补心泻肺法联合参附汤对慢性心肾阳虚型心衰患者的临床疗效  

Clinical effect of Bushen xiefei method combined with Shenfu Decoction on patients with chronic heart failure of heart and kidney yang deficiency

作　　者：伍灏堃 余天浩[1] 张英[1] 范海媚[1] 樊婷[1] Wu Haokun;Yu Tianhao;Zhang Ying;Fan Haimei;Fan Ting(Guangdong Second People's Hospital,Guangzhou,Guangdong 510000,China)

机构地区：[1]广东省第二人民医院,广东广州510000

出　　处：《首都食品与医药》2022年第17期123-126,共4页Capital Food Medicine

摘　　要：目的探究补心泻肺法联合参附汤对慢性心肾阳虚型心衰患者的临床疗效.方法选取该院2021年6月-2022年6月心血管内科门诊及住院部收治的心肾阳虚型慢性心衰患者74例为研究对象.根据随机数字表法将患者分为两组.对照组(37例)予以常规西药治疗,实验组(37例)在常规西药治疗基础上加以补心泻肺法联合参附汤治疗,两组患者的治疗周期均为4周,对比两组患者治疗总有效率,记录所有患者的心功能变化,研究该经验方对患者的脑钠肽(NT-proBNP)、心功能指标左室射血分数(LVEF)、左室舒张末内径(LVEDD)以及对心率变异性(HRV)的影响.结果两组治疗后中医证候疗效比较,实验组总有效率(94.59%,35/37)高于对照组(81.08%,30/37),差异有统计学意义(P<0.05).通过对比两组治疗前后LVEF及LVEDD,发现两组治疗后LVEF及LVEDD较治疗前均有改善,差异有统计学意义(P<0.05).对比两组治疗前后NT-proBNP水平,发现两组治疗后NT-proBNP水平与治疗前相比均有降低,差异有统计学意义(P<0.05).且治疗后实验组上述指标变化幅度大于对照组,差异有统计学意义(P<0.05).使用动态心电图分别对两组治疗前后进行HRV时域分析,发现两组治疗后SDNN、SDANN、RMSSD及心率变异性三角指数较治疗前均有上升,其中实验组上升趋势较对照组更明显,差异有统计学意义(P<0.05).结论心肾阳虚型慢性心衰患者应用补心泻肺法联合参附汤治疗能够有效改善患者的临床症状,值得推广使用.Objective To explore the clinical effect of Tonifying the heart and purging the lung combined with Shenfu Decoction on patients with chronic heart failure of heart and kidney yang deficiency.Method 74 patients with chronic heart failure with deficiency of heart and kidney yang treated in the outpatient and inpatient department of cardiovascular medicine from June 2021 to June 2022 were selected as the research objects.The patients were divided into two groups according tothe random number table method.The control group(37 cases)was treated with conventional westem medicine,and the experimental group(37 cases)was treated with shenbuxin xiefei method combined with Shenfu Decoction on the basis of conventional westerm medicine.The treatment cycle of the wo groups was 4 weeks.The total effective rates of the two groups were compared,the changes of cardiac function of all patients were recorded,and the effects of the empirical formula on patients'brain natriuretic peptide(NT proBNP)and cardiac function indexes(left ventricular ejection fraction(LVEF)were studied Left ventricular end diastolic diameter(LVEDd)and its effect on heart rate variabilty(HRV).Result The total effective rate of the experimental group(94.59%,35/37)was significantly higher than that of the control group(81.08%,30/37)(P<0.05).By comparing the LVEF and LVEDD of the two groups before and after treatment,t was found that the LVEF and LVEDD of the two groups after treatment were improved compared with those before treatment,and the dfference was statistically significant(P<0.05).Comparing the NT proBNP levels of the two groups before and afer treatment,it was found that the NT proBNP levels of the two groups after treatment were lower than those before treatment,and the diference was statistically significant(P<0.05).After treatment,the change range of the above indexes in the experimental group was greater than that in the control group,and the diference was statistically significant(P<0.05).HRV time domain analysis was carried out before and after

关 键 词：心肾阳虚型 慢性心衰 补心泻肺法 参附汤 HRV 

分 类 号：R256.2[医药卫生—中医内科学]