神道八阵穴隔药灸联合西药治疗慢性心力衰竭心肺气虚证疗效观察  

Therapeutic Efficacy of Herb-partitioned Moxibustion at Shendao Bazhen Points Combined with Western Medication for Chronic Heart Failure of Heart-lung Qi Deficiency Pattern

作　　者：高晨[1] 冯伟[1] 刘海立 张卫丽 李劼 李淑欣 陈科[1] 郑艳 GAO Chen;FENG Wei;LIU Hai-li;ZHANG Wei-li;LI Jie;LI Shu-xin;CHEN Ke;ZHENG Yan(Tangshan Hospital of Traditional Chinese Medicine,Tangshan 063000,China;North China University of Science and Technology Affiliated Hospital,Tangshan 063000,China)

机构地区：[1]唐山市中医医院,唐山063000 [2]华北理工大学附属医院,唐山063000

出　　处：《上海针灸杂志》2020年第9期1089-1093,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河北省中医药管理局中医药类科研计划课题(2018327)。

摘　　要：目的观察神道八阵穴隔药灸联合西药治疗慢性心力衰竭心肺气虚证的临床疗效。方法将122例慢性心力衰竭心肺气虚证患者随机分为对照组和观察组,每组61例。对照组接受规范西药治疗(螺内酯片、盐酸贝那普利片、富马酸比索洛尔片、地高辛片),观察组在对照组的基础上给予神道八阵穴隔药灸治疗。治疗前后观察Lee氏心衰计分法、中医证候评分、6 min步行距离、心脏彩超检查指标,检测N末端B型利钠肽原(NT-proBNP),比较临床疗效。结果观察组和对照组总有效率分别为90.2%、72.1%,两组比较差异有统计学意义(P<0.05)。治疗后观察组Lee氏心衰评分、血清NT-proBNP、中医证候评分(心悸、气短、咳嗽、气喘、乏力)、左室收缩末期内径(LVEDs)、左室舒张末期内径(LVEDd)、室间隔厚度(IVSd)、左室心肌质量指数(LVMI)均低于对照组,6 min步行距离、射血分数(EF)高于对照组,差异均有统计学意义(P<0.05)。结论在规范西药治疗基础上联合神道八阵穴隔药灸能明显提高慢性心力衰竭心肺气虚证患者的临床疗效,改善患者的左室收缩功能。Objective To observe the clinical efficacy of herb-partitioned moxibustion at Shendao Bazhen points[eight points taking Shendao(GV11)as the center]plus Western medication in treating chronic heart failure(CHF)of heart-lung qi deficiency pattern.Method A total of 122 patients with CHF of heart-lung qi deficiency pattern were randomized into a control group and an observation group,with 61 cases in each group.The control group received standard Western medication treatment(Spironolactone,Benazepril hydrochloride,Bisoprolol fumarate and Digoxin tablets),while the observation group was given additional herb-partitioned moxibustion at Shendao Bazhen points.Before and after treatment,the Lee’s heart failure score,syndromes scores of traditional Chinese medicine(TCM),6-min walk distance,cardiac color Doppler ultrasound examination indexes and N-terminal pro-B-type natriuretic peptide(NT-proBNP)were observed,and the clinical efficacy was compared.Result The total effective rate was 90.2%in the observation group and 72.1%in the control group,and the between-group difference was statistically significant(P<0.05).After treatment,Lee’s heart failure score,serum NT-proBNP,syndromes scores of traditional Chinese medicine(TCM)(palpitation,shortness of breath,cough and lassitude),left ventricular end-systolic dimension(LVEDs),left ventricular end-diastolic dimension(LVEDd),interventricular septal thickness(IVST)and left ventricular mass index(LVMI)in the observation group were lower than those in the control group,and the 6-min walk distance and ejection fraction(EF)in the treatment group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion In addition to the standard Western medication,herb-partitioned moxibustion at Shendao Bazhen points can markedly enhance the clinical efficacy in treating patients with CHF due to heart-lung qi deficiency and improve the patients’left ventricular systolic function.

关 键 词：灸法 心肺气虚 心力衰竭 Lee氏心衰计分法 N末端B型利钠肽原 

分 类 号：R246.1[医药卫生—针灸推拿学]