扶阳针刺疗法治疗心肾阳虚型慢性心力衰竭的回顾性研究  

Retrospective Study on Yang-Reinforcing Acupuncture Therapy for ChronicHeart Failure of Heart-Kidney Yang Deficiency

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5期1161-1167,共7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】探讨扶阳针刺疗法治疗心肾阳虚型慢性心力衰竭(CHF)患者的临床疗效。【方法】采用回顾性分析的研究方法,选取2021年1月~2022年6月在新疆医科大学附属中医医院心内科就诊的69例心肾阳虚型CHF患者,根据治疗方案的不同将其分为观察组和对照组,对照组33例,观察组36例。对照组给予常规方案治疗,观察组在对照组治疗的基础上,给予扶阳针刺疗法治疗,2组均治疗8周。治疗8周后,观察2组患者治疗前后左室射血分数(LVEF)、每搏输出量(SV)、氨基末端脑钠肽前体(NT-proBNP)水平和T细胞CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平的变化情况,以及lee心衰积分、中医证候积分、6 min步行距离(6MWT)和明尼苏达心力衰竭生活质量量表(MLHFQ)评分的变化情况,并评价2组的临床疗效。【结果】(1)观察组总有效率80.56%(29/36)比对照组63.64%(21/33)高,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的LVEF、SV水平均比治疗前升高,且观察组比对照组高(P<0.05)。(3)治疗后,2组患者的NT-proBNP水平均比治疗前降低,且观察组比对照组低(P<0.05)。(4)2组治疗后T细胞CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平明显改善,且观察组改善优于对照组(P<0.05)。(5)治疗后,2组患者的中医证候积分及lee心衰积分均比治疗前降低,且观察组比对照组低(P<0.05)。(6)2组治疗后的6MWT和MLHFQ总分均明显改善,且观察组改善优于对照组(P<0.05)。【结论】扶阳针刺疗法治疗心肾阳虚型CHF患者能明显改善患者的心功能,减轻患者的相关症状,缓解心衰,并调节患者的免疫功能,提高患者的生活质量,疗效确切。Objective To investigate the clinical efficacy of yang-reinforcing acupuncture on chronic heart failure(CHF)patients with heart-kidney yang deficiency type.Methods A retrospective analysis was conducted,and 69 patients with heart-kidney yang deficiency type of CHF who attended the Department of Cardiology of the Affiliated Hospital of Xinjiang Medical University from January 2021 to June 2022 were selected and divided into the observation group and the control group according to the treatment regimen,with 33 cases in the control group and 36 cases in the observation group.The control group was given conventional treatment and the observation group was treated with yang-reinforcing acupuncture therapy on the basis of the treatment in the control group.After 8 weeks of treatment,the patients in both groups were observed before and after treatment for changes in left ventricular ejection fraction(LVEF),stroke volume(SV),amino-terminal brain natriuretic peptide precursor(NT-proBNP)levels and CD4^(+),CD8^(+),CD4^(+)/CD8^(+)of T-lymphocyte,as well as lee heart failure score,traditional Chinese medicine(TCM)syndrome score,6-minute walking distance(6MWT)and Minnesota Living with Heart Failure Questionnaire(MLHFQ).The clinical efficacy of the two groups was evaluated.Results(1)The total effective rate of the observation group was 80.56%(29/36)higher than that of the control group 63.64%(21/33),and the difference was statistically significant(P<0.05).(2)After treatment,the LVEF and SV levels of patients in both groups were higher than those before treatment,and the observation group was higher than the control group(P<0.05).(3)After treatment,the NT-proBNP levels of patients in both groups were lower than those before treatment,and the observation group was lower than the control group(P<0.05).(4)The levels of CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)were significantly improved in the two groups after treatment,and the improvement in the observation group was superior to that in the control group(P<0.05).(5)After treatment,the TC

关 键 词：扶阳针刺疗法 慢性心力衰竭 心肾阳虚证 心功能 免疫功能 临床疗效 

分 类 号：R246.9[医药卫生—针灸推拿学]