加味当归补血汤联合补铁治疗对老年慢性心力衰竭伴轻度贫血患者血象及预后的影响  

Effects of Jiawei Danggui Buxue Decoction Combined with Iron Supplementation on Blood Phenomenon and Prognosis of Senile Chronic Heart Failure with Mild Anemia

作　　者：何文静 赵春新 李薇薇[1] He Wenjing;Zhao Chunxin;Li Weiwei(Department of Geriatrics,Qinhuangdao City Harbor Hospital,Qinhuangdao 066000,China;Department of Emergency,Qinhuangdao City Military Hospital,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市海港医院老年病科,秦皇岛066000 [2]河北省秦皇岛市军工医院急诊科,秦皇岛066000

出　　处：《世界中医药》2019年第11期2960-2963,2968,共5页World Chinese Medicine

基　　金：秦皇岛市科学技术研究与发展计划项目(201602A137)

摘　　要：目的:探究加味当归补血汤联合补铁治疗老年慢性心力衰竭(CHF)伴轻度贫血患者的临床效果,并分析其对预后的影响。方法:选取2013年3月至2014年10月秦皇岛市海港医院收治的老年CHF伴轻度贫血患者60例进行前瞻性研究,按照随机数字表法将其分为对照组和观察组,每组30例。对照组给予蔗糖铁治疗,观察组在此基础上加用加味当归补血汤治疗,2组均连续治疗3个月。统计2组患者治疗前后总铁结合力(TIBC)、血清铁蛋白(SF)、转铁蛋白饱和度(TS)水平变化;记录2组患者治疗前后血红蛋白(Hb)、6 min步行试验(6MWT)、氨基端脑钠肽前体(NT-proBNP)水平;记录2组患者治疗前后左室舒张末期内径(LVEDD)、左心室射血分数(LVEF);对2组患者治疗前后心功能进行NYHA分级。结果:治疗后,观察组临床治疗有效率高于对照组,差异有统计学意义(P<0.05);治疗后观察组TIBC、SF、TS水平显著高于治疗前与对照组,差异有统计学意义(P<0.05)。与治疗前比较,观察组患者Hb、6MWT水平显著增高,且显著高于对照组,差异有统计学意义(P<0.05);治疗后观察组患者NT-proBNP水平显著下降,且显著低于对照组,差异有统计学意义(P<0.05)。与治疗前比较,治疗后2组患者LVEF水平显著增高,且观察组显著高于对照组,差异有统计学意义(P<0.05);治疗后观察组LVEDD水平显著下降,且显著低于对照组,差异有统计学意义(P<0.05)。与治疗前比较,治疗后2组患者NYHA分级Ⅱ~Ⅲ级例数均显著降低,且观察组显著低于对照组,差异有统计学意义(P<0.05)。结论:加味当归补血汤联合补铁治疗可有效缓解CHF合并轻度贫血患者临床的症状,提高Hb水平,改善心功能,疗效优于常规抗心力衰竭治疗。Objective:To explore the clinical effectS of Jiawei Danggui Buxue Decoction combined with iron supplementation in the treatment of elderly patients with chronic heart failure and mild anemia,and to analyze its impact on prognosis.Methods:A prospective study was conducted on 60 elderly patients with chronic heart failure and mild anemia in Qinhuangdao City Harbor Hospital from March 2013 to October 2014.They were divided into a control group(n=30)and an observation group(n=30)according to random number table method.The control group was treated with iron sucrose,while the observation group was treated with Jiawei Danggui Buxue Decoction on this basis.Both groups were treated continuously for 3 months.The levels of TIBC,SF and TS before and after treatment were counted;the levels of Hb,6 MWT and NT-proBNP before and after treatment were recorded;the data of LVEF and LVEDD before and after treatment were recorded;the cardiac function of the 2 groups was graded by NYHA before and after treatment.Results:After treatment,the total clinical effective rate of the observation group was higher than that of the control group.The levels of TIBC,SF and TS in the observation group was higher than before treatment and the control group(P<0.05 or P<0.01).Compared with before treatment,the level of Hb,6 MWT in the observation group increased markedly,and was higher than that in the control group(P<0.01);the levels of NT-proBNP in the observation group decreased memorably and was lower than that in the control group(P<0.05 or P<0.01).Compared with before treatment,the level of LVEF in the 2 groups increased dramatically after treatment,and the observation group was substantially higher than that in the control group(P<0.01);after treatment,the level of LVEDD in the observation group decreased markedly,and was dramatically lower than that in the control group(P<0.01).Compared with before treatment,the number of NYHA grade II-III cases in the 2 groups decreased memorably after treatment;and the observation group was significantly lo

关 键 词：老年慢性心力衰竭 加味当归补血汤 轻度贫血 蔗糖铁 心功能 临床效果 

分 类 号：R289.5[医药卫生—方剂学] R541.4[医药卫生—中药学]