养心益肾温阳利水法结合常规西药治疗冠心病心力衰竭临床研究  

Clinical Study on Method of Nourishing the Heart,Boosting the Kidney,Warming Yang and Promoting Urination Combined with Routine Western Medicine for Heart Failure Caused by Coronary Heart Disease

作　　者：王宝宝[1] 王晓娟[1] WANG Baobao;WANG Xiaojuan(Department of Cardiology,Anyang Chinese Medicine Hospital,Anyang He'nan 455000,China)

机构地区：[1]安阳市中医院心内科,河南安阳455000

出　　处：《新中医》2023年第15期54-58,共5页New Chinese Medicine

摘　　要：目的:观察养心益肾温阳利水法结合常规西药治疗冠心病心力衰竭(心肾阳虚水泛证)的临床疗效。方法:选取冠心病心力衰竭(心肾阳虚水泛证)患者96例,按随机数字表法分为对照组和观察组各48例,对照组脱落2例。对照组予以常规西药治疗,观察组在对照组基础上给予养心益肾温阳利水法治疗。评价2组临床疗效,比较2组治疗前后中医证候评分、心功能指标、血清N末端脑钠肽前体(NT-proBNP)、肌钙蛋白I(cTnI)、血管紧张素Ⅱ(AngⅡ)水平,观察不良反应发生情况。结果:观察组总有效率为93.75%,高于对照组78.26%(P<0.05)。治疗后,2组主症评分、次症评分和总分较治疗前降低(P<0.05),且观察组主症评分、次症评分和总分低于对照组(P<0.05)。治疗后,2组左室射血分数(LVEF)、心排量(CO)较治疗前升高(P<0.05),左室舒张末期内径(LVEDD)较治疗前降低(P<0.05);且观察组LVEF、CO高于对照组(P<0.05),LVEDD低于对照组(P<0.05)。治疗后,2组血清NT-proBNP、cTnI、AngⅡ水平较治疗前降低(P<0.05),且观察组血清NT-proBNP、cTnI、AngⅡ水平低于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:养心益肾温阳利水法结合常规西药治疗冠心病心力衰竭(心肾阳虚水泛证)可减轻患者临床症状,降低血清NT-proBNP、cTnI、AngⅡ水平,改善心功能。Objective:To observe the clinical effect of method of nourishing the heart,boosting the kidney,warming yang and promoting urination combined with routine western medicine for heart failure caused by coronary heart disease(edema due to heart-kidney yang deficiency syndrome).Methods:A total of 96 cases of patients with heart failure caused by coronary heart disease(edema due to heart-kidney yang deficiency syndrome)were selected and divided into the control group and the observation group according to the random number table method,with 48 cases in each group.There were two cases of detachment in the control group.The control group was treated with routine western medicine,and the observation group was additionally treated with method of nourishing the heart,boosting the kidney,warming yang and promoting urination based on the treatment of the control group.The clinical effects in the two groups were evaluated.Before and after treatment,the traditional Chinese medicine syndrome scores,and levels of heart function indexes,N-terminal pro-B-type natriuretic peptide(NT-proBNP),cardiac troponin I(cTnI),and angiotensin-Ⅱ(Ang-Ⅱ)in the two groups were compared.The incidence of adverse reactions were observed.Results:The total effective rate was 93.75%in the observation group,higher than that of 78.26%in the control group(P<0.05).After treatment,the scores of main symptoms and secondary symptoms as well as the total scores in the two groups were decreased when compared with those before treatment(P<0.05),and the scores of main symptoms and secondary symptoms as well as the total scores in the observation group were lower than those in the control group(P<0.05).After treatment,left ventricular ejection fraction(LVEF)and cardiac output(CO)in the two groups were increased when compared with those before treatment(P<0.05),and left ventricular end diastolic diameter(LVEDD)was decreased when compared with that before treatment(P<0.05);LVEF and CO in the observation group were higher than those in the control group(P<0.05),and

关 键 词：冠心病心力衰竭 心肾阳虚水泛证 养心益肾温阳利水法 心功能 血清N末端脑钠肽前体 肌钙蛋白Ⅰ 血管紧张素Ⅱ 

分 类 号：R541.4[医药卫生—心血管疾病] R259[医药卫生—内科学]