温肺祛瘀方治疗老年卧床坠积性肺炎合并心衰临床观察

Clinical Study of Wenfei Quyu Decoction in the Treatment of Elderly Bedridden Patients with Hypostatic Pneumonia and Heart Failure

目的观察温肺祛瘀方改善老年卧床坠积性肺炎合并心衰的临床疗效。方法患者120例随机分为治疗组63例与对照组57例。两组均予西医综合治疗,治疗组加用温肺祛瘀方,对照组加用温肺祛瘀方模拟剂。观察比较两组患者治疗前后的氨基末端B型脑钠肽前体(NT-proBNP)、左室射血分数(LVEF)、心肌肌钙蛋白I(cTNI)、血清降钙素(PCT)、中医证候评分。结果治疗后,治疗组NT-proBNP水平优于对照组(P<0.05);治疗组心脏超声检查LVEF改善程度优于对照组(P<0.05);两组治疗后c TNI均呈下降趋势,差异无显著意义(P>0.05);PCT水平治疗组下降较对照组更为明显(P<0.05);治疗组中医证候评分明显优于对照组(P<0.01)。结论针对老年卧床坠积性肺炎合并心衰患者,温肺祛瘀方可在有效控制感染的基础上改善患者心衰症状,治疗效果较佳,不良反应发生率低,临床应用价值高。

Objective:To observe the effectiveness of Chinese medicine in the treatment of elderly bedridden patients with hypostatic pneumonia and heart failure.Methods:A total of 120 elderly bedridden patients were randomly divided into two groups,with 63 in the treatment group and 57 in the control group.In the treatment group,Wenfei Quyu Decoction was added to the basic treatment,while in the control group,a mimetic decoction was added to the basic treatment.The changes in N-terminal B-type pro-brain natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),cardiac troponin I(c TNI),procalcitonin(PCT)and Chinese medicine evidence scores before and after the treatment in the two groups were observed and compared.Results:The level of NTproBNP was better in the treatment group than in the control group(P<0.05).The level of LVEF was better in the treatment group than in the control group(P<0.05).The level of cTNI tended to decrease after treatment in both groups,but the difference was not significant(P>0.05).The level of PCT decreased more significantly in the treatment group than in the control group(P<0.05).The TCM evidence scores in the treatment group were significantly better than that in the control group(P<0.01).Conclusion:For elderly bedridden patients with hypostatic pneumonia and heart failure,Wenfei Quyu Decoction can effectively control the infection and improve the symptoms of heart failure,with a better therapeutic efficacy and a lower incidence of adverse reactions.