扶阳针刺疗法治疗阳虚型慢性心力衰竭合并轻中度肾功能不全患者的临床观察  

Clinical Observation Yang-Supplementing Acupuncture Therapy in the Treatment of Chronic Heart Failure with Yang Deficiency Type Combined with Mild-to-Moderate Renal Insufficiency

作　　者：杨燕 杨新[2] 李秀芬[1] YANG Yan;YANG Xin;LI Xiu-Fen(Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University,Urumqi 830000 Xinjiang,China;People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830000 Xinjiang,China)

机构地区：[1]新疆医科大学附属中医医院,新疆乌鲁木齐830000 [2]新疆维吾尔自治区人民医院,新疆乌鲁木齐830000

出　　处：《广州中医药大学学报》2023年第4期911-916,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：新疆维吾尔自治区卫生健康青年医学科技人才专项科研资助项目(编号:WJWY-202228)。

摘　　要：【目的】观察扶阳针刺疗法治疗阳虚型慢性心力衰竭(CHF)合并轻中度肾功能不全患者的临床疗效。【方法】将110例阳虚型CHF合并轻中度肾功能不全患者随机分为观察组与对照组,每组各55例,对照组给予常规基础治疗,观察组在对照组治疗的基础上,给予扶阳针刺疗法治疗。连续治疗2周。治疗2周后,观察2组患者治疗前后氨基末端脑钠肽前体(NTproBNP)浓度和中医证候积分的变化情况,以及血清尿素氮(BUN)、血肌酐(SCr)、肌酐清除率(Ccr)水平的情况。比较2组患者治疗前后6 min步行距离(6MWT)以及左室射血分数(LVEF)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVDED)的变化情况。【结果】(1)治疗后,2组患者的NT-proBNP水平明显改善(P<0.05),且观察组在改善NT-proBNP水平方面明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的中医证候积分明显改善(P<0.05),且观察组在改善中医证候积分方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的BUN、SCr、Ccr含量均明显改善(P<0.05),且观察组在改善BUN、SCr、Ccr含量方面明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者的6MWT明显改善(P<0.05),且观察组在改善6MWT方面明显优于对照组,差异有统计学意义(P<0.05)。(5)治疗后,2组患者的LVDED、LVESD、LVEF水平均明显改善(P<0.05),且观察组在改善LVDED、LVESD、LVEF水平方面明显优于对照组,差异有统计学意义(P<0.05)。【结论】扶阳针刺疗法治疗阳虚型CHF合并轻中度肾功能不全患者可明显改善患者的临床症状,调节NT-proBNP水平,改善患者心功能与肾功能,提高患者的运动耐量,疗效显著。Objective To observe the clinical efficacy of yang-supplementing acupuncture therapy in treating patients with chronic heart failure(CHF) of yang deficiency type combined with mild-to-moderate renal insufficiency. Methods The 110 patients with CHF combined with mild-to-moderate renal insufficiency were randomly divided into the observation group and the control group,with 55 patients in each group. The control group was given conventional basic treatment, while the observation group was given yang-supplementing acupuncture therapy on the basis of the treatment in the control group. Both groups of patients were treated for consecutive 3 months. After 3 months of treatment,the changes in N-terminal pro brain natriuretic peptide(NTproBNP)concentration and traditional Chinese medicine(TCM)syndrome score,as well as the levels of blood urea nitrogen(BUN),serum creatinine(SCr)and creatinine clearance rate(Ccr)were observed before and after treatment in the two groups. The changes in 6-minute walk test(6MWT)and left ventricular ejection fraction(LVEF), left ventricular end-systolic internal diameter(LVESD)and left ventricular end-diastolic internal diameter(LVDED)were compared before and after treatment in the two groups. Results(1)After treatment,the NT-proBNP levels of the two groups were significantly improved(P<0.05), and the observation group was significantly superior to the control group in improving NT-proBNP levels, and the difference was statistically significant(P<0.05).(2)After treatment, the TCM syndrome scores of patients in the two groups were significantly improved(P<0.05), and the observation group was significantly superior to the control group in improving the TCM syndrome scores, and the difference was statistically significant(P<0.05).(3)After treatment, the BUN, SCr and Ccr levels in the two groups were significantly improved(P<0.05), and the observation group was significantly superior to the control group in improving the BUN,SCr and Ccr levels,the difference being statistically significant(P<0.05

关 键 词：扶阳针刺疗法 阳虚型慢性心力衰竭 肾功能不全 临床观察 

分 类 号：R246.9[医药卫生—针灸推拿学]