益气温阳活血利水法联合小剂量多巴胺治疗重度失代偿性心力衰竭的临床研究  

Clinical Research of Yiqi Wenyang Huoxue Lishui Therapy Combined with Low-dose Dopamine in the Treatment Severe Decompensated Heart Failure

作　　者：徐文伟 李秋桦 李乙根[1] 王桂红[1] XU Wenwei;LI Qiuhua;LI Yigen;WANG Guihong(Guangzhou Hospital of Traditional Chinese Medicine,Guangzhou 510130,Guangdong,China)

机构地区：[1]广州市中医医院,广州510130 [2]广东省工伤康复医院

出　　处：《中西医结合心脑血管病杂志》2019年第12期1832-1834,共3页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的探讨在常规治疗心力衰竭药物基础上加用益气温阳活血利水法并联合小剂量多巴胺注射液(间歇短程泵入)治疗重度失代偿性心力衰竭的临床疗效。方法选择经常规方法治疗2d后、纽约心脏病协会(NYHA)分级Ⅲ~Ⅳ级,且左室射血分数(LVEF)<40%的失代偿性心力衰竭病人60例,按照随机数字表法分成观察组和对照组,各30例,对照组继续常规治疗,观察组在对照组基础上加用益气温阳活血利水中药口服并联合小剂量巴胺注射液静脉泵入,连续治疗3d。比较两组中医疗效、心功能疗效、N末端B型钠尿肽原(NT-proBNP)水平LVEF等。结果观察组中医总有效率和心功能总有效率高于对照组(P<0.05)。治疗后,两组NT-proBNP水平和红细胞分布宽度(RDW)较治疗前均明显下降(P<0.01),且观察组低于对照组(P<0.01)。治疗后,两组LVEF较治疗前均明显升高(P<0.01);且观察组高于对照组(P<0.01)。观察组住院时间明显短于对照组(P<0.01)。结论益气温阳活血利水法联合小剂量多巴胺(间歇短程泵入)治疗重度失代偿性心力衰竭是有效的。Objective To study the clinical efficacy of traditional Chinese medicine combined with low-dose dopamine injection (intermittent short-term pumping) on severe decompensated heart failure.Methods After routine treatment for 2 days,60 patients with New York heart association (NYHA) cardiac function classification Ⅲ~Ⅳ and left ventricular ejection fraction (LVEF)<40% were randomly divided into observation group and control group,30 cases in each group.The control group continued the routine treatment,while the observation group were combined with Yiqi Wenyang Huoxue Lishui of Chinese medicine and small doses dopamine by intravenous injection on the basis of the control group for 3 d.The clinical efficacy of traditional Chinese medicine,cardiac function,N-terminal type B natriuretic peptide(NT-proBNP),and LVEF were compared between two groups.Results The clinical efficacy of traditional Chinese medicine and cardiac function in the observation group were better than those in the control group ( P <0.05).NT-proBNP and red blood cell distribution width(RDW ) in the observation group and the control group were significantly decreased than those before treatment( P <0.01),NT-proBNP and RDW in the observation group were lower than those in the control group ( P <0.01).LVEF in the observation group and the control group were significantly increased than those before treatment ( P <0.01).LVEF in the observation group was higher than that in the control group ( P <0.01).The average hospital stay in the observation group was significantly shorter than that in the control group ( P <0.01).Conclusion Yiqi Wenyang Huoxue Lishui therapy combined with low-dose dopamine (intermittent short-term pumping) was effective in the treatment of severe decompensated heart failure.

关 键 词：失代偿性心力衰竭 益气温阳活血利水法 多巴胺 N末端B型钠尿肽原 红细胞分布宽度 

分 类 号：R541.6[医药卫生—心血管疾病] R256.2[医药卫生—内科学]