炙甘草汤联合西医常规治疗对老年慢性心力衰竭病人血流动力学及心肌酶的影响  

The Influence of Zhigancao Decoction Combined with Western Medicine on Hemodynamics and Myocardial Enzymes in the Elderly Patients with Chronic Heart Failure

作　　者：宋春雪 SONG Chunxue(Fourth Affiliated Hospital,Liaoning University of Traditional Chinese Medicine,Shenyang 110100,Liaoning,China)

机构地区：[1]辽宁中医药大学附属第四医院

出　　处：《中西医结合心脑血管病杂志》2019年第24期3981-3985,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的观察炙甘草汤联合西医常规治疗对老年慢性心力衰竭病人血流动力学及心肌酶的影响。方法选取2015年10月-2017年10月辽宁中医药大学附属第四医院收治的128例老年慢性心力衰竭病人,按照随机数表法分为观察组与对照组,各64例,其中对照组予以常规西医治疗,观察组采用炙甘草汤联合西医常规治疗。以4周为1个疗程,持续治疗3个疗程后评价两组中医证候疗效,观察两组治疗前后血流动力学指标及心肌酶谱变化。结果观察组中医证候疗效总有效率为87.50%,对照组总有效率为65.62%,差异有统计学意义(P<0.05)。两组治疗前血流动力学指标比较差异无统计学意义(P>0.05);两组治疗后心率、外周阻力指数、胸部液体含量较治疗前明显下降(P<0.05),心脏指数、每搏指数、加速指数较治疗前明显上升(P<0.05);观察组治疗后外周阻力指数、胸部液体含量明显低于对照组(P<0.05),心脏指数、每搏指数、加速指数明显高于对照组(P<0.05)。两组治疗后天冬氨酸氨基转移酶(AST)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)水平均明显低于治疗前(P<0.05),且观察组治疗后AST、CK、CK-MB、LDH、α-HBDH水平均明显低于对照组(P<0.05)。结论炙甘草汤联合西医常规治疗老年慢性心力衰竭,能有效改善血流动力学、心肌酶及心功能,增加心肌收缩力,提高临床疗效。Objective To observe the effects of Zhigancao decoction(ZGCD)and western medicine on hemodynamics and myocardial enzymes in elderly patients with chronic heart failure(CHF).Methods One hundred and twenty-eight elderly patients with CHF in our hospital from October 2015 to October 2017 were randomly divided into two groups:the control group(n=64)treated with conventional western medicine treatment,the observation group(n=64)treated with ZGCD and conventional western medicine treatment for 3 courses of treatment,with 4 weeks as a course of treatment.The efficacy of traditional Chinese medicine(TCM)syndromes was evaluated in two groups.The changes in hemodynamic indexes and myocardial enzymes were observed before and after treatment.Results The total effective rate was 87.50%in the observation group,and that was 65.62%in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in hemodynamic indexes between two groups before treatment(P>0.05).There was no significant difference in systolic and diastolic blood pressure between two groups after treatment(P>0.05).The heart rate,peripheral resistance index,and thoracic fluid content in two groups after treatment were decreased significantly compared with that before treatment(P<0.05).The cardiac weight index,stroke index,acceleration index significantly increased in two groups after treatment(P<0.05).After treatment,the peripheral resistance index and thoracic fluid content in the observation group were significantly lower than those in the control group(P<0.05),while the cardiac weight index,stroke index,and acceleration index were significantly higher than in the control group(P<0.05).After treatment in two groups,aspartate aminotransferase(AST),creatine kinase(CK),creatine kinase isoenzyme MB(CK-MB),lactate dehydrogenase(LDH),andα-hydroxybutyrate dehydrogenase(α-HBDH)levels were significantly lower than that before treatment(P<0.05),which were significantly lower in the observation group than that in the control

关 键 词：慢性心力衰竭 老年人 炙甘草汤 中医证候 血流动力学 心肌酶 水肿 

分 类 号：R541.6[医药卫生—心血管疾病] R289.5[医药卫生—内科学]