扶阳益心方治疗气虚血瘀型射血分数保留心力衰竭患者临床疗效研究  

Clinical Efficacy of Fuyang Yixin Decoction(扶阳益心方)in the Treatment of Qi Deficiency and Blood Stasis Type HFpEF

作　　者：盛晟 李玲秀[2] 程丹 孔令洋 李凤 杜朝阳 程晓昱[3] SHENG Sheng;LI Lingxiu;CHENG Dan;KONG Lingyang;LI Feng;DU Chaoyang;CHENG Xiaoyu(Anhui Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Hefei 230031,Anhui,China;Anhui University of Traditional Chinese Medicine,Hefei 230012,Anhui,China;The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230031,Anhui,China)

机构地区：[1]安徽省中西医结合医院,安徽合肥230031 [2]安徽中医药大学,安徽合肥230012 [3]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《辽宁中医药大学学报》2024年第8期200-204,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：安徽省卫生和计划生育委员会中医药领军人才培养对象专项(中医药发展秘[2018]23号);安徽中医药大学科研项目(2018zryb64);安徽省高校自然科学研究项目(2023AH050841)。

摘　　要：目的探究扶阳益心方治疗气虚血瘀型射血分数保留心力衰竭(HFpEF)患者的临床疗效。方法选择安徽省中西医结合医院心血管内科2020年1月—2022年12月间收治的68例气虚血瘀型HFpEF患者并以随机数字表法分为对照组(34例,给予常规西药治疗)与观察组(34例,在对照组基础上服用扶阳益心方治疗)。对比两组患者中医证候疗效及心功能疗效、中医证候积分、Lee氏心衰积分、运动耐量试验、超声心动图指标[舒张早期/晚期二尖瓣血流峰值(E/A)、左房容积指数(LAVI)及左室质量指数(LVMI)]。结果治疗后观察组中医证候总有效率为97.06%,高于对照组76.47%(P<0.05);治疗后两组均未见恶化者,观察组心功能总有效率为91.18%,高于对照组70.59%(P<0.05);治疗后两组患者主症和次症积分及Lee氏心衰积分均降低,且观察组低于对照组(P<0.05);治疗后观察组和对照组6 min步行距离分别为(336.47±41.95)m及(285.73±38.72)m,观察组明显长于对照组(P<0.05);治疗后两组患者LAVI和LVMI均降低,E/A均升高,且观察组各心功能指标升高或降低的幅度高于对照组(P<0.05)。结论扶阳益心方治疗气虚血瘀型HFpEF患者可有效改善患者中医证候,提高患者心功能和运动耐量,值得临床推广应用。Objective To investigate the clinical efficacy of Fuyang Yixin Decoction(扶阳益心方)in the treatment of Qi deficiency and blood stasis type heart failure with preserved ejection fraction(HFpEF).Methods Using random number table method,68 patients with Qi deficiency and blood stasis type HFpEF who were admitted to the department of cardiovascular medicine,Anhui integrated traditional Chinese and Western medicine hospital from January 2020 to December 2022 were divided into the control group(34 patients treated with conventional Western medicine)and the observation group(34 patients treated with Fuyang Yixin Decoction on the basis of conventional treatment).Comparison was made between the two groups in terms of the therapeutic effects on traditional Chinese medicine(TCM)syndromes and cardiac function,TCM syndrome scores,Lee's heart failure score,exercise tolerance test,echocardiographic parameters[diastolic early/advanced peak mitral flow(E/A),left atrial volume index(LAVI)and left ventricular mass index(LVMI)],and the renin-angiotensin-aldosterone system(RAAS)activity[plasma aldosterone(ALD)and angiotensinⅡ(AngⅡ)/plasma renin activity(PRA)].Results After treatment,the total effective rates for TCM syndromes and cardiac function in the observation group(97.06%and 91.18%)were higher than those in the control group(76.47%and 70.59%)(P<0.05).After treatment,the scores of primary and secondary symptoms and Lee's heart failure scores of the two groups decreased,and the observation group had lower scores than the control group(P<0.05).After treatment,6-minute walking distance of the observation group[(336.47±41.95)m]was significantly longer than that of the control group[(285.73±38.72)m](P<0.05).After treatment,E/A increased,while LAVI and LVMI decreased in the two groups.The increase or decrease of each cardiac function index in the observation group was higher than that in the control group(P<0.05).Conclusion Fuyang Yixin Decoction can effectively improve the TCM syndromes,cardiac function and exercise toler

关 键 词：射血分数保留心力衰竭 气虚血瘀型 扶阳益心方 临床疗效 中医证候积分 

分 类 号：R256.2[医药卫生—中医内科学]