加味真武汤联合西药治疗腹膜透析合并慢性心力衰竭临床研究

Clinical Study on Modified Zhenwu Decoction Combined with Western Medicine for Peritoneal Dialysis Complicated with Chronic Heart Failure

目的:观察加味真武汤联合西药治疗腹膜透析(PD)合并慢性心力衰竭(CHF)阳虚水泛证的临床疗效。方法:选取54例PD合并CHF阳虚水泛证患者,采用随机数字表法分为对照组与观察组各27例。研究过程中对照组剔除2例、观察组剔除3例,最终纳入研究对照组25例、观察组24例。对照组给予常规西药治疗,观察组在对照组基础上给予加味真武汤治疗,2组均治疗24周。比较2组临床疗效、中医证候积分及心功能指标[脑钠肽(BNP)、半乳糖凝集素-3 (Galectin-3)]水平。结果:治疗24周后,观察组总有效率79.17%,高于对照组28.00%,差异有统计学意义(P<0.05)。观察组中医证候积分较治疗前降低,且低于对照组,差异均有统计学意义(P<0.05);对照组中医证候积分与治疗前比较,差异无统计学意义(P>0.05)。观察组血清BNP、Galectin-3水平均较治疗前降低,且均低于对照组,差异均有统计学意义(P<0.05);对照组血清BNP、Galectin-3水平与治疗前比较,差异均无统计学意义(P>0.05)。结论:加味真武汤联合西药治疗PD合并CHF阳虚水泛证临床疗效较好,可有效改善临床症状,降低血清BNP、Galectin-3水平。

Objective:To observe the clinical effect of the therapy of modified Zhenwu Decoction combined with western medicine on peritoneal dialysis(PD)complicated with chronic heart failure(CHF)with syndrome of yang deficiency with water flood.Methods:A total of 54 PD cases of patients complicated with CHF with syndrome of yang deficiency with water flood were selected and divided into the control group and the observation group according to the random number table method,with 27 cases in each group.During the study,two and three cases were culled in the control group and the observation group respectively,and finally 25 and 24 cases were included in each group.The control group was treated with routine western medicine,and the observation group was additionally treated with modified Zhenwu Decoction based on the treatment of the control group.Both groups were treated for 24 weeks.The clinical effects, traditional Chinese medicine (TCM) syndrome scores, and levels of heart function indexes [brainnatriuretic peptide (BNP) and Galectin-3] were compared between the two groups. Results:After 24 weeksof treatment,the total effective rate was 79.17% in the observation group,higher than that of 28.00% inthe control group,the difference being significant (P<0.05). The TCM syndrome scores in the observationgroup were reduced when compared with those before treatment and were lower than those in the controlgroup, differences being significant (P<0.05);there was no significant difference being found in thecomparison of TCM syndrome scores in the control group with those before treatment (P>0.05). The levelsof serum BNP and Galectin-3 in the observation group were down-regulated when compared with thosebefore treatment and were lower than those in the control group,differences being significant (P<0.05);there was no significant difference being found in the comparisons of levels of serum BNP and Galectin-3 inthe control group with those before treatment (P>0.05). Conclusion: The therapy of modified ZhenwuDecoction combined with western medicine has a great clinical effect on PD complicated with CHF withsyndrome of yang deficiency with water flood, which can effectively improve the clinical symptoms anddecrease the levels of serum BNP and Galectin-3.