防己黄芪汤合真武汤加减治疗气虚血瘀型慢性心力衰竭患者临床观察  

Clinical Observation of Fangji Huangqi Tang Combined with Zhenwutang for Chronic Heart Failure with Qi Deficiency and Blood Stasis Type

作　　者：郭继芳[1] 高晶[2] 

机构地区：[1]牡丹江医学院附属红旗医院,黑龙江牡丹江157011 [2]黑龙江中医药大学,哈尔滨150040

出　　处：《中国实验方剂学杂志》2017年第16期171-175,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：黑龙江省卫生厅科研项目(2012-298)

摘　　要：目的:观察防己黄芪汤合真武汤加减治疗慢性心力衰竭气虚血瘀型患者的临床疗效。方法:将符合纳入标准的80例慢性心力衰竭(气虚血瘀型)患者,随机分为对照组与治疗组,各40例。对照组给予常规抗心衰西药治疗,包括血管紧张素转化酶抑制剂(angiotensin converting enzyme inhibitors,ACEI)或血管紧张素Ⅱ受体阻滞剂(angiotensinⅡreceptor blockers,ARB),扩血管药物,β受体阻滞剂,利尿剂,地高辛等;治疗组在常规治疗基础上加用防己黄芪汤合真武汤加减,共4周。观察两组患者治疗前与治疗后中医证候疗效、心功能分级比较、左室舒张末内径(left ventricular end diastole,LVED),左室收缩末内径(left ventricular end of systolic diameter,LVSD),左室射血分数(left ventricular ejection fraction,LVEF)。结果:经过治疗,在中医证候疗效方面,治疗组总有效率82.5%,优于对照组的65%(P<0.05);在心功能分级比较方面,治疗组总有效率85%,优于对照组的60%(P<0.05);在心功能指标方面,对照组和治疗组LVED和LVSD均降低,LVEF上升(P<0.05);治疗组LVED和LVSD均低于对照组,LVEF高于对照组(P<0.01)。结论:防己黄芪汤合真武汤加减在改善慢性心力衰竭患者的中医证候、心功能分级、以及改善心功能和心室重构方面具有一定作用。Objective：To observe the clinical efficacy of Fangji Huangqi Tang combined with Zhenwutang for chronic heart failure（Qi deficiency and blood stasis type）.Method：According to the inclusion criteria,80 patients with chronic heart failure（Qi deficiency and blood stasis type） were randomly divided into control group and treatment group（40 cases in each group）.The patients in control group received conventional anti-heart failure western medicine（including angiotensin converting enzyme inhibitors or angiotensin Ⅱ receptor blockers,vasodilator drugs,beta blockers,diuretics,digoxin,et al）;patients in treatment group received Fangji Huangqi Tang combined with Zhenwutang on the basis of routine treatment,for a total of 4 weeks.Two groups of patients were observed before and after treatment for traditional Chinese medicine（TCM） syndrome curative effect,cardiac function grading,left ventricular end diastolic diameter（LVED）,left ventricular end systolic diameter（LVSD）,and left ventricular ejection fraction（LVEF）.Result：After treatment,the total effective rate for TCM syndrome was 82.5% in treatment group,better than 65% in control group（P〈0.05）;the total effective rate of cardiac functions grading was 85% in treatment group,better than the 60% in control group（P〈0.05）;in the index of heart function,LVED and LVSD levels were decreased,and LVEF was increased in both treatment group and control group after treatment（P〈0.05）;the LVED and LVSD levels in treatment group were lower while LVEF was higher than those in the control group（P〈0.01）.Conclusion：Fangji Huangqi Tang combined with Zhenwutang has a certain role in improving TCM syndrome,cardiac functions grading,cardiac functions and ventricular remodeling in patients with chronic heart failures.

关 键 词：防己黄芪汤 真武汤 慢性心力衰竭 心功能 临床观察 

分 类 号：R287[医药卫生—中药学] R259.4[医药卫生—中医学]