参附竹苈汤联合西药治疗慢性充血性心力衰竭随机平行对照研究  

Clinical Randomized Controlled Study Integrated Shenfuzhuli Tang and Western Medicine on Treating Chronic Heart Failure

作　　者：王海燕[1] 周慧君[1] 曲燕[1] 

机构地区：[1]大连市中医医院内一心血管病房,辽宁大连116013

出　　处：《实用中医内科杂志》2013年第3期88-90,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察参附竹苈汤联合西药治疗慢性充血性心力衰竭疗效。[方法]使用随机平行对照方法,将96例住院患者按抽签方法随机分为两组,对照组48例西医常规治疗,治疗组48例参附竹苈汤(生晒参、炮附子先煎、玉竹、葶苈子、丹参、桂枝、红花各15g,云苓30g,泽泻、白术各15g,黄芪30g,陈皮15g)1剂/d,水煎150mL,早晚服,西药治疗同对照组。连续治疗14d为1疗程。观测临床症状、心功能(左室收缩末径LVESD、左室舒张末径CO、左室射血分数LVEF、心搏出量FS)、血浆B型利钠肽(BNP)、不良反应。连续治疗1疗程,判定疗效。[结果]治疗组显效20例,有效25例,无效3例,总有效率93.75%。对照组显效10例,有效24例,无效14例,总有效率70.83%。治疗组疗效优于对照组(P<0.05,P<0.01)。心功能两组均有改善(P<0.05),治疗组改善优于对照组(P<0.05)。对照组出现恶心呕吐3例,短阵室速2例,心动过缓(心室率<45次/min)1例,经停用地高辛,补钾等治疗后缓解,治疗组未出现明显不良反应。[结论]参附竹苈汤治疗慢性充血性心力衰竭疗效肯定,单用或联合西药均可,值得推广。[Objective]To investigate the clinical effect of Shenfuzhuli Tang to treat chronic heart failure.[Methods]By the scheme matched to the requirement of randomized controlled clinical trial,96 patients with chronic heart failure（CHF） were assigned into treatment group and control group.Control group（48 patients） were treated by conventional western medicine,treatment group（48 patients） were treated by Shenfuzhuli Tang（sheng Shaishenn,Paofuzi xianjian,Yuzhu,Tinglizi,Danshen,Guizhi,Honghua ge 15g,Yunling 30g,Zexie,Baizhu ge 15g,Huangqi 30g,Chenpi 15g） 1 doses of / d,Decoction 150mL,sooner or later,the western medicine treatment with the control group.The treatment course was 14 days.Observe symptom,left ventricular end systolic dimension（LVESD）,left ventricular end diastolic dimension（LVEDD）,left ventricular ejection fraction（LVEF）,cardiac output（CO）,Plasma natriuretic peptide（BNP） and harmful effects.Continuous 1 courses of treatment,the curative effect.[Results]The treatment group 20 cases,effective 25 cases,invalid 3 cases,the total efficiency of 93.75%.The control group 10 cases markedly effective,effective 24 cases,invalid 14 cases,the total efficiency of 70.83%.the treatment group was better than the control group（P〈0.05,P〈0.01）.Both of them could improve LVESD,LVEDD,LVEF,CO and BNP（P〈0.05）,and the difference of the two groups was statistical significance（P〈0.05）.The treatment group hasn’t harmful effects.[Conclusion]Shenfuzhuli Tang is a reasonable alternative to the chronic heart failure.Single or with western medicine have significant effect.

关 键 词：慢性充血性心力衰竭 胸痹 参附竹苈汤 心功能 血浆B型利钠肽(BNP) 中西医结合治疗 随机平行对照研究 

分 类 号：R256.22[医药卫生—中医内科学]