益心颗粒联合常规疗法治疗慢性心力衰竭(阳气亏虚-血瘀水停证)临床观察  

Clinical Study of Yixin Granules Combined with Routine Therapy on Chronic Heart Failure with Yang Qi Deficiency and Blood Stasis and Water Retention Syndrome

作　　者：张仁国[1] 武子健 王丽[1] 谢涛[1] 钟代荣 郑纯书 郭小辉 罗杰 李忠釜 Zhang Renguo;Wu Zijian;Wang Li;Xie Tao;Zhong Dairong;Zheng Chunshu;Guo Xiaohui;Luo Jie;Li Zhongfu(Zigong Traditional Chinese Medicine Hospital,Sichuan,Zigong 643010,China)

机构地区：[1]四川省自贡市中医医院,四川自贡643010

出　　处：《中国中医急症》2023年第3期460-463,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：四川省中医药管理局科学技术研究专项课题(2021MS345)。

摘　　要：目的观察自拟益心颗粒联合常规疗法治疗慢性心力衰竭(阳气亏虚-血瘀水停)患者的临床疗效。方法将60例患者随机分为治疗组与对照组各30例。两组患者均采用西医常规疗法,治疗组加用益心颗粒,两组疗程均为14 d。观察并比较两组患者治疗前后血清N末端前体B型钠尿肽(NT-ProBNP)水平、血清超敏肌钙蛋白(hs-cTnI)水平、红细胞分布宽度(RDW)水平、超声心动图左心室射血分数(LVEF)、6 min步行距离、中医证候积分、中医证候疗效、心功能疗效变化情况。结果治疗后两组患者血清NT-ProBNP、血清hs-cTnI、RDW水平均较治疗前明显降低(P<0.01),治疗组明显低于对照组(P<0.05)。治疗后两组患者超声心动图LVEF均较治疗前明显改善(P<0.01),治疗组改善程度明显优于对照组(P<0.05)。治疗后两组患者6 min步行距离均较治疗前明显提高(P<0.01),治疗组提高程度明显优于对照组(P<0.05)。治疗后两组中医证候积分之和均较治疗前明显降低(P<0.01),治疗组明显低于对照组(P<0.05)。治疗组中医证候疗效总有效率为93.33%,明显高于对照组的73.33%(P<0.05)。治疗组心功能总有效率为80.00%,明显高于对照组的70.00%(P<0.05)。结论在常规治疗方案基础上加用益心颗粒可以明显降低心衰指标,减轻心肌损伤,并对心衰远期预后具有积极作用,在改善中医证候及提高生活质量方面具有一定优势。Objective:To observe the clinical efficacy of Yixin Granules combined with conventional therapy in the treatment of chronic heart failure patients with Yangqi deficiency and blood stasis and water retention syndrome.Methods:A total of 60 patients with chronic heart failure of Yangqi deficiency and blood stasis and water retention were randomly divided into the treatment group(30 cases)and control group(30 cases).Both groups were treated with conventional western medicine,and the treatment group was added with Yixin Granules;.The course of treatment in both groups was 14 days.The serum N-terminal precursor B-type natriuretic peptide(NTProBNP)level,serum hypersensitive troponin(hs-cTnI)level,red blood cell distribution width(RDW)level,left ventricular ejection fraction(LVEF)on echocardiography,6-minute walking test results,Traditional Chinese Medicine syndrome score,Traditional Chinese Medicine syndrome efficacy,and cardiac function efficacy were observed and compared before and after treatment.Results:After treatment,serum NT-ProBNP,serum hs-cTnI and RDW levels in the two groups were significantly lower than those before treatment(P<0.01),and the treatment group was significantly lower than that in the control group(P<0.05).After treatment,the echocardiography LVEF of the two groups was significantly improved compared with that before treatment(P<0.01),and the improvement in the treatment group was significantly better than that in the control group(P<0.05).After treatment,the results of 6-minute walking in the two groups were significantly higher than those before treatment(P<0.01),and the improvement degree of treatment group was significantly better than that of the control group(P<0.05).After treatment,the sum of medical syndrome scores in the two groups was significantly lower than that before treatment(P<0.01),and the treatment group was significantly lower than that of the control group(P<0.05).The total effective rate of medical symptoms in the treatment group was 93.33%,which was significantly higher than

关 键 词：慢性心力衰竭 阳气亏虚 血瘀水停 益心颗粒 N末端前体B型钠尿肽 超敏肌钙蛋白 红细胞分布宽度 

分 类 号：R541.61[医药卫生—心血管疾病]