养心汤加减联合管式耳针治疗气虚血瘀型慢性心力衰竭的临床研究  

Clinical study on treating chronic heart failure of Qi deficiency and blood stasis type with modified Yangxin Decoction and Guan's ear needle combination therapy

作　　者：吴咚咚 刘旭英[1] 于国强 滕金艳 谭曾德 周亚滨[2] 张明明[1] WU Dongdong;LIU Xuying;YU Guoqiang;TENG Jinyan;TAN Zengde;ZHOU Yabin;ZHANG Mingming(Clinical Medicine School of Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China;不详)

机构地区：[1]黑龙江中医药大学临床医学院,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第一医院治未病中心,黑龙江哈尔滨150040 [3]黑龙江中医药大学附属第二医院针灸七科,黑龙江哈尔滨150001 [4]湖北省中医院(湖北中医药大学附属医院)针灸科,湖北武汉430000

出　　处：《中华全科医学》2024年第6期987-990,1032,共5页Chinese Journal of General Practice

基　　金：黑龙江省博士后基金项目(LBH-Z19216)。

摘　　要：目的观察养心汤加减联合管式耳针对慢性心力衰竭(CHF)患者的心功能、活动耐力、中医证候、临床疗效的影响,探讨养心汤加减联合管式耳针改善CHF患者心功能、活动耐力、中医证候的作用机制。方法选择2021年1—12月期间就诊于黑龙江中医药大学附属第一医院心内科门诊,气虚血瘀型CHF患者100例,采用随机单盲方案将100例CHF患者分为观察组与对照组,最终完成实验的观察组48例,对照组47例。2组患者均给予基础治疗,对照组给予基础治疗+常规西医治疗方案,观察组给予基础治疗+常规西医治疗方案+养心汤加减联合管氏耳针治疗方案。观察2组患者治疗前后中医证候、心脏功能、活动耐力、N末端B型利钠肽原(NT-proBNP)水平及心脏彩超变化,比较2组患者临床疗效。结果治疗后观察组中医证候积分、NT-proBNP水平、Lee氏心衰计分显著低于对照组,活动耐力较对照组显著提升(P<0.05);观察组左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)、左室心肌质量指数(LVMI)、室间隔厚度(IVST)较对照组显著下降,LVEF显著升高(P<0.05);观察组总有效率为93.8%(45/48),显著优于对照组的总有效率78.7%(37/47),P<0.05。结论养心汤加减联合管式耳针能显著提升CHF患者临床疗效,可有效改善CHF患者中医症候活动耐力以及心功能,提高CHF患者LVEF,降低CHF患者LVEDD、LVESD、LVMI、IVST及NT-proBNP水平。Objective To observe the effects of modified Yangxin Decoction combined with Guan's ear needle on heart function,activity endurance,Chinese medicine syndrome,and clinical efficacy in patients with chronic heart failure(CHF),and to explore the mechanism by which this combination improves these parameters in CHF patients.Methods During the period from January to December 2021,100 patients with Qi deficiency and blood stasis type CHF were treated at the Internal Medicine Clinic.They were randomly divided into an observation group and a control group using a single-blind protocol.Finally,48 patients in the observation group and 47 patients in the control group were completed.Both groups of patients were given basic treatment.The control group received routine western medicine treatment,including cardiac strengthening,diuresis,and vasodilation.The observation group received a combination of modified Yangxin Decoction and Guan's ear needle treatment in addition to the control group.Changes in Chinese medicine syndromes,cardiac function,activity endurance,N-terminal prohormone of brain natriuretic peptide(NT-proBNP)levels,and cardiac ultrasound were observed before and after treatment in two groups of patients.The clinical efficacy of the two groups was then compared.Results After treatment,the Chinese medicine syndrome score,NT-proBNP level,and Lee's heart failure score in the observation group were significantly lower than those in the control group,and the activity endurance was significantly improved compared to the control group(P<0.05).The left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular mass index(LVMI),and interventricular septal thickness(IVST)in the observation group were significantly decreased,while left ventricular ejection fraction(LVEF)was significantly increased compared to the control group(P<0.05).The total effective rate of the observation group was 93.8%(45/48),significantly higher than the 78.7%(37/47)in the control group(P<0.05).Conclusio

关 键 词：慢性心力衰竭 耳针疗法 管氏耳针 气虚血瘀 

分 类 号：R541.6[医药卫生—心血管疾病] R246.1[医药卫生—内科学]