温阳活血法治疗慢性心力衰竭的临床研究  

Clinical Observation on Yang-warming and Blood-activating Therapy for Chronic Heart Failure

作　　者：田俊 邬渊敏 吴敏雨 谈宏强 黄盛娜 丁雪华 曹燕 

机构地区：[1]上海市浦东新区中医医院

出　　处：《中西医结合心脑血管病杂志》2012年第8期897-899,共3页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：上海市浦东新区卫生局名中医工作室建设基金资助项目(No.PWZS2009-08)

摘　　要：目的观察温阳活血法对慢性心力衰竭的临床疗效。方法将100例慢性心力衰竭病人随机分为治疗组和对照组,各50例。对照组给予常规抗心力衰竭治疗(血管紧张素转换酶抑制剂或血管紧张素受体拮抗剂、β受体阻滞剂、血管扩张剂、利尿剂、强心剂等药物),治疗组在对照组治疗基础上加用温阳活血为主的温阳益气活血汤,疗程4周。观察两组治疗前后中医临床症状与体征、纽约心脏病协会(NYHA)心功能分级变化,应用彩色多普勒测定两组每搏输出量(SV)、心输出量(CO)、心脏指数(CI)、左室射血分数(LVEF)、左室短轴缩短率(FS)、左室舒张末内径(LVEDD),测定血清脑钠肽(BNP)浓度。结果治疗组总有效率94%,优于对照组的78%(P<0.05)。两组治疗后SV、CO、CI、LVEF、LVEDD、BNP较治疗前均有明显改善,但治疗组优于对照组(P<0.05)。结论温阳活血法对慢性心力衰竭具有确切的疗效,对心功能各项指标均具有明显的改善作用。Objective To investigate the effects of yang-warming and blood-activating therapy in the treatment of chronic heart failure（CHF）.Methods One hundred patients with CHF were randomly divided into two groups：Control group（n=50）treated by conventional anti-heart failure treatment（angiotensin-converting enzyme inhibitors or angiotensin receptor blockers,β-blockers,vasodilators,diuretics,inotropic）,treatment group（n=50）treated by conventional anti-heart failure treatment and Wenyang Yiqi Huoxue decoction for 4 weeks.The traditional Chinese medical symptoms,New York Heart Association（NYHA） heart function classification were observed.The systolic volume（SV）,cardiac output（CO）,cardiac index（CI）,left ventricular ejection fraction（LVEF）,fractional shortening of left ventricular short axis（FS）,and left ventricular end-diastolic diameter（LVEDd）were observed.The level of plasma B-type natriuretic peptide（BNP）was detested.Results The total effective rate was 94% in treatment group,which was significantly higher than that in control group（78%,P〈0.05）.The levels of SV,CO,CI,LVEF,LVEDD,and BNP in treatment group were better than that in control group（P〈0.05）.Conclusion Yang-warming and blood-activating therapy was effective for CHF,which could improve heart function.

关 键 词：慢性心力衰竭 温阳活血法 左室射血分数 左室舒张末内径 血清脑钠肽 

分 类 号：R541.6[医药卫生—心血管疾病] R289.5[医药卫生—内科学]