温阳活血方治疗冠心病心衰的预后研究  

Prognosis Research of Wenyanghuoxue Decoction on Chronic Heart Failure in Patients with Coronary Heart Disease

作　　者：薛金贵[1] 王玉琦[1] 高俊杰[1] 兰德辉[1] 陈铁军[1] 沈智杰[1] 王肖龙[1] 周华[1] 

机构地区：[1]上海中医药大学附属曙光医院,上海201203

出　　处：《中国中医急症》2013年第10期1666-1667,共2页Journal of Emergency in Traditional Chinese Medicine

基　　金：吴阶平基金会临床科研专项资助基金(320.6750.12183);上海市卫生局科研项目(20124069);上海市中医药事业发展三年行动计划项目(zysnxd-cc-yjxyy)

摘　　要：目的观察温阳活血方对冠心病心衰患者临床预后的影响。方法 100例确诊的冠心病心衰患者(中医辨证阳虚血瘀证),随机分为两组各50例,对照组予标准抗心衰治疗,治疗组在此基础上给予温阳活血方,每日1剂,疗程1年;观察患者死亡,因心衰恶化再入院,脑钠肽(BNP)和左心室射血分数(LVEF)。结果对照组死亡6例,因心衰再入院15例,治疗组死亡0例,因心衰再入院4例,两组间比较均有明显差异(P<0.05)。对照组治疗前后BNP和LVEF均有显著性改变(P<0.05),治疗组治疗前后BNP和LVEF均有非常显著性改变(P<0.01)。两组间比较,治疗前治疗组LVEF较对照组有非常显著性降低(P<0.01),治疗后两组间LVEF无显著差异。结论在常规西药的基础上加上温阳活血方长期治疗可显著降低患者的死亡率和再入院率,改善患者的心功能,降低BNP。Objective：To observe the effect of clinical prognosis of chronic heart failure （CHF） in patients with coronary heart disease （CAD） treated with Wenyanghuoxue Decoction.Methods：100 CHF patients with CAD,belonging to syndrome of yang deficiency and blood stasis in TCM,were randomly divided into 2 groups,the control group （50 cases） treated with standard anti-CHF drugs,and the treatment group （50 cases） treated with Wenyanghuoxue Decoction,1 dose per day to 1 year,based on standard anti-CHF drugs.These indices were observed including the death,the hospital readmission due to CHF exacerbation,the brain natriuretic peptide（BNP）and the left ventricular ejection fraction （LVEF）.Results：6 patients were dead and 15 patients were readmitted in hospital of the control group,which were 0 and 4 respectively in the treatment.There were some significant differences between the 2 groups.BNP and LVEF were more changed after treatment than before in the control group （P＜ 0.05）.BNP and LVEF were mostly changed after treatment than before in the treatment group （P＜0.05）.Before treatment,LVEF were much more lower in the treatment group than that in the control group （P ＜0.01）.After treatment,there were no differences between 2 groups （P＞ 0.05）.Conclusion：Long term therapies with Wenyanghuoxue Decoction based on routine western medicine treatment could significantly decrease the mortality and hospital readmission,improve cardiac function and decrease BNP in CHF patients with CAD.

关 键 词：慢性心衰 温阳活血方 阳虚血瘀证 预后 

分 类 号：R541.4[医药卫生—心血管疾病]