中医药预防慢性风湿性心脏瓣膜病患者风湿热发作的临床研究  

Clinical Observation on Chinese Herbal Medicine in Preventing the Attack of Rheumatic Fever in Patients with Chronic Rheumatic Valvular Heart Disease

作　　者：魏文康[1] 莫少琪[1] 

机构地区：[1]广东省人民医院心血管研究所,广州510100

出　　处：《广州中医药大学学报》2005年第3期167-169,共3页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药管理局立项科研课题(编号:98032)

摘　　要：[目的]观察具有清热解毒、活血祛瘀、祛风除湿作用的抗风湿方(由银花、连翘、秦艽、防己、甘草、桔梗、丹参、黄芪等组成)预防风湿性心脏瓣膜病变加重的疗效和安全性评价。[方法]采用随机对照法将100例患者分为中药组(50例)和青霉素组(50例)两组,中药组用抗风湿方治疗,每月月初和月中各服5剂;青霉素组用长效青霉素120万U 肌注,每月1次。均连续观察2年。两组治疗前后均检查心功能、血常规、血液沉降速率(血沉)、血清抗“O”试验(抗“O”)、抗DNA酶试验、咽拭子查链球菌、X线胸片、心脏B型超声波扫描、心电图和肝肾功能等指标,并进行比较。[结果]治疗后,中药组对血沉的调整比青霉素组好(P<0.01),其余各项指标两组的作用相仿(P>0.05)。[结论]中药抗风湿方在预防慢性风湿性心脏瓣膜病变恶化和减少风湿热发作方面的作用与长效青霉素相仿,在临床症状的改善方面有优于青霉素的趋势。[Objective] To observe the therapeutic effect and safety of Kang Fengshi Prescription (KFP) in preventing the aggravation of chronic rheumatic valvular heart disease ( CRVHD) . KFP is mainly composed of Flos Lonicerae, Fructus Forsythiae, Radix Gentianae Macrophyllae, Radix Stephaniae Tetrandrae, Radix Glycyrrhizac, Radix Platycodonis, Radix Salviae Miltiorrhizae, Radix Astragali, etc. and has the actions of clearing heat and toxins, activating blood and removing blood-stasis, dissipating wind and removing damp. [Methods] One hundred cases of CRVHD were randomized into KFP group (group A, n = 50) and penicillin group (group B, n = 50) . KFP group was given 5 doses of KFP at the beginning of every month and another 5 doses in the middle of the month. Penicillin group was given benzathine benzylpenicillin 1.2 million IU im once per month continuously for 2 years. Cardiac function, hepatic and renal function, blood sedimentation rate (BSR), chest radiogram, echocardiogram and electrocardiogram (ECG) were detected; blood routine examination, blood anti-O test, anti-DNAase test and throat swab for detecting streptococcus were also performed before and after treatment. [Results] After treatment, all the above parameters were similar in both groups (P > 0.05) except BSR ( P < 0.01). [ Conclusion] In preventing the aggravation of CRVHD and relieving the attack of rheumatic fever, KFP and benzathine benzylpenicillin have the similar effect; but in relieving the clinical symptoms, KFP tends to have a better effect.

关 键 词：心脏瓣膜疾病/预防和控制 抗风湿方/治疗应用 清热解毒 活血祛瘀 

分 类 号：R259.425[医药卫生—中西医结合]