四君子汤合防己黄芪汤加减治疗射血分数降低慢性心力衰竭气虚血瘀痰饮证患者的临床疗效  

Clinical effect of Sijunzi decoction combined with Fangji Huangqi decoction added and decreased in treating chronic heart failure patients with reduced ejection fraction and Qi deficiency,blood stasis and phlegm retention syndrome

作　　者：刘杰[1] 梁春玲[1] 陈晓杰[1] 李宁[1] 黄媛媛 LIU Jie;LIANG Chunling;CHEN Xiaojie;LI Ning;HUANG Yuanyuan(Department of Emergency Medicine,Wangjing Hospital,Chinese Academy of Traditional Chinese Medicine,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院急诊内科,北京100102

出　　处：《重庆医学》2024年第14期2168-2172,共5页Chongqing medicine

摘　　要：目的观察四君子汤合防己黄芪汤加减联合沙库巴曲缬沙坦钠片治疗射血分数降低慢性心力衰竭气虚血瘀痰饮证患者的临床疗效。方法选取2021年1月至2022年12月于该院住院治疗的94例慢性心力衰竭患者为研究对象,根据随机数字表法分为四君子汤合防己黄芪汤加减联合沙库巴曲缬沙坦钠片组(中药联合组)和沙库巴曲缬沙坦钠片组(对照组)。两组患者行标准治疗,中药联合组在此基础上加用四君子汤合防己黄芪汤加减方,均连续治疗8周。对比两组治疗前后24 h平均收缩压、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、中医证候积分和6 min步行实验(6-MWT)。结果与治疗前比较,治疗后两组24 h平均收缩压、中医证候积分总分及各项评分、LVEDD下降,LVEF、6-MWT升高,差异有统计学意义(P<0.05);与对照组比较,治疗后中药联合组24 h平均收缩压更高,中医证候积分总分及各项评分、LVEDD更低,LVEF、6-MWT更高,差异有统计学意义(P<0.05)。结论四君子汤合防己黄芪汤加减联合沙库巴曲缬沙坦钠片治疗射血分数降低慢性心力衰竭气虚血瘀痰饮证患者疗效较好,可有效提高患者收缩压,改善患者心脏冠脉血流灌注和生活质量,减轻左心室重构状态。Objective To observe the clinical effect of Sijunzi decoction and Fangji Huangqi decoction combined with Sacubitril Valsartan Sodium Tablets in treating chronic heart failure patients with reduced ejection fraction and Qi deficiency,blood stasis and phlegm retention.Methods Ninety-four inpatients with chronic heart failure treated in this hospital from January 2021 to December 2022 were selected as the study subjects and divided into the Sijunzi Decoction and Fangji Huangqi Decoction combined with Sacubitril Valsartan Sodium Tablets group(the Chinese medicine combined group)and Sacubitril Valsartan Sodium Tablets group(the control group)according to the random number table method.Both groups were treated with standard therapy,and the Chinese medicine combined group added Sijunzi Decoction and Fangji Huangqi Decoction on this basis.Both groups were continuously treated for 8 weeks.The mean systolic blood pressure,left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),TCM syndrome score and 6 min walking test(6-MWT)results at 24 h before treatment and after treatment were compared between the two groups.Results The average 24 h systolic blood pressure,score of each TCM syndrome and LVEDD after treatment in the two groups were decreased compared with those before treatment(P<0.05),while LVEF and 6-MWT in the two groups were increased,and the differences were statistically significant(P<0.05).Compared with the control group,the average 24 h systolic blood pressure in the Chinese medicine combined group was higher,each score of TCM syndrome score and LVEDD were lower,LVEF and 6-MWT were higher,and the differences were statistically significant(P<0.05).Conclusion Sijunzi Decoction and Fangji Huangqi Decoction combined with Sacubitril Valsartan Sodium Tablets has a good effect on the patients with chronic heart failure with reduced ejection fraction and Qi deficiency,blood stasis and phlegm retention,which could effectively increase the systolic blood pressure,improve the cardiac coronar

关 键 词：射血分数 慢性心力衰竭 气虚血瘀痰饮证 四君子汤合防己黄芪汤加减 沙库巴曲缬沙坦钠片 收缩压 左心室重构 

分 类 号：R541.6[医药卫生—心血管疾病]