加味三仁汤治疗冠心病慢性心力衰竭三焦湿热证临床研究  

The clinical effect of adding flavor sangren decoction for treating chronic heart failure of coronary heart disease with trifocal heat syndrome

作　　者：吕俊芳 朱明军[2] Lv Junfang;Zhu Mingjun(Department of Internal Medicine,Xuchang Hospital of Traditional Chinese Medicine(Xuchang 461000))

机构地区：[1]河南省许昌市中医院内一科,许昌461000 [2]河南中医学院第一附属医院心血管内科,郑州450000

出　　处：《陕西中医》2018年第5期596-598,共3页Shaanxi Journal of Traditional Chinese Medicine

基　　金：河南省科技攻关项目(0624410031)

摘　　要：目的:结合临床实践经验,探讨加味三仁汤治疗冠心病慢性心力衰竭三焦湿热证的临床疗效。方法:选取冠心病慢性心力衰竭三焦湿热证患者106例,根据随机数表法分为观察组和对照组,各53例,对照组使用西医常规治疗,所用药物为马来酸依那普利片、呋塞米片、地高辛、拜阿司匹林片等,观察组患者在此基础上使用加味三仁汤进行联合治疗,对比两组治疗疗效,对两组冠心病慢性心力衰竭三焦湿热证患者左心室射血分数(LVEF)和收缩末期内径(LVESD)和6min步行试验行走距离进行比较,并观察两组患者所发生的不良反应。结果:观察组患者中27例显效,23例有效,3例无效,治疗总有效率94.33%;对照组21例显效,23例有效,9例无效,总有效率83.02%,两组差异显著(P<0.05);治疗前,两组患者LVEF和LVESD水平无显著差异(P>0.05);治疗后两组患者均明显改善,且观察组改善程度更加明显,差异有统计学意义(P<0.05);治疗前,两组6min步行试验行走距离无显著显著差异(P>0.05);6min步行试验观察组优于对照组,两组均出现轻度腹痛,腹泻,恶心等现象,但观察组发生例数较少(P<0.05)。结论:加味三仁汤在治疗冠心病慢性心力衰竭三焦湿热证治疗中具有可靠效果,患者左心室射血分数和收缩末期内径改善明显,且患者发生不良反应情况较少。Objective:Combined with clinical practice experience,we discussed the clinical effect of Jiawei Sanren decoction to treat chronic heart failure of CHD.Methods:Selection of coronary heart disease,106 cases of patients with chronic heart failure in the hot and humid card,according to the stochastic indicator method was divided into observation group and control group,53 cases,control group using conventional western medicine treatment,the drug for maleic acid enalaprilat slice,cefuroxime crunching of cornflakes,digoxin,aspirin and so on,on the basis of the observation group patients using Sanren decoction,compared two groups of curative effect,the two groups of coronary heart disease(CHD)patients with chronic heart failure in the hot and humid card left ventricular ejection fraction(LVEF)and end systolic diameter(LVESD)and 6 min walking distance to walk test,and observe the adverse reaction of two groups of patients.Results:The patients in the observation group,27 showed significant effect,23 were effective,3 were ineffective,and the total effective rate was 94.33%.In the control group,21 cases were developed,23 were valid,9 were invalid,total effective rate was 83.02%,and the difference between the two groups was significant(P<0.05).Before treatment,there was no significant difference between LVEF and LVESD levels in both groups(P>0.05).After treatment,both groups significantly improved,and the improvement degree of observation group was more obvious,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in walking distance between the two groups of 6 min walking distance(P>0.05).The 6 min walking test observation group was superior to the control group.Both groups showed mild abdominal pain,diarrhea,nausea and other phenomena,but the number of observed groups was less(P<0.05).Conclusion:Flavored three kernel decoction in the treatment of coronary heart disease in the hot and humid in the treatment of chronic heart failure has reliable effect,patients with lef

关 键 词：心力衰竭/中西医结合疗法 心脏病 三仁汤/治疗应用 湿热弥漫三焦 

分 类 号：R541.6[医药卫生—心血管疾病]