加味四妙勇安汤治疗气滞血瘀证慢性心力衰竭患者30例

Simiao Yongan Decoction on Qi Stagnancy and Blood Stasis in Patients of 30 Cases with Chronic Heart Failure

目的:观察四妙勇安汤加味对气滞血瘀型慢性心力衰竭患者的临床疗效,并探讨其作用机制。方法:将60例气滞血瘀型慢性心力衰竭患者随机分为观察组、对照组各30例。两组患者均给予阿司匹林肠溶片,口服,100 mg/次,1次/d;阿托伐他汀片,口服,20 mg/次,1次/d。观察组在对照组治疗基础上给予四妙勇安汤加味,水煎服,1剂/d。两组均以4周为1个疗程,间隔1周,开始第2个疗程,共4个疗程。结果:临床治愈率观察组57.50%,对照组40.00%,总有效率观察组95.00%,对照组75.00%,两组差异显著(P<0.05)。治疗后全血高切黏度、全血中切黏度、全血低切黏度、血浆黏度、红细胞压积观察组分别为[(3.52±0.62),(4.33±0.54),(7.18±1.55),(1.32±0.14)mPa.s,(34.43±5.54)%],对照组分别为[(3.72±0.58),(44.52±0.64),(7.41±1.23),(1.41±0.15)mPa.s,(36.78±5.68)%],两组治疗后与治疗前比有明显下降(P<0.05),治疗后观察组改善优于对照组(P<0.05)。血清TC,TG,LDL-C,HDL-C观察组分别为(3.62±1.60),(2.32±1.54),(3.15±1.55),(1.92±0.14)mmol·L-1,对照组分别为(4.75±1.58),(3.32±1.64),(4.31±1.23)(1.56±0.15)mmol·L-1,两组治疗后与治疗前比有明显下降(P<0.05),治疗后观察组改善优于对照组(P<0.05)。结论:四妙勇安汤加味对气滞血瘀型慢性心力衰竭临床疗效显著,其作用机制与影响血液流变性及血脂各项指标有关。

Objective： To observe the Simiao Yongan decoction on qi stagnancy and blood stasis syndrome in patients with chronic heart failure and to explore the related mechanism.Method： Cases of stagnancy of Qi and blood stasis with chronic heart failure were randomly divided into the observation group,the control group,with 30 cases in each group.Two groups of patients were given aspirin enteric-coated tablets,oral,100 mg daily;atorvastatin tablets,oral,20 mg daily.In the observation group based on the treatment of control group given Simiao Yongan decoction.The two groups were daily 4 weeks as 1 course.An interval of 1 week,was scheduled before starting second course.The total treatment lasted 4 courses.Result： The clinical cure rate was observed in observation group 57.50%,control group 40%（P0.05）.The total efficiency of the observation group was 95%,control group 75%（P0.05）.After treatment of high shear viscosity of whole blood,blood middle shear viscosity,blood low shear viscosity,plasma viscosity,hematocrit in observation group were（3.52±0.62）,（4.33±0.54）,（7.18±1.55）,（1.32±0.14）mPa·s,（34.43±5.54）%,compared to the control group respectively（3.72±0.58）,（4.52±0.64）,（7.41±1.23）,（1.41±0.15）mPa·s,（36.78±5.68）%,（P0.05）.After treatment,the observation group was better than the control group（P0.05）.TC,TG,LDL-C,HDL-C group respectively（3.62±1.60）,（2.32±1.54）,（3.15±1.55）,（1.92±0.14） mmol·L-1,the control group respectively（4.75±1.58）（3.32±1.64）（4.31±1.23）（1.56±0.15） mmol·L-1,（P0.05）.After treatment,the observation group was better than control group（P0.05）.Conclusion：Clinical curative effect of Simiao Yongan decoction on qi stagnancy and blood stasis syndrome of chronic heart failure is significant.Its mechanism may be related to effect on hemorheology and blood lipids indicators concerned.