炙甘草汤联合西药治疗心阳虚慢性心衰随机平行对照研究  

Zhigancao Tang(炙甘草汤) Combined with Western Treatment of Heart Yang Chronic Heart Failure Randomized Controlled Study

作　　者：王奎英[1] 

机构地区：[1]沈阳市中医院心内科,沈阳110004

出　　处：《实用中医内科杂志》2016年第9期61-63,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察炙甘草汤联合西药治疗心阳虚慢性心衰疗效。[方法]使用随机平行对照方法,将120例住院患者按病志号抽签方法简单随机分两组。对照组60例参照《内科学》采用对症西医基础治疗和康复运动：利尿剂,从最小剂量25mg/d开始,逐渐增加剂量直至尿量增加,最大剂量不超过100mg/d;另外在服用氢氯噻嗪过程中应密切观察血钾的变化;ACEI：依那普利,起始剂量2.5mg,2次/d,逐渐增加剂量直至10~15mg,3次/d;强心剂：地高辛,0.25mg/d,在利尿剂、ACEI等基础上应用,不建议过早应用。治疗组60例炙甘草汤（炙甘草20g,人参30g,桂枝10g,干姜20g,麦冬、生地黄各15g,阿胶20g,大枣10g,黄芪、丹参各30g）,1剂/d,水煎200~300m L,早饭前、晚睡前口服;西药治疗同对照组。连续治疗45周为1疗程。观测临床症状、每搏输出量（SV）、射血分数（EF）、不良反应。治疗1疗程,判定疗效。[结果]心衰疗效积分疗效治疗组优于对照组（P〈0.05）,心功能分级疗效两组间无明显差异（P〉0.05）。心功能指标两组均有改善（P〈0.05）,治疗组改善优于对照组（P〈0.01）。[结论]炙甘草汤联合西药治疗心阳虚慢性心衰,疗效满意,无严重不良反应,值得推广。[Objective] To observe the Zhigancao Tang combined with western medicine treatment of chronic heart failure yang effect. [Method] Random palallel control method, 120 cases of hospitalized patients by disease Zhi No. balloting simple random divided into two groups. The control group of 60 patients with reference to ＂internal medicine＂ symptomatic western medicine and rehabilitation exercise： diuretics, start with the smallest dose of 25 mg/d, gradually increase the dosage until the volume increases, the maximum dose does not exceed 100 mg/d; Also taking hydrochlorothiazide process It should be closely observed changes in serum potassium; ACEI： enalapril, a starting dose of 2.5 mg, 2 times/d, gradually increase the dosage until 10-15mg, 3 times/d; tonic： digoxin, 0.25 mg/ d , diuretics, ACEI and other basic application, do not recommend early application. Treatment group, 60 patients Zhigancao Tang , ZhiGanCao 20 g ginseng 30 g, Gui 10g, ginger 20 g, Radix, Rehmanniae the 15 g, donkey-hide gelatin 20 g, jujube 10 g, Astragalus, Salvia 30 g）, 1 Ji/d, decoction of 200-300 mL, breakfast, orally before sleep; western medicine with the control group. Continuous treatment for 45 weeks for a course. Observation of clinical symptoms, stroke volume （SV）, ejection fraction （EF）, adverse reactions. One course of treatment, to determine efficacy. [Results] Heart failure efficacy integral treatment group than the control group （P〈0.05）, no significant difference efficacy between the two groups NYHA （P〉0.05）. Cardiac function improved in both groups （P〈0.05）, to improve the treatment group than the control group （P〈0.05）. [Conclusion] Zhiganeao Tang combined with western medicine Xin-Yang chronic heart failure, results were satisfactory, no serious adverse reactions, should be promoted.

关 键 词：慢性心衰 心悸 炙甘草汤 心阳虚 利尿剂 依那普利 地高辛 每搏输出量(SV) 射血分数(EF) 中西医结合治疗 随机平行对照研究 

分 类 号：R781.4[医药卫生—口腔医学]