葶苈大枣泻肺汤合决渎汤治疗心力衰竭阳虚水泛证临床研究

Analysis of curative effect of Tingli Dazao Xiefei decoction and Juedu decoction in heart failure with yang deficiency and water flooding syndrome

目的:探究葶苈大枣泻肺汤合决渎汤在心力衰竭阳虚水泛证中的临床疗效。方法:将86例慢性心力衰竭患按照随机数字表法分为观察组和对照组,各43例,对照组采用左西孟坦治疗,观察组予葶苈大枣泻肺汤合决渎汤治疗。治疗2周后,比较两组的中医症候评分、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、N-脑钠肽前体(NT-proBNP)、高敏心肌肌钙蛋白(hsTn)T、血管紧张素Ⅱ(AgnⅡ)、同型半胱氨酸(Hcy)、疗效及不良反应。结果:治疗后,两组主症积分、次症积分均降低,观察组低于对照组(P<0.05);两组LVEF均升高,观察组高于对照组(P<0.05);两组LVESD及LVEDD均降低,观察组低于对照组(P<0.05);两组NT-proBNP、hsTnT、AgnⅡ、Hcy均降低,观察组低于对照组(P<0.05)。观察组临床疗效优于对照组(P<0.05)。两组治疗期间均未出现严重不良反应。结论:葶苈大枣泻肺汤合决渎汤治疗阳虚水泛证心力衰竭,有助于促进患者心功能的恢复,临床疗效优越且安全性较好。

Objective:To explore the therapeutic effect of Tingli Dazao Xiefei decoction and Juedu decoction in the treatment of heart failure with yang deficiency and water flooding syndrome.Methods:86 patients with chronic heart failure were divided into observation group and control group according to random number table method,43 patients in each group.The control group was treated with levosimontan,and the observation group was treated with combination of Tingli Dazao Xiefei decoction and Juedu decoction.After 2 weeks of treatment,the TCM syndrome score,left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF),N-proBNP precursor(NT-proBNP),high-sensitivity cardiac troponin(hsTn)T,angiotensinⅡ(AgnⅡ),homocysteine(Hcy),efficacy and adverse reactions were compared between the two groups.Results:After treatment,the main syndrome score and secondary syndrome score of the two groups decreased,and the observation group was lower than the control group(P<0.05);LVEF in both groups was higher than that in the control group(P<0.05);LVESD and LVEDD in the two groups were lower than those in the control group(P<0.05);NT-proBNP,hsTnT,AgnⅡand Hcy in the two groups were lower than those in the control group(P<0.05).The clinical effect of the observation group was better than that of the control group(P<0.05).There were no serious adverse reactions during treatment in both groups.Conclusion:Tingli Dazao Xiefei decoction combined with Juedu decoction in the treatment of heart failure due to yang deficiency and water flooding syndrome was helpful to promote the recovery of patients’cardiac function,with superior clinical efficacy and good safety.