Ⅲ型前胶原(PCⅢ)水平。结果:试验期间,治疗组5例患者剔除或脱落,对照组6例患者剔除或脱落,最终纳入统计分析者治疗组31例、对照组30例。①治疗后,治疗组、对照组的临床总有效率分别为74.19%、63.33%,治疗组的疗效明显优于对照组(P<0.05)。②治疗后,两组患者的LVEF水平均明显升高(P<0.05),血清NT-proBNP、TGF-β_(1)、CTGF、PCⅠ、PCⅢ水平均明显降低(P<0.05),且治疗组患者的LVEF水平高于对照组(P<0.05)。结论:与单纯西医常规疗法相比,中药联合针刺结合西医常规疗法治疗气虚血瘀证慢性心力衰竭(心功能Ⅱ级)患者,可有效改善患者的心衰指标,提高临床疗效。Objective:To observe the clinical efficacy of traditional Chinese medicine combined with acupuncture and conventional western medicine treatment in the treatment of chronic heart failure(cardiac function grade Ⅱ)with Qi deficiency and blood stasis syndrome.Methods:Seventy-two patients with chronic heart failure(cardiac function grade Ⅱ)were randomly divided into treatment group and control group,36 cases in each group. The control group was treated with basic western medicine. On the basis of the control group,the treatment group was treated with traditional Chinese medicine combined with acupuncture. The treatment course of both groups was 4 weeks. The clinical efficacy was observed. Before and after treatment,the left ventricular ejection fraction(LVEF)was calculated,and the serum levels of N-terminal pro-brain natriuretic peptide(NT-ProBNP),transforming growth factor-β_(1)(TGF-β_(1)),connective tissue growth factor(CTGF),procollagen Ⅰ(PC Ⅰ)and procollagen Ⅲ(PC Ⅲ)in patients of both groups were detected and compared.Results:During the experiment,5 patients in the treatment group and 6 patients in the control group were excluded or dropped out.Finally,31 patients in the treatment group and 30 patients in the control group were included in the statistical analysis.①After treatment,The total clinical effective rate of the treatment group and the control group was 74.19% and 63.33%,respectively. And the clinical curative effect of the treatment group was significantly better than that in the control group(P<0.05).②After the treatment,the LVEF level in both groups was significantly increased(P<0.05). The serum levels of NT-ProBNP,TGF-β_(1),CTGF,PC Ⅰ,PC Ⅲ were significantly decreased,and the level of LVEF in the treatment group was higher than that in the control group(P<0.05).Conclusion:Compared with the conventional treatment of western medicine,traditional Chinese medicine combined with acupuncture and conventional western medicine treatment can effectively improve the index of heart failure

关 键 词：慢性心力衰竭 气虚血瘀证 针刺 中药 

分 类 号：R259[医药卫生—中西医结合]