益气活血法治疗充血性心力衰竭的临床研究

Clinical research on congestive heart failure treated by Qi-supplementing and blood-activating method(益气活血法)

目的:观察中医益气活血法治疗充血性心力衰竭(CHF)的临床疗效。方法:将依据纽约心脏病协会(NYHA)心功能分级标准,判定心功能为Ⅲ级或Ⅳ级的63例CHF患者,按2∶1随机分为观察组和对照组,两组一般治疗相同。观察组加用中药汤药(由党参、麦冬、丹参、葶苈子等组成)口服,黄芪注射液足三里穴位注射,15 d为1个疗程。结果:观察组显效率为71.43%,有效率为21.47%,总有效率为92.90%;治疗前后左室射血分数(LVEF)分别为0.32±0.04与0.48±0.07(P<0.001);左室短轴缩短率〔ΔFS(%)〕分别为(19.29±2.23)%与(27.10±4.10)%(P<0.001);左室舒张期E点至室间隔距离(EPSS)分别为(15.89±4.25)mm与(7.64±3.57)mm(P<0.001);E峰/A峰比值(E/A)分别为0.89±0.24与1.38±0.32(P<0.01);心力衰竭各指标积分均明显降低(P均<0.05)。以上各指标与对照组比较差异均有显著性(P<0.05或P<0.01),观察组疗效优于对照组。结论:中医益气活血法对CHF有良好的治疗效果,且未见明显不良反应。

Objective： To observe the clinical therapeutic effects of Qi -supplementing and blood - activating method （益气活血法） for congestive heart failure （CHF）. Methods： Sixty-three patients with CHF [observation cardiac function It or IV according to the grande scale of cardiac function -New York Heart Association （NYHA）] were randomly divided into the observation group （n= 42） and the control group （n=21）. The general therapy of the two groups was the same. In addition, orally to the observation group was administered a decoction, which includes Radix Ginseng （人参）, Radix Ophiopogonis （麦冬）, Radix Salviae Mihiorrhizae （丹参） and Semen Lepidii seu Rescurainiae （葶苈子）, and astragalus injection （黄芪注射液） was injected in the Zushanli （ST 36） point, 15 days constituting one therapeutic course. Results： In the observation group, the obviously effective rate being the 71.43% and the effective rate was 21.47%, the total effective rate being the 92.90% ; ejection fraction （EF） of left ventricle was 0. 32 ± 0. 04 and 0. 48 ± 0.07 before and after treatment （P〈 0. 001） respectively, fractional shortening of short axis of left ventricle [AFS（%）] was （19.29±2. 23）% before treatment and （27.10±4. 10）% after treatment （P〈0. 001）; the distance of E point at diastolic stage to interventricler septum in left ventriculer （EPSS） was （15.89± 4.25） mm before treatment and （7.64±3.57） mm after treatment （P〈0. 001）; E/A was 0.89±0. 24 before treatment and 1.38±0. 32 after treatment （P〈0. 01）. The scores of indexes for heart failure were all lowered significantly （all P〈0. 05）. The differences of above parameters were significant between the two groups, and they were superior in observation group than those in the control group. Conclusion： Qi -supplementing and blood- activating method has good effects on CHF, and no side -effects are found.