真武汤合五苓散治疗阳虚水泛型心力衰竭的研究

Study on the Treatment of Heart Failure of Yang Deficiency and Water Flooding Type by Zhenwu Decoction Combined with Wuling Powder

目的探究真武汤合五苓散治疗阳虚水泛型心衰的临床效果。方法将我院于2020年12月—2023年12月收治的64例阳虚水泛型心衰患者纳入研究,通过随机数字表法分为对照组与观察组,每组各32例。对照组应用常规西医治疗,观察组加以真武汤合五苓散治疗,对比两组治疗后中医证候积分、心功能指标、预后指标、不良反应发生率、生活质量评分。结果观察组心悸、气喘或不得卧、咳吐泡沫痰、面肢体浮肿、畏寒制冷等各项中医证候积分、脑钠肽(BNP)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)等预后指标以及不良反应发生率均低于对照组(均P<0.05)。观察组左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)低于对照组,左室射血分数(LVEF)以及各项生活质量评分均高于对照组(均P<0.05)。结论真武汤合五苓散治疗阳虚水泛型心衰效果显著,可有效减轻患者相关症状,改善其心功能及预后,并降低不良反应发生风险,从而提其生活质量。

Objective Exploring the clinical effect of Zhenwu decoction combined with Wuling powder in the treatment of Yang deficiency and water flooding type heart failure.Methods During the research period from December 2020 to December 2023,our hospital enrolled a total of 64 patients diagnosed with Yang deficiency-induced generalized heart failure.These individuals were randomly divided into two groups:control group and observation group,each consisting of 32 cases.The control group received conventional western medicine treatment,while the observation group was administered Zhenwu decoction and Wuling powder.After the treatment,we conducted a comparative analysis between the two groups in terms of TCM syndrome score,cardiac function index,prognosis index,incidence of adverse reactions,and quality of life score.Results Prognostic indicators such as palpitation,shortness of breath or inability to lie down,coughing and spitting foamy sputum,swelling of the face and limbs,fear of cold and refrigeration,and prognostic indicators such as brain natriuretic peptide(BNP),angiotensinⅡ(AngⅡ),aldosterone(ALD),as well as the incidence rate of adverse effects in the Observation Group were lower than those in the Control Group(all P<0.05).In the observation group,the left ventricular end-systolic internal diameter(LVESD)and left ventricular end-diastolic internal diameter(LVEDD)were lower than those in the control group,and the left ventricular ejection fraction(LVEF)as well as the quality of life scores were higher than those in the control group(all P<0.05).Conclusions The combination therapy of Zhenwu decoction and Wuling powder effectively manages generalized heart failure caused by Yang deficiency water,improving symptoms,cardiac function,prognosis,and overall quality of life while minimizing adverse reactions.