中医药干预慢性心衰的治疗方案研究  

Study of Clinical Intervention of Chinese Medicine for Chronic Heart Failure

作　　者：宫丽鸿[1] 张艳[2] 

机构地区：[1]辽宁中医药大学,2009级博士后辽宁沈阳110032 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《世界中西医结合杂志》2012年第2期166-168,共3页World Journal of Integrated Traditional and Western Medicine

基　　金：国家"十一五"科技支撑计划课题(No.2007BAI20B076)

摘　　要：目的观察中医药强心通脉颗粒治疗慢性心力衰竭的临床疗效。方法采用随机、双盲、安慰剂平行对照、多中心临床试验设计方法。共纳入患者280例,按分层区组随机法分为治疗组和对照组各140例,两组均予抗慢性心力衰竭常规治疗包括血管紧张素转换酶抑制剂(赖诺普利2.5mg日一次起,如能耐受可达到最大剂量)、利尿剂(氢氯噻嗪25 mg日一次,逐渐加量)、洋地黄(地高辛片0.125～0.25 mg日一次)长期服用。利尿剂、洋地黄在患者症状得到控制或心功能达到一级即可停用。治疗组加服强心通脉颗粒每次8 g,每日3次开水冲服,疗程3个月。于治疗前后观察并记录心衰疗效(Lee氏)记分、心功能分级(NYHA)、中医症状疗效记分、6 min步行试验,并进行心功能测定和胸部X线检查,6个月再住院率和病死率。结果治疗组心衰计分、6 min步行试验、中医症状疗效计分和6个月再住院率和病死率改善情况均明显优于对照组。结论中医药强心通脉颗粒能够显著提高慢性心力衰竭患者临床治疗疗效。Objective To observe the clinical efficacy of qiangxin tongmai granules in the treatment of chronic heart failure.Methods The random,double-blind,placebo control and multi-center clinical trial was designed.280 cases were included totally and randomized into a treatment group and a control group,140 cases in each one.The cases in either group were treated conventionally for anti-chronic heart failure with angiotensin-converting-enzyme inhibitor（ACEI）（lisinopril,initial dose 2.5 mg once a day,up to the maximal dose if tolerable）,diuretic（hydrochlorothiazide,25 mg once a day,increased gradually）and digitalis（digoxin tablets,0.125~0.25 mg once a day）for long term medication.Diuretic and digitalis stopped taking when the symptoms were controlled or the heart function was improved to the grade I.In treatment group,qiangxin tongmai granules were prescribed for oral administration,8 g each time,three times a day.Before and after treatment,the score of heart failure efficacy（Lee′s）,NYHA,the efficacy score of Chinese medicine symptoms and 6 min walking test were observed and recorded.The detection of heart function and X-ray test of the chest were conducted.The re-admission rate and death rate were recorded in 6 months.Results In treatment group,the improvements in heart failure score,6min walking test,the efficacy score of Chinese medicine symptoms as well as the re-admission rate and death rate in 6 months were all apparently superior to those in control group.Conclusion Qiangxin tongmai granules can significantly improve the clinical efficacy on chronic heart failure.

关 键 词：强心通脉颗粒 慢性心衰 中医症状疗效计分 气虚血瘀水停型 

分 类 号：R285.6[医药卫生—中药学]