温润通降法对慢性充血性心力衰竭患者的疗效分析  

Therapeutic effect of Wenruntongjiang method on patients with chronic congestive heart failure

作　　者：贾运时 刘琪 马秀娟[1] 宋温婷 付玉娜[1] JIA Yun-shi;LIU Qi;MA Xiu-juan;SONG Wen-ting;FU Yu-na(Department of Cardiology,Traditional Chinese Medicine Hospital of Shijiangzhuang City,Shijiangzhuang,Hebei,050051,China)

机构地区：[1]石家庄市中医院心内科,河北石家庄050051

出　　处：《心血管康复医学杂志》2023年第1期34-39,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：河北省中医药管理局资助项目(2019441)。

摘　　要：目的:探讨温润通降法对慢性充血性心力衰竭(CHF)患者的临床疗效。方法:将本院心病科住院的125例CHF患者随机分为常规治疗组(62例)与温润通降法组(63例,给予常规+温润通降法治疗)。治疗3个月,对比两组治疗前后中医证候积分、中医疗效、心功能分级、6min步行距离(6MWD)、N末端脑钠肽前体(NT-proBNP)、内皮素-1(ET-1)及超声心动图相关指标变化情况,并记录不良反应及治疗后6个月主要不良心血管事件(MACE)发生情况。结果:治疗3个月后,与常规治疗组比较,温润通降法组中医证候积分[(4.19±0.58)分比(3.22±0.54)分]、心功能Ⅲ+Ⅳ级占比(35.00%比18.03%)均显著降低,中医有效率(80.00%比93.44%)及临床有效率(75.00%比90.16%)均显著提高,P<0.05或<0.01;与常规治疗组比较,温润通降法组治疗1、3个月后的6MWD、左室射血分数(LVEF)均显著增加,左室舒张期末内径(LVEDd)、左心房内径(LAD)及NT-proBNP、ET-1水平均显著减少,P均<0.01;温润通降法组随访期间总MACE发生率显著低于常规治疗组(11.48%比31.67%,P=0.007),两组总不良反应发生率比较无显著差异(P=0.335)。结论:在常规治疗基础上,对CHF患者加用温润通降法治疗,可显著促进临床症状好转,改善心功能,提高疗效,且具有一定安全性。Objective:To explore clinical therapeutic effect of Wenruntongjiang(WRTJ) method on patients with chronic congestive heart failure(CHF).Methods:A total of 125 CHF patients hospitalized in our department were randomly divided into routine treatment group(n=62) and WRTJ group(n=63, received routine + WRTJ treatment). After three-month treatment, traditional Chinese medicine(TCM) syndrome score, TCM therapeutic effect, cardiac function class, 6 min walking distance(6 MWD), levels of N terminal pro brain natriuretic peptide(NT-proBNP) and endothelin(ET)-1 and related indexes of echocardiography(ECG) were compared between two groups before and after treatment, adverse reactions and incidence of major adverse cardiovascular events(MACE) within six months after treatment were recorded.Results:Compared with routine treatment group after three-month treatment, there were significant reductions in TCM syndrome score [(4.19±0.58) scores vs.(3.22±0.54) scores], percentage of cardiac function class III+IV(35.00% vs. 18.03%), and significant rise in TCM effective rate(80.00% vs. 93.44%) and clinical effective rate(75.00% vs. 90.16%) in WRTJ group, P<0.05 or <0.01;compared with routine treatment group, there were significant rise in 6 MWD and LVEF, and significant reductions in left ventricular end-diastolic dimension(LVEDd), left atrial diameter(LAD) and NT-proBNP and ET-1 levels in WRTJ group after one and three-month treatment, P<0.01 all;total incidence rate of MACE in WRTJ group during follow-up was significantly lower than that of routine treatment group,(11.48% vs. 31.67%,P=0.007). There was no significant difference in total incidence rate of adverse reactions between two groups, P=0.335.Conclusion: Wenruntongjiang method based on routine treatment can significantly promote the improvement of clinical symptoms, improve heart function and therapeutic effect with certain safety in CHF patients.

关 键 词：心力衰竭 中医疗法 治疗结果 

分 类 号：R541.61[医药卫生—心血管疾病]