参桂益心汤治疗慢性心力衰竭临床观察  

Clinical observation of Shengui-yixi decoction on the treatment of chronic heart failure

作　　者：冯庆涛[1] 苗华为[2] 杨静[1] 张燕[1] 

机构地区：[1]河北省中医院功能科,河北石家庄050011 [2]河北省中医院心内科,河北石家庄050011

出　　处：《河北中医》2016年第9期1292-1296,1304,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2014年度中医药类科研计划课题(编号:2014025)

摘　　要：目的观察参桂益心汤治疗慢性心力衰竭临床疗效。方法将160例慢性心力衰竭患者随机分为2组。对照组80例采用去除各种诱发因素、调整生活方式,对有焦虑、抑郁的患者及时进行心理干预,药物治疗包括给予利尿剂、血管紧张素转换酶抑制剂(ACEI)、β受体阻滞剂、醛固酮受体拮抗剂、血管紧张素Ⅱ受体阻滞剂(ARB)、地高辛等药物治疗,治疗组80例在对照组基础上予参桂益心汤口服。2组均2周为1个疗程,2个疗程后统计临床疗效,并采用Lee氏心力衰竭评分对治疗效果进行评价,观察2组左室舒张末期内径(LVDD)、左室射血分数(LVEF)及6 min步行距离(6 MWT)变化,检测2组治疗前后N末端利钠(NTpro BNP)、心脏肌钙蛋白T(c Tn T)、半乳糖凝集素-3水平变化。分别采用健康调查简表(SF-36)和明尼苏达心衰生活质量量表(MLHFQ)对2组治疗前后的生活质量改善情况进行评价。结果治疗组总有效率92.50%,对照组总有效率61.25%,2组比较差异有统计学意义(P<0.05),治疗组疗效优于对照组。2组治疗后LVDD、LVEF、6 MWT及生活质量评分SF-36、MLHFQ评分均较本组治疗前均改善(P<0.05),NT-pro BNP、c Tn T、半乳糖凝集素-3较治疗前下降(P<0.05),且上述指标治疗后的组间比较差异均有统计学意义(P<0.05),治疗组改善优于对照组。结论参桂益心汤可通过改善微循环,增加冠脉血流,调节神经内分泌细胞因子,增加心肌抗缺氧能力,排钠利尿减轻心负荷,减轻炎症反应等多种作用机制,减轻心肌损伤,延缓慢性心力衰竭心室重构,改善患者生活质量。Objective To observe the clinical effects of Shengui - yixi decoction on the treatment of chronic heart failure（CHF）. Methods 160 patients with CHF were randomly divided into two groups. The control group （n = 80）received the treatment of adjusting inducing factors and life - style,the psychological intervention of anxiety and depression,and the pharmacotherapy of diuretic,ACE inhibitor,beta - adrenergic blocker,aldosterone receptor antagonist,angiotensin receptor antagorists（ARB）,digoxin. The treatment group（n = 80）received Shengui - yixin decoction on the basis of control group treatment. The treatment course was 2 weeks for two courses in two groups. The clinical effect was evaluated after two courses. The therapeutic effect was evaluated by Lee＇s heart failure score. The left ventricular end diastolic diameterleft（LVDD）,left ventricular ejection fraction（LVEF）and 6 - min wake distance（6MWT）were observed in two groups. The N terminus natriuretic peptide（NT - proBNP）,cardiac troponin T（cTnT）and galectin - 3 before and after treatment were observed. The life quality was evaluated by the 36 - item short form health questionnaire（SF - 36）and the Minnesota living with heart failure quality scale（MLHFQ）. Results The total effective rate in treatment group（92. 50% ）was superior to that in control group（61. 25% ,P 〈0. 05）. The LVDD,LVEF,6MWT,SF - 36 and MLHFQ after treatment were improved in two groups（ P 〈 0. 05）. The NT - proBNP,cTnT and galectin - 3 after treatment were decreased in two groups（P 〈 0. 05）,and there were statistical differences on above indexes between two groups （P 〈 0. 05）,the improvement after treatment in treatment group was superior to control group. Conclusion Shengui - yixin decoction has the effects of abate myocardial damage,delay ventricular reconstruction and improve the quality of life,which may be related with the mechanism of improve microcirculation,enhance the coronary blood flow,regulate the neuroendocrine cyto

关 键 词：慢性病 心力衰竭 中药疗法 

分 类 号：R287[医药卫生—中药学] R541.610.531[医药卫生—中医学]