参附强心汤联合西药治疗重症心力衰竭随机平行对照研究

Shenfu Qiangxin Soup combined Western Medicine Severe Heart Failure Randomized Parallel Group Study

[目的]观察参附强心汤联合西药治疗重症心力衰竭疗效。[方法]使用随机平行对照方法,将120例住院患者按抛硬币法简单随机分为两组。对照组60例常规治疗:吸氧、严密的心电监护、记录24H出入量、开通静脉通道,针对情况予小剂量硝普钠静脉泵入控制血压,依情况用美托洛尔控制心率;纠正水电解质紊乱及恶性心律失常,治疗原发病如溶栓、抗感染、抗过敏。治疗组60例参附强心汤(人参10g,黄芪30g,附子10g,生大黄5g,桂枝10g,毛冬青30g,水蛭粉3g,泽兰10g,冬葵子5g,滑石10g,牵牛子5g,葶苈子、桑白皮各10g,大腹皮15g,白术10g,甘草6g,防己10g,茯苓15g),水煎100m L,1h内口服,1次/d;西药治疗同对照组。连续治疗14d为1疗程。观测临床症状、左室收缩末容积(LVESV)、左心射血分数(LVEF)、每搏心输出量(SV)、心输出量(CO)不良反应。连续治疗2疗程,疗程间隔3d,判定疗效。[结果]治疗组显效34例,有效16例,无效10例,总有效率83.33%。对照组显效22例,有效23例,无效15例,总有效率75.00%。治疗组疗效优于对照组(P<0.05)。心功重症心力衰竭是由各种外界环境或内在原因致心功能短期内急剧恶化,心脏泵血功能降低,病情危重、进展迅速、预后凶险,严重甚至导致死亡[1-2]。我们使用参附强心汤联合西药治疗重症心力衰竭,获满意疗效,与单纯西药治疗对照,现报告如下。能指标两组均有改善(P<0.05),治疗组改善优于对照组(P<0.05)。[结论]参附强心汤联合西药治疗重症心力衰竭疗效满意,无副作用,值得推广。

[Objective]To observe Shenfu Qiangxin Soup combined with western treatment of severe heart failure treatment. [Methods]Randomized parallel-group method using the 120 cases of hospitalized patients simply by flipping a coin law randomized into two groups. 60 cases in the control group of conventional treatment： oxygen, tight ECG, 24H record intake and output, open venous channels, giving a small dose of intravenous infusion of sodium nitroprusside to control blood pressure, according to the situation with metoprolol controls heart rate for the case; correct water and electrolyte disorders and malignant arrbythmias, such as thrombolytic treatment of primary disease, anti-infective, anti-allergic. Treated 60 cases of cardiac Shenfu Tang （Renshen 10g, Huangqi 30g, Fuzi lOg, Shengdahuang 5g, Guizhi 10g, Maodongqing 30g, Shuizhifen 3g, Zelan log, Dongkuizi 5g,Huashi 10g, Qianniuzi 5g, Tinglizi, Sangbaipi lOg, Dafupi 15g, Baizhu lOg, Gancao 6g, Fangji lOg, Fuling 15g）, decoction 100mL, within lh oral, 1 / d; Western medicine with the control group. 14d for a course of continuous treatment. Observation of clinical symptoms, left ventricular end-systolic volume （LVESV）, left ventricular ejection fraction （LVEF）, cardiac output, stroke volume （SV）, cardiac output （CO）, adverse reactions. Continuous treatment for 2 course of treatment interval 3d, to determine efficacy. [Results]Treatment group 34 cases, effective in 16 cases, 10 cases, the total efficiency of 83.33%. The control group 22 cases markedly effective in 23 cases, 15 cases, the total efficiency of 75.00%. Treatment group than in the control group （P〈0.05）. Improve cardiac function in both groups （P〈0.05）, the treatment group than the control group improvement （P 〈0.05）. [Conclusion]Shenfu Qiangxin Soup combined cardiac medicine treatment of severe heart failure results were satisfactory, no side effects, it is worth promoting.