真武汤合四君子汤加味治疗阳虚血瘀水结型慢性心力衰竭临床研究  

Clinical Study on Modified True Warrior Decoction Combined with Four Gentlemen Decoction in the Treatment of Chronic Heart Failure with Yang Deficiency and Blood Stasis and Water Retention

作　　者：杜昌鹏 冯涛聚 郭军婷 乔松彦 DU Changpeng;FENG Taoju;GUO Junting;QIAO Songyan(Nanyang Hospital of Traditional Chinese Medicine,Nanyang,Henan,China,473007)

机构地区：[1]南阳市中医院,河南南阳473007

出　　处：《河南中医》2025年第5期749-754,共6页Henan Traditional Chinese Medicine

基　　金：2023年度中国中医科学院望京医院南阳医院苗圃培育专项课题项目(2023002)。

摘　　要：目的:观察真武汤合四君子汤加味治疗阳虚血瘀水结型慢性心力衰竭(chronic heart failure,CHF)的临床疗效。方法:选择2023年1月至2024年7月在南阳市中医院接受治疗的阳虚血瘀水结型CHF患者62例作为研究对象,按照随机数字表法分为对照组30例和治疗组32例。对照组给予常规西药治疗,治疗组在对照组治疗的基础上加用真武汤合四君子汤加味治疗。观察两组治疗前后脑钠肽(brain natriuretic peptide,BNP)、左室射血分数(left ventricular ejection fraction,LVEF)、6分钟步行试验距离、明尼苏达州心功能不全生存质量量表(minnesota living with heart failure questionnaire,MLHFQ)评分、中医证候积分变化情况及临床疗效。结果:治疗组有效率为93.75%,对照组有效率为73.33%,治疗组有效率高于对照组,差异有统计学意义(P<0.05)。两组治疗后BNP均低于治疗前,且治疗组治疗后BNP低于对照组,差异有统计学意义(P<0.05)。两组治疗后LVEF均低于治疗前,且治疗组治疗后LVEF高于对照组,差异有统计学意义(P<0.05)。两组治疗后6分钟步行试验距离大于对照组,且治疗组6分钟步行试验距离大于对照组,差异有统计学意义(P<0.05)。两组治疗后MLHFQ评分均低于治疗前,且治疗组治疗后MLHFQ评分低于对照组,差异有统计学意义(P<0.05)。治疗组治疗后中医证候积分低于对照组,差异有统计学意义(P<0.05)。结论:真武汤合四君子汤加味治疗阳虚血瘀水结型CHF有较好的临床疗效,可减轻患者心室压力负荷,提高患者心功能和生活质量,保护心肌细胞,调节神经内分泌功能,促进心脏康复。Objective:To observe the clinical efficacy of Modified True Warrior Decoction combined with Four Gentlemen Decoction on chronic heart failure(CHF)with syndrome of yang deficiency and blood stasis and water retention.Methods:A total of 62 CHF patients with syndrome of yang deficiency,blood stasis and water retention treated in Nanyang Hospital of Traditional Chinese Medicine from January 2023 to July 2024 were selected as the research subjects and randomly divided into the control group with 30 cases and the treatment group with 32 cases respectively.The control group was given conventional Western medicine treatment,while the treatment group was treated with Modified True Warrior Decoction combined with Four Gentlemen Decoction on the basis of the control group′s treatment.Then the changes in brain natriuretic peptide(BNP),left ventricular ejection fraction(LVEF),6-minute walk test,Minnesota Living with Heart Failure Questionnaire(MLHFQ)score,and TCM syndrome score,as well as clinical efficacy,were observed in both groups.Results:The effective rate of the treatment group was 93.75%,which was higher than that of the control group 73.33%,with a statistically significant difference(P<0.05).After treatment,BNP in both groups was lower than that before treatment,and BNP in the treatment group was lower than that in the control group,with a statistically significant difference(P<0.05);LVEF in both groups was lower than that before treatment,and LVEF in the treatment group was higher than that in the control group,with a statistically significant difference(P<0.05);the 6-minute walk test distance in both groups was better than that before treatment,and the 6-minute walk test distance in the treatment group was better than that in the control group,with a statistically significant difference(P<0.05);MLHFQ score in both groups was lower than that before treatment,and the MLHFQ score in the treatment group was lower than that in the control group,with a statistically significant difference(P<0.05);the TCM syndrome scores

关 键 词：慢性心力衰竭 阳虚血瘀水结证 真武汤 四君子汤 

分 类 号：R259.416[医药卫生—中西医结合]