益气活血利水方治疗气虚血瘀水停型慢性心力衰竭的临床研究  

Clinical Study of Yiqi Huoxue Lishui Prescription in the Treatment of Chronic Heart Failure with Qi Deficiency,Blood Stasis,and Water Retention Syndrome

作　　者：孙嘉豪 李衍达 邢雁伟[2] SUN Jiahao;LI Yanda;XING Yanwei(Beijing University of Traditional Chinese Medicine,Beijing 100020,China;Guang′anmen Hospital of China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]北京中医药大学,北京100020 [2]中国中医科学院广安门医院,北京100053

出　　处：《世界中医药》2023年第20期2941-2944,共4页World Chinese Medicine

基　　金：国家重点研发计划项目(2018YFC1704901);国家中医药管理局国家中医临床研究基地业务建设科研专项(JDZX2015007)。

摘　　要：目的:观察益气活血利水方联合使用常规西药治疗对气虚血瘀水停证慢性心力衰竭患者的临床疗效。方法:选取2017年7—12月中国中医科学院广安门医院心血管科门诊及病房就诊的气虚血瘀水停证慢性心力衰竭患者58例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组29例。对照组给予常规西药治疗;观察组给予益气活血利水方与常规西药联合治疗。治疗4周后观察并记录患者初诊用药前和治疗结束时6 min步行距离、明尼苏达心力衰竭量表积分、N末端前体脑利钠肽(NT-proBNP)、左室射血分数和中医证候积分。结果:观察组患者治疗后6 min步行距离增加程度明显优于对照组(P<0.05),观察组治疗后中医证候评分改善程度明显优于对照组(P<0.05)。2组治疗前后明尼苏达心力衰竭量表积分、左室射血分数、NT-proBNP的变化程度差异均无统计学意义(均P>0.05)。结论:益气活血利水方结合常规西药治疗气虚血瘀水停型慢性心力衰竭患者疗效显著,可以明显改善患者6 min步行距离以及中医证候评分,增强患者心肺功能和运动耐量,提升患者生命质量。Objective:This paper aims to observe the clinical efficacy of Yiqi Huoxue Lishui Prescription combined with conventional western medicine in the treatment of chronic heart failure with Qi deficiency,blood stasis,and water retention syndrome.Methods:A total of 58 patients with chronic heart failure featuring Qi deficiency,blood stasis,and water retention in the cardiovascular clinic and ward of Guang′anmen Hospital of China Academy of Chinese Medical Sciences from July 2017 to December 2017 were taken as the research objects,and they were randomly divided into a treatment group(n=29) and a control group(n=29).The treatment group was treated with conventional western medicine,and the control group was treated with the Yiqi Huoxue Lishui Prescription combined with conventional western medicine.Before and after four weeks of treatment,the TCM syndrome score,NT-proBNP,left ventricular ejection fraction,6-min walking distance,and Minnesota heart failure scale score were observed and recorded.Results:The increase in 6-minute walking distance in the treatment group was significantly better than that in the control group(P0.05).Conclusion:Yiqi Huoxue Lishui Prescription combined with conventional western medicine is effective in the treatment of patients with chronic heart failure featuring Qi deficiency,blood stasis,and water retention,which can significantly improve the 6-minute walking distance and TCM syndrome score,enhance cardiopulmonary function and exercise tolerance,and improve the quality of life of patients.

关 键 词：慢性心力衰竭 气虚血瘀水停证 随机对照临床试验 益气活血利水方 中西医结合 中医证候积分 6分钟步行距离 明尼苏达心力衰竭量表 

分 类 号：R289[医药卫生—方剂学] R259[医药卫生—中药学]