益气化瘀利水方对慢性心力衰竭(气虚血瘀兼水停证)患者心脏康复临床疗效观察  

Observation on the Cardiac Rehabilitation of Patients with Chronic Heart Failure(Qi Deficiency and Blood Stasis Combined with Water Withdrawal Syndrome)by Yiqi Huayu Decoction(益气化瘀利水方)

作　　者：李强 黄建 白长川 LI Qiang;HUANG Jian;BAI Changchuan(Dalian Hospital of Traditional Chinese Medicine,Dalian 116013,Liaoning,China)

机构地区：[1]大连市中医医院,辽宁大连116013

出　　处：《辽宁中医药大学学报》2022年第2期157-161,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家中医药管理局全国名中医传承工作室建设项目(国中医药办人教函[2018]119号);辽宁省自然基金指导计划项目(2019-ZD-0889);大连市卫生计生机构中医药科研计划项目(17Z1002)。

摘　　要：目的观察益气化瘀利水方对慢性心力衰竭(气虚血瘀兼水停证)患者心脏康复的临床疗效。方法将2018年5月—2020年5月就诊于大连市中医医院心血管科的112例慢性心力衰竭(气虚血瘀兼水停证)患者通过随机数字表法分为治疗组56例和对照组56例,对照组给予西医常规抗心衰治疗,治疗组在对照组的基础上给予益气化瘀利水方,治疗时间为2周。观察两组患者治疗后的临床疗效、Lee氏心衰积分、NT-proBNP、基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶抑制因子-1(TIMP-1)、转化生长因子-β1(TGF-β1)、MLHFQ、中医证候总积分、6 min步行距离、左心室射血分数(LVEF)、左心室收缩末期内径(LVEDs)、左心室舒张末期内径(LVEDd)、左心室收缩末期容积(LVESV)及左室心肌质量指数(LVMI)。结果经治疗后,治疗组中医证候积分总有效率为91.07%,明显优于对照组75%(P<0.05);治疗组心功能临床总有效率为83.93%,明显高于对照组64.29%(P<0.05)。治疗后,两组患者的NT-proBNP水平、MLHFQ评分、中医证候总积分及Lee氏心衰积分均较治疗前明显下降(P<0.05),且治疗组下降幅度高于对照组(P<0.05)。治疗后,两组患者的血清MMP-9和TGF-β1水平均明显下降,治疗组下降幅度高于对照组(P<0.05);两组患者的TIMP-1水平升高,治疗组升高幅度大于对照组(P<0.05)。治疗后,两组患者6 min步行距离、LVEF均较治疗前明显增加,且治疗组高于对照组(P<0.05);治疗后两组患者的LVEDs、LVEDd、LVESV、LVMI均较治疗前明显降低,且治疗组明显低于对照组(P<0.05);两组患者治疗后经过复查血、尿、便常规,肾功能及肝功能均未见异常,治疗期间未发生严重心血管事件。结论益气化瘀利水方治疗气虚血瘀兼水停证心力衰竭患者临床疗效显著,可明显提高患者心功能和运动耐量,改善临床症状,临床安全性较高,值得在临床推广。Objective To observe the clinical effect of Yiqi Huayu Lishui Decoction(益气化瘀利水方)on cardiac rehabilitation in patients with chronic heart failure(Qi deficiency and blood stasis combined with water withdrawal syndrome).Methods Between May 2018 and May 2020 in the Dalian hospital of traditional Chinese medicine cardiovascular division of 112 cases of chronic heart failure patients with Qi deficiency,blood stasis combined with water withdrawal syndrome,through the random number table method 56 patients were divided into treatment group(and 56 cases in the control group,control group was given conventional Western medicine heart failure treatment,treatment group on the basis of the control group was given Yiqi Huayu Lishui Decoction,treatment time was 2 weeks.To observe the clinical effects of two groups of patients after treatment,Lee’s integral,NT-proBNP,matrix metalloproteinases 9(MMP-9)and matrix metalloproteinases inhibitory factor 1(TIMP-1),and transforming growth factor beta 1(TGF-β),MLHFQ,TCM syndrome total integral,6 minutes walking distance,left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVEDs),left ventricular end-diastolic diameter(LVEDd),left ventricular end systolic volume(LVESV)and left ventricular mass index(LVMI).Results After treatment,the total effective rate of TCM syndrome score in treatment group was 91.07%,significantly better than that in control group 75%(P<0.05).The total effective rate of heart function in the treatment group was 83.93%,which was significantly higher than that in the control group(64.29%,P<0.05).After treatment,the level of NT-proBNP,MLHFQ score,total TCM syndrome score and Lee’s heart failure score in 2 groups were significantly decreased compared with before treatment(P<0.05),and the decrease rate in the treatment group was higher than that in the control group(P<0.05).After treatment,serum MMP-9 and TGF-βlevels in 2 groups were significantly decreased,and the decrease rate in treatment group was higher than that in contr

关 键 词：慢性心力衰竭 益气化瘀利水方 气虚血瘀兼水停证 

分 类 号：R541.6[医药卫生—心血管疾病]