益气活血法治疗左心室射血分数正常心力衰竭40例临床观察

Clinical observation of heart failure with normal left ventricular ejection fraction treated by traditional Chinese drug of benefiting qi for activating blood circulation

目的观察益气活血法治疗左心室左心室射血分数正常心力衰竭的临床疗效。方法将40例左心室射血分数正常心力衰竭患者随机分为治疗组与对照组,各20例。对照组采用常规西药治疗,治疗组在常规西药的基础上加用益气活血中药(生黄芪、丹参、川芎、檀香、桂枝、炙甘草),疗程2周。采用超声心动图检测治疗前后左室舒张功能指标舒张早期二尖瓣血流峰值(Emas),舒张晚期二尖瓣血流峰值(Amas),两者之比值(E/A),左房前后径(LAD),检测血浆脑钠肽(BNP),并观察临床疗效及中医证候疗效。结果治疗组Emas、E/A、Amas及BNP与治疗前及对照组治疗后比较差异均有统计学意义(P<0.05);中医证候疗效显效率与对照组比较差异有统计学意义(P<0.05)。临床疗效治疗组总有效率95%,对照组总有效率70%,2组比较差异有统计学意义(P<0.05)。结论益气活血中药能够改善左心室射血分数正常心力衰竭患者左室血流动力学状态,提高左室舒张能力,对心力衰竭具有改善作用。

Objective To investigate the effect of traditional Chinese drug of benefiting qi for activating blood circulation on heart failure with normal left ventricular ejection fraction.Methods 40 patients with heart failure with normal left ventricular ejection fraction were randomly divided into the treatment group and control group,20 cases each group.The control group received routine western medicine therapy.Patients in treatment group received combination of traditional Chinese drug of benefiting qi for activating blood circulation（consisting of Astragalus,danshen,hemlock parsley,sandalwood,cassia twig,radix glycyrrhizae preparata） and routine therapy.2 weeks was as a therapeutic course.Left ventricular diastolic function index including early mitral valve diastolic flow peak velocity（Emax）,late diastolic peak flow peak velocity（Amax）,ratio of E and A（E/A）,Left atrium diameter（LAD） were detected using echocardiography test and the clinical curative effect and the symptoms of traditional Chinese medicine were observed before and after treatment.Results There was significant difference between two groups in Emax,E/A,Amax and BNP after treatment.These of the treatment group were improved significantly after treatment（P0.05）.The total effective rate of traditional Chinese traditional syndrome in treatment group（95%） was higher than that in the control group（70%,P0.05）.Conclusion Traditional Chinese drug of benefiting qi for activating blood circulation can ameliorate left ventricular hemodynamic status of heart failure with normal left ventricular ejection fraction,improve left ventricular diastolic ability.