中医辨证治疗慢性心力衰竭及对血清脑钠肽和血尿酸的影响  

Traditional Chinese Medicine Treatment with Syndrome Differentiation for Chronic Heart Failure and Its Effects on Serum Brain Natriuretic Peptide and Serum Uric Acid

作　　者：于彦 隋殿军[1] Yu Yan;Sui Dianjun(Changchun University of Chinese Medicine,Changchun 130117,China;Chuiyangliu Hospitalaffiliated to Tsinghua University,Beijing 100022,China)

机构地区：[1]长春中医药大学,长春130117 [2]北京市垂杨柳医院,北京100022

出　　处：《世界中医药》2019年第2期390-394,共5页World Chinese Medicine

基　　金：国家中医药管理局郭维琴名医工作站;北京市中医药薪火传承"3+3工程"郭维琴名医传承工作站项目(2011-SZ-C-33);郭士魁名家研究室项目(2011-SZ-A-27)

摘　　要：目的:探讨中医辨证治疗慢性心力衰竭及对血清脑钠肽和血尿酸的影响,为慢性心理衰竭的临床治疗提供参考。方法:选取2017年1月至2018年6月北京市垂杨柳医院收治的慢性心力衰竭患者60例为研究对象,随机分为观察组和对照组,每组30例,其中对照组给予常规西医治疗,观察组在上述治疗基础上给予中医辨证治疗,比较2组的血清脑钠肽(BNP)、血尿酸(UA)水平以及心功能指标变化,分析2组治疗后的心力衰竭以及中医证候疗效。结果:治疗前2组的心功能指标以及血清BNP、UA水平差异无统计学意义(P> 0. 05)。治疗后2组的心脏指数(CI)和左室射血分数(LVEF)均明显升高,血清BNP、UA水平以及左室舒张末内径(LVDD)均明显降低,且观察组上述指标改善更为显著(P <0. 05)。治疗后观察组的中医证候疗效和心力衰竭疗效均明显优于对照组,差异有统计学意义(P <0. 05)。结论:中医辨证治疗慢性心力衰竭患者可以明显降低其血清BNP和UA水平,改善心功能,中医证候以及心力衰竭症状恢复较好,减轻患者痛苦,效果显著。Objective:To explore the effects of Traditional Chinese Medicine(TCM)with syndrome differentiation in the treatment of chronic heart failure,and its influences on serum brain natriuretic peptide and serum uric acid,and to provide reference for the clinical treatment of chronic heart failure.Methods:A total of sixty patients with chronic heart failure who were admitted to Chuiyangliu Hospital from January 2017 to June 2018 were selected and randomly divided into observation group and control group,with 30 cases in each group.Patients in the control group were treated with conventional Western medicine,and patients in the observation group were given TCM treatment based on the above treatments.The levels of serum brain natriuretic peptide(BNP),serum uric acid(UA),and changes in cardiac function before and after treatment were compared between the two groups of patients.The curative effect of heart failure after treatment and the effect of TCM symptom were analyzed.Results:There was no significant difference in the level of serum cardiac function and serum BNP and UA before treatment between the two groups(P>0.05).After treatment,CI and LVEF in the two groups were significantly increased,serum BNP,UA levels,and LVDD were significantly reduced,and the above indicators improved more in the observation group(P<0.05).After treatment,the efficacy of TCM syndrome and heart failure in the observation group were significantly better than those in the control group.The difference was statistically significant(P<0.05).Conclusion:TCM syndrome differentiation treatment for patients with chronic heart failure can significantly reduce serum BNP and UA levels,improve cardiac function,better promote TCM symptom and heart failure recovery,and reduce patients′suffering,and the effect is significant.

关 键 词：中医辨证论治 中医证候 疗效 慢性心力衰竭 脑钠肽 血尿酸 

分 类 号：R242[医药卫生—中医临床基础] R541.4[医药卫生—中医学]