穴位贴敷疗法不同选穴对扩张型心肌病心力衰竭利尿剂抵抗患者临床疗效的影响  

Clinical efficacy of different acupoint selection of acupoint application in the treatment of diuretic resistance in dilated cardiomyopathy(DCM)heart failure

作　　者：刘红霞[1] 马金生 鲁彦辉 张欣 申思龙 杨荷 白春雨[1] LIU Hong-xia;MA Jin-sheng;LU Yan-hui;ZHANG Xin;SHEN Si-long;YANG He;BAI Chun-yu(The Greatwall Hospital,Shijiazhuang 050035,China)

机构地区：[1]石家庄长城中西医结合医院,石家庄050035

出　　处：《实用药物与临床》2021年第6期518-521,共4页Practical Pharmacy and Clinical Remedies

基　　金：河北省中医药管理局计划项目(编号:2019424)。

摘　　要：目的观察穴位贴敷疗法不同选穴对扩张型心肌病心力衰竭利尿剂抵抗患者临床疗效的影响。方法选取2018年9月至2020年3月在我院住院的108例扩张型心肌病心力衰竭利尿剂抵抗患者,随机分为穴位贴敷1组、穴位贴敷2组(两组穴位贴敷治疗组选穴不同)和常规治疗对照组,7 d为1个疗程,共2个疗程;记录患者24 h尿量、NT-proBNP、NYHA分级、左室舒张末内径(LVDd)、左室射血分数(LVEF)等指标;治疗结束后,对比各组之间的相关指标。结果治疗前后比较,穴位贴敷1组和穴位贴敷2组均较对照组临床状况改善更为显著,差异均有统计学意义(P<0.05);穴位贴敷1组与穴位贴敷2组之间对比,临床疗效差异无统计学意义(P>0.05)。三组尿量均较基线水平增加(P<0.05),穴位贴敷1组尿量较穴位贴敷2组和对照组增加更为明显(P<0.05),穴位贴敷2组较对照组尿量无明显增加(P>0.05)。三组血清NT-proBNP水平均较基线水平降低(P<0.05),穴位贴敷1组和穴位贴敷2组均较对照组降低(P<0.05)。穴位贴敷1组和穴位贴敷2组LVDd与对照组比较均未见缩小(P>0.05),而LVEF较对照组增加(P<0.05),穴位贴敷1组和穴位贴敷2组之间比较,LVDd和LVEF差异均无统计学意义(P>0.05)。结论穴位贴敷疗法可明显改善扩张型心肌病心力衰竭临床状况,对利尿剂抵抗状况的改善不同选穴疗效不同。Objective To explore the clinical efficacy of different acupoint selection of acupoint application in the treatment of diuretic resistance in dilated cardiomyopathy heart failure.Methods A total of 108 patients with diuretic resistance in dilated cardiomyopathy heart failure admitted to our hospital from September 2018 to March 2020 were randomized into acupoint application treatment group 1,acupoint application treatment group 2 and conventional treatment control group.The two acupoint application treatment groups selected different acupoints,seven days as a course of treatment for a total of two courses of treatment.The 24-hour urine volume,N terminal B type natriuretic peptide(NT-proBNP),NYHA classification,left ventricular end-diastolic diameter(LVDd)and left ventricullar ejection fration(LVEF)were recorded.After the treatment,the indexes among the groups were compared.Results Before and after treatment,the clinical effect of acupoint application treatment group 1 and acupoint application treatment group 2 was improved more significantly than that of control group(P<0.05);there was no statistical difference in the improvement of clinical effect between acupoint application treatment group 1 and acupoint application treatment group 2(P>0.05).Comared with the baseline,the urine volume of the three groups was obviously increased(P<0.05),and the increase of urine in acupoint application treatment group 1 was more obvious than that in the other two groups(P<0.05),but the urine volume of acupoint application treatment group 2 was not significantly higher than that of the control group(P>0.05).The NT-proBNP was obviously reduced in the three groups after treatment compared with basline(P<0.05).Compared with control group,the NT-proBNP in the two treatment groups was obviously reduced(P<0.05).Compared with control group,the LVDd was not reduced after treatment in the two treatment groups(P>0.05),but the LVEF was significantly increased(P<0.05).The LVDd and LVEF were not significantly different between the two treatme

关 键 词：穴位贴敷疗法 穴位选择 利尿剂抵抗 心力衰竭 扩张型心肌病 

分 类 号：R541.6[医药卫生—心血管疾病] R542.2[医药卫生—内科学]