益气温阳联合西药治疗上凌心肺型充血性心力衰竭随机平行对照研究

Effect of Yiqi Wenyang combined with Western Medicine in Treating Ling Heart Lung Type Congestive Heart Failure a Randomized Controlled Study

[目的]益气温阳联合西药治疗上凌心肺型充血性心力衰竭。[方法]使用随机平行对照方法,将80例住院及门诊患者按就诊顺序编号法随机分为两组。对照组40例常规西药治疗,扩血管、利尿、强心、减轻心脏负荷、卧床休息、低盐饮食,酌情吸氧;卡托普利12.5mg/次,2次/d,口服;单硝酸异山梨酯40mg/次,1次/d,口服;水肿,双氢克尿噻,25mg/次,2次/d,口服;安体舒通,20mg/次,2次/d,口服;心功能四级,西地兰0.4mg＋0.9%生理盐水10mL,1次/d,缓慢静注,用药2d;硝酸甘油10mg＋0.9%生理盐水100mL,5gtt/min,静滴,视血压调滴速;速尿,20mg/次,2次/d,静注,用药1-2d,同时注意纠正电解质紊乱。治疗组40例益气温阳,制附子先煎15g,干姜10g,桂枝15g,白芍10g,白术15g,葶苈子10g,甘草5g。每日1剂/d,水煎300mL,分3次服;西药治疗同对照组。两组均连续治疗7d为1疗程。观测临床症状、心电图,胸部X线检查、血电解质、血尿素氮、肌酐、不良反应。连续治疗2个疗程,判定疗效。[结果]治疗组显效15例,有效22例,无效3例,总有效率92.5%。对照组显效12例,有效18例,无效10例,总有效率75%。治疗组疗效优于对照组（P〈0.05）。[结论]益气温阳联合西药治疗上凌心肺型充血性心力衰竭效果显著,值得推广。

[ Objective ] Yiqiwenyang combined with western medicine in treating Ling heart lung type of congestive heart failure. [ Method ] Using randomized controlled methods, 80 cases of inpatient and outpatient patients according to the order number method and were randomly divided into two groups. Routine western medicine treatment group 40 cases, vasodilators, diuretics, digitalis, decrease the heart load, bed rest, low salt diet, appropriate oxygen; Kato Pury 12.5mg/, 2/d, oral; isosorbide mononitrate 40mg/times, 1 time / d, oral; edema, hydrochlorothiazide, 25mg/time/d, 2, oral; spironolactone, 20mg/, 2/d, oral; heart function grade four, cedilanid 0.4mg＋0.9% 10mL normal saline, 1 times/d, slow intravenous injection, use 2D ; nitroglycerin 10mg＋0.9% physiological saline 100mL, 5gtt/min, intravenous drip, drip speed as the blood pressure adjustment; furosemide, 20rag / time, 2/d, intravenous administration of 1 - 2D, and correction of electrolyte imbalance. The treatment group of 40 cases of Yiqi Wenyang, Radix Aconiti Lateralis Preparata first decoct 15g, ginger 10g, cassia twig 15g, 10g of root of herbaceous peony, Atractylodes 15g, Tinglizil0g, licorice 5G. Daily 1 agent/d, water simmer in water 300mL, cent is taken 3 times ; western medicine treatment with the control group. The two groups were continuous treatment with 7d for 1 courses. Observation of clinical symptoms, electrocardiogram, chest X-ray, blood electrolytes, blood urea nitrogen, creatinine, adverse reaction.Continuous treatment of 2 courses, to judge the curative effect. 15 cases of group therapy [ Results ] Effective 22 cases, invalid 3 cases, the total efficiency of 92.5%. 12 cases of control group, 18 cases were effective, 10 cases ineffective, the total efficiency of 75%. The treatment group was better than control group （ P 〈 0.05 ） . [ Conclusion ] Yiqiwenyang combined with western medicine in treatment of congestive heart failure affects the heart lung type effect is significant, worthy of promotion.