归附五苓汤加味治疗肺心病合并心力衰竭的临床观察  

Clinical Study on Modified Guifu Wuling Decoction in Treating COR Pulmonale Complicated with Heart Failure

作　　者：聂伟 丁金玲 丁丽 陶明 韩琴 王梦云 Nie Wei;Ding Jinling;Ding Li;Tao Ming;Han Qin;Wang Mengyun(Huaibei City Hospital of Chinese Medicine,Huaibei,Anhui 235000,China)

机构地区：[1]安徽省淮北市中医医院,安徽淮北235000

出　　处：《中国中医急症》2023年第5期853-856,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：安徽省卫健委科研项目(AHWJ2021b044)。

摘　　要：目的 观察归附五苓汤加味治疗肺心病合并心力衰竭的临床疗效。方法 选取肺心病合并心力衰竭(阳虚水泛证)患者66例,随机分观察组与对照组各33例。对照组采用西医常规治疗,治疗组在对照组基础上加用归附五苓汤治疗,治疗7 d后,比较两组临床疗效,并观察治疗前后血浆NT-proBNP、D-二聚体、C反应蛋白(CRP)指标及在心脏超声下观察肺动脉压、右心室Tei指数、TAPSE值的变化。结果 治疗组总有效率为90.91%,对照组为75.76%,差异有统计学意义(P <0.05);两组治疗后血浆NT-proBNP、D-二聚体、CRP水平及肺动脉压、右心室Tei指数均明显下降,TAPSE值均明显升高,且治疗组优于对照组(P <0.05)。结论 归附五苓汤加味治疗肺心病合并心力衰竭(阳虚水泛证)能有效改善患者临床症状,改善凝血功能及降低炎症指标,降低肺动脉压,改善心功能。Objective:To observe the clinical efficacy of modified Guifu Wuling Decoction on Cor pulmonale complicated with heart failure(syndrome of Yang deficiency and water diffusion).Methods:A total of 66 cases of Cor pulmonale complicated with heart failure(syndrome of Yang deficiency and water diffusion)were selected and randomly divided into the observation group(33 cases)and control group(33 cases).The control group was treated with conventional western medicine,and the treatment group was treated with Guifu Wuling Decoction on the basis of the control group.After 7 days of treatment,the changes of NT-proBNP,D-dimer,CRP in plasma,pulmonary artery pressure,right ventricular Tei index and TAPSE were observed before and after treatment.Results:The total effective rate was 90.91%in the treatment group and 75.76%in the control group(P<0.05).The levels of plasma NT-proBNP,D-dimer,CRP,pulmonary artery pressure and right ventricular TEI index were significantly decreased and TAPSE was significantly increased after treatment in both groups,and the treatment group was superior to the control group(P<0.05).Conclusion:Modified Guifu Wuling Decoction treatment on Cor pulmonale complicated with heart failure(syndrome of Yang deficiency and water diffusion)can effectively improve the clinical symptoms of patients,improve blood clotting function and reduce inflammatory markers,reduce pulmonary artery pressure and improve cardiac function,which is worthy of clinical reference.

关 键 词：肺心病 心力衰竭 阳虚水泛型 右心室Tei指数 TAPSE值 归附汤 五苓汤 

分 类 号：R541.5[医药卫生—心血管疾病]