强心利水通脉汤治疗慢性心力衰竭利尿剂抵抗的临床研究  

Clinical study on the treatment of diuretic resistance in chronic heart failure with Qiangxin Lishui Tongmai Decoction

作　　者：滑莹莹[1] 张晓明[1] HUA Ying-ying;ZHANG Xiao-ming(Traditional Chinese Medicine Department,Fuxing Hospital of Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属复兴医院中医科,北京100038

出　　处：《中华中医药杂志》2020年第8期4235-4238,共4页China Journal of Traditional Chinese Medicine and Pharmacy

摘　　要：目的:探讨强心利水通脉汤对慢性心力衰竭利尿剂抵抗患者心脏功能、炎性反应及生活质量的影响。方法:收集慢性心力衰竭利尿剂抵抗患者80例,随机分为两组,对照组西药规范化治疗,治疗组加用强心利水通脉汤。治疗4周后,观察心功能指标、血清炎性因子、24h尿量、心衰症状及中医证候积分。结果:治疗组患者治疗后24h尿量改善程度,心功能指标,脑钠肽(BNP)改善程度,心输出量、心率改善情况均优于对照组(P<0.05);治疗组白细胞介素(IL)-6、肿瘤坏死因子α(TNF-α)水平均低于对照组(P<0.05),IL-4水平高于对照组(P<0.05)。结论:常规治疗基础上加强心利水通脉汤治疗慢性心力衰竭利尿剂抵抗,临床疗效更优,患者生命体征得到明显改善,增加心肌收缩力,降低心脏负荷,减轻炎性反应,对患者的生活质量及预后有着积极意义,值得临床治疗应用推广。Objective:To investigate the effects of Qiangxin Lishui Tongmai Decoction on the inflammatory response and left ventricular ejection fraction in patients with chronic heart failure who are resistant to diuretics.Methods:Eighty patients with chronic heart failure were selected from January 2016 to December 2018 and randomly divided into two groups.The control group was treated by normalized western medicine,the treatment group was treated by normalized western medicine and Qiangxin Lishui Tongmai Decoction.After 4 weeks treatment,the cardiac parameters,serum inflammatory factors,24 h urine volume,heart failure syndrome and TCM syndrome were observed.Results:The improvement of 24 h urine volume,cardiac function indexes,BNP,cardiac output and heart rate in the treatment group was better than that in the control group(P<0.05).The levels of IL-6 and TNF-αin the treatment group were lower than those in the control group(P<0.05),and the levels of IL-4 were higher than those in the control group(P<0.05).Conclusion:Based on conventional treatment in patients with chronic heart failure with strong heart,water through the use of pulse method,the clinical curative effect of patients with more superior,relieve patients with inflammatory reaction,dramatically improve patient vital signs,increase myocardial contraction force,reduce the cardiac load,has a positive significance on the patient’s quality of life and prognosis,worthy of clinical application.

关 键 词：强心利水通脉汤 利尿剂抵抗 心力衰竭 炎性反应 

分 类 号：R259[医药卫生—中西医结合]