补肾活血汤治疗慢性心力衰竭的临床观察

Clinical Observation of Chronic Heart Failure Treated with Bushen Huoxue Decoction

目的观察补肾活血汤治疗慢性心力衰竭的临床疗效及其对血浆脑钠肽(BNP)水平和左室射血功能的影响。方法将106例慢性心力衰竭患者随机分为治疗组54例和对照组52例。对照组根据病情给予西医基础治疗(血管紧张素受体拮抗剂、硝酸酯类药物、β受体阻滞剂、利尿剂、强心剂等药物),治疗组在对照组治疗基础上加服补肾活血汤,疗程4周,观察临床疗效,于治疗前后分别检测患者BNP水平,并测定患者治疗前后左室射血功能,包括左室收缩末内径(LVESD)、左室收缩末容积(LVESV)、每搏输出量(SV)、左室射血分数(LVEF)。结果治疗组总有效率94.4%,对照组总有效率63.5%,两组比较,差异有统计学意义(P<0.05)。治疗组血浆BNP水平、LVESD、LVESV、SV、LVEF值均有所改善,与对照组比较,差异有统计学意义(P<0.05)。结论补肾活血汤能明显降低慢性心力衰竭患者血浆BNP水平,提高患者左室射血功能,改善患者心功能,具有良好的应用前景。

Objective To observe the clinical efficacy of bushen huoxue decoction on chronic heart failure and the impacts on plasma brain natriuretic peptide（BNP）level and left ventricular ejection function.Methods 106 cases of chronic heart failure were randomized into a treatment group（54 cases）and a control group（52 cases）.In the control group,according to the situation of disease,the basic treatment of western medicine was given（angiotension receptor antagonist,nitric acid ester agents,β receptor blockers,diuretic,cardiotonic,etc.）.In the treatment group,on the basis of the treatment as the control group,bushen huoxue decoction was supplemented.The treatment lasted for 4 weeks.The clinical efficacy was observed.BNP level was detected before and after treatment,as well as the left ventricular ejection function including left ventricular end-systolic dimension（LVESD）,left ventricular end-systolic volume（LVESV）,stroke volume（SV）and left ventricular ejection fraction（LVEF）.Results The total effective rate was 94.4% in the treatment group and was 63.5% in the control group,indicating the statistical significant difference between two groups（P0.05）.In the treatment group,the plasma BNP level,LVESD,LVESV,SV and LVEF values were all improved,presenting statistical significant differences as compared with those in the control group（P0.05）.Conclusion Bushen huoxue decoction reduces obviously the plasma BNP level and improves the left ventricular ejection function and heart function for the patients with chronic heart failure,presenting the positive prospect in clinical application.