葶苈大枣泻肺汤治疗慢性心力衰竭的临床观察  

Clinical observation of Tingli Dazao Xiefei Decoction in the treatment of chronic heart failure

作　　者：曾莉[1] 程玲[2] 居海宁[1] 江冰 葛俊炜 张璇 丁毓 鲁成[1] 庄少伟 ZENG Li;CHENG Ling;JU Haining;JIANG Bing;GE Junwei;ZHANG Xuan;DING Yu;LU Cheng;ZHUANG Shaowei(Department of Cardiology,Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China;Department of Acupuncture and Moxibustion,Oriental Hospital Affiliated to Tongji University, Shanghai 200120,China)

机构地区：[1]上海中医药大学附属第七人民医院心内科,上海200137 [2]同济大学附属东方医院针灸科,上海200120

出　　处：《上海中医药大学学报》2018年第6期11-14,共4页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：上海市科委科研计划项目(16ZR1428300)

摘　　要：目的:探讨葶苈大枣泻肺汤加减治疗慢性充血性心力衰竭(简称"慢性心衰")患者的临床疗效及其对相关指标的影响。方法:纳入80例慢性心衰患者,随机分为中药组和对照组,每组各40例。对照组患者给予西医常规治疗,中药组在西医常规治疗的基础上加服葶苈大枣泻肺汤加减治疗,治疗疗程为20 d。比较两组患者的心功能改善疗效和临床症状改善疗效,检测患者的脑尿钠肽(BNP)、左心室射血分数(LVEF)水平。结果:治疗后,中药组患者的心功能改善疗效总有效率为92. 5%,对照组为85. 0%,中药组的疗效优于对照组(P<0.05);中药组患者的临床症状改善疗效总有效率为95.0%,对照组为82.5%,中药组的疗效优于对照组(P<0.05)。治疗后,两组患者的BNP水平明显降低(P<0.01),LVEF水平明显升高(P<0.05),且中药组患者的BNP水平低于对照组(P<0.01)。结论:葶苈大枣泻肺汤加减结合西医常规疗法治疗慢性心衰患者,可显著提高临床疗效,降低患者的BNP水平,增加其LVEF,值得在临床中推广应用。Objective: To explore the clinical efficacy of modified Tingli Dazao Xiefei Decoction in the treatment of chronic heartfailure ( CHF) and its influence on the corresponding indexes. Methods: Eighty patients with CHF were selected and randomly dividedinto the Chinese medicine group and control group,40 cases in each group. The patients in the control group were treated with routinewestern medicine,and the patients in the Chinese medicine group were treated with modified Tingli Dazao Xiefei Decoction combined withroutine western medicine,with a course of 20 days. The efficacy on the improvement of heart function and the improvement of clinicalsymptoms were compared,and the levels of brain natriuretic peptide ( BNP) and left ventricular ejection fraction ( LVEF) were detected.Results: After treatment,the total effective rates on the improvement of heart function in the Chinese medicine group and the controlgroup were 92.5% and 85. 0% respectively,and the efficacy of the Chinese medicine group was better than that of the control group( P<0.05) . After treatment,the total effective rates on the improvement of clinical symptoms in the Chinese medicine group and thecontrol group were 95.0% and 82.5% respectively,and the efficacy of the Chinese medicine group was better than that of the control group( P<0.05) . After treatment,the level of BNP in both groups was obviously decreased ( P<0.01) ,the level of LVEF was increased( P<0.05) ,and the level of BNP in the Chinese medicine group was lower than that in the control group ( P<0.01) . Conclusion:Modified Tingli Dazao Xiefei Decoction combined with routine western medicine can significantly improve the clinical efficacy,reduce thelevel of BNP and increase the level of LVEF in the treatment of CHF,which is worth promoting in clinic.

关 键 词：葶苈大枣泻肺汤 慢性心力衰竭 中西医结合疗法 

分 类 号：R259[医药卫生—中西医结合]