苓桂术甘汤加味治疗充血性心力衰竭49例  

Supplemented Poria and Cinnamon Twig and Atractylodes Macrocephala and Licorice Decoction for the Treatment of 49 Cases of Congestive Heart Failure

作　　者：肖向金 刘国珍 李小军 XIAO Xiang-jin;LIU Guo-zhen;LI Xiao-jun(Yudu County Hospital of Traditional Chinese Medicine,Yudu,Jiangxi,China,342300)

机构地区：[1]于都县中医院,江西于都342300

出　　处：《河南中医》2023年第6期831-835,共5页Henan Traditional Chinese Medicine

基　　金：赣州市指导性科技计划项目(GZ2015ZSF440)。

摘　　要：目的:观察苓桂术甘汤加味治疗心肾阳虚型充血性心力衰竭(congestive heart failure, CHF)的临床疗效。方法:将98例心肾阳虚型CHF患者按照随机数字表法分为对照组和研究组,每组各49例。对照组给予常规西药治疗,研究组在对照组治疗的基础上联合苓桂术甘汤加味治疗。观察两组患者的临床疗效,比较两组患者治疗前后中医证候积分、心功能分级、心功能指标[心脏指数、左心室射血分数(left ventricular ejection fraction, LVEF)、每搏输出量(stroke volume, SV)]、N端脑钠肽前体(N-terminal pro-brain natriuretic peptide, NT-proBNP)及6分钟步行实验(6 minute walking distance, 6MWD)变化情况。结果:研究组有效率高于对照组(P<0.05)。两组患者治疗后心悸胸闷、下肢浮肿、畏寒肢冷、腰酸尿少评分低于本组治疗前,且研究组治疗后低于对照组(P<0.05)。两组治疗后心功能分级优于治疗前,且研究组优于对照组(P<0.05)。两组患者治疗后LVEF、心脏指数、SV高于本组治疗前,且治疗后研究组高于对照组(P<0.05)。两组患者治疗后NT-proBNP低于本组治疗前,6MWD高于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。结论:苓桂术甘汤加味治疗心肾阳虚型CHF,可提高临床疗效,改善患者心功能及运动耐力。Objective: To observe the clinical efficacy of Supplemented Poria and Cinnamon Twig and Atractylodes Macrocephala and Licorice Decoction on congestive heart failure(CHF)with heart and kidney yang deficiency syndrome.Methods: A total of 98 patients with CHF of heart and kidney yang deficiency type were randomly divided into the control group and the study group, with 49 cases in each group.The control group was treated with conventional Western medicine, while the study group was treated with Supplemented Poria and Cinnamon Twig and Atractylodes Macrocephala and Licorice Decoction on the basis of the control group.Then the clinical efficacy was observed;the changes of the TCM syndrome scores, cardiac function classification, cardiac function indicators [including cardiac index, left ventricular ejection fraction(LVEF),stroke volume(SV)],N-terminal pro-brain natriuretic peptide(NT-proBNP) and 6-minute walking distance(6MWD) of the two groups before and after treatment were compared.Results: The effective rate of the study group was higher than that of the control group(P<0.05).After treatment, the scores of palpitations, chest tightness, lower limb edema, chills, and low back pain and urine in both groups were lower than those of the same group before treatment, and the study group′s were lower than those of the control group(P<0.05);The cardiac function grading of the two groups was better than that of the same group before treatment, and the study group′s was better than that of the control group(P<0.05);The LVEF,cardiac index, and SV of the two groups were higher than those of the same group before treatment, and the study group′s were higher than those of the control group(P<0.05);The NT-proBNP of the two groups was lower than that of the same group before treatment, while the 6MWD was higher than that before treatment.All the differences between the two groups were statistically significant(P<0.05).Conclusion: Supplemented Poria and Cinnamon Twig and Atractylodes Macrocephala and Licorice Decoction can i

关 键 词：充血性心力衰竭 心肾阳虚证 苓桂术甘汤加味 《伤寒论》 张仲景 

分 类 号：R259.414[医药卫生—中西医结合]