合用参附汤和乌拉地尔治疗难治性充血性心力衰竭疗效观察

Observation on therapeutic efficacy of Shenfu Decoction combined urapidil on congestive heart failure

目的：探讨中西医结合治疗难治性充血性心力衰竭（ＣＨＦ）的疗效。方法：２８例ＣＨＦ患者随机分为治疗组１８例和对照组１０例，治疗组在对照组治疗基础上加用参附汤。观察治疗前后症状、心率、血压、左室射血分数（ＬＶＥＦ）和乌拉地尔药物消耗量等指标。结果：治疗后治疗组总有效率为９４．４％，明显优于对照组总有效率（８０．０％）。治疗组治疗后心功能提高２级者１１例，提高１级者６例，无改变１例；对照组心功能提高２级者３例，提高１级者５例，无改变２例。治疗组治疗后心率较对照组明显降低（Ｐ＜０．０５），ＬＶＥＦ较对照组显著增高（Ｐ＜０．０１）。乌拉地尔２组平均用量分别为（１２６６±６４）ｍｇ和（１６７６±７６）ｍｇ，有显著性差异（Ｐ＜０．０１）。

Objective:To explore the effect of TCM WM in treatment of refractory congestive heart failure (CHF).Methods:Twentyeight cases of CHF were divided into treatment group ( n =18) and control group ( n =10).The treatment group was treated with Shenfu Decoction on the basis of routine therapy of control group.Moreover,to observe the changes of some parameters including symptom,heart rate,blood pressure,left ventricular ejection fraction (LVEF) and urapidil consumption.Results:After therapy,the total effective rate in treatment group (94 4%) was obviously superior to the control group (80 0%);the cardiac function increased 2 grade,1 grade and no change in 11 cases,6 cases and 1 cases respectively in treatment group,and in 3 cases,5 cases and 2 cases respectively in control group;the heart rate was decreased and LVEF was increased significanty in treatment group compared to the control group ( P <0 05 and P <0 01).the therapy doses of urapidil were (1 266±64)mg and (1 676±76) mg in treatment group and control group respectively ( t =2 858, P <0 01).Conclusions:It has a better therapeutic efficacy of urapidil combined Shengfu Decoction treating CHF.