益气活血、通阳泄浊方对冠心病慢性心力衰竭伴颈动脉斑块患者的影响

Treatment of Chronic Heart Failure with Carotid Plaque Patients by Yiqi Huoxue Tongyang Xiezhuo Recipe

目的评估益气活血、通阳泄浊方治疗冠状动脉粥样硬化性心脏病(简称冠心病)慢性心力衰竭(简称心衰)伴颈动脉斑块患者的临床疗效,探索中医药治疗冠心病慢性心衰伴颈动脉斑块的新途径。方法采用平行队列研究方法,将69例气虚痰瘀证冠心病慢性心衰伴颈动脉斑块患者分为两组,对照组(34例)予西医常规治疗,治疗组(35例)在西医常规治疗基础上加益气活血、通阳泄浊方治疗,每日2次,疗程均为3个月。治疗前后比较两组心功能分级、心脏超声(简称心超)、颈动脉斑块、血脂、安全性指标。结果两组心功能疗效比较,治疗组优于对照组(P<0.05)。治疗组LDL-C下降高于对照组(P<0.01)。与治疗前比较,治疗组左室射血分数(LVEF)、颈动脉内膜中层厚度(intima-media thickness,IMT)值、LDL-C、TC、TG治疗后差异均有统计学意义(P<0.05)。对照组LDL-C、TG较治疗前下降(P<0.05)。对照组左室射血分数、颈动脉IMT、TC及两组每搏输出量、左室舒张末内径、颈动脉斑块面积、HDL-C治疗前后比较,差异均无统计学意义(P>0.05)。结论益气活血、通阳泄浊方能有效改善气虚痰瘀证冠心病慢性心衰伴颈动脉斑块患者的心功能,降低血脂水平及IMT值,对老年患者短期使用未见明显不良反应。

Objective To evaluate the clinical effectiveness of Yiqi Huoxue Tongyang Xiezhuo Recipe（YHTXR,capable of supplementing qi,activating blood,warming yang,and discharge turbidity）in treating coronary atherosclerotic heart disease（CAHD） and chronic heart failure（CHF） with carotid plaque patients,and to explore new ways of Chinese medicine（CM）.Methods Totally 69 CAHD-CHF patients of qi deficiency phlegm stasis syndrome（QDPSS） with carotid plaque were recruited in this study using parallel cohort method.They were assigned to the treatment group（35 cases） and the control group（34 cases）.Patients in the control group received routine treatment of Western medicine,while those in the treatment group were additionally treated with YHTXR（twice daily）.The therapeutic course for all was three months.Cardiac function levels,echocardiography,carotid plaque,blood lipids and safety indicators were observed before and after treatment.Results After treatment the improvement of cardiac function levels was better in the treatment group than in the control group（P 0.05）.Decreased LDL-C levels were higher in the treatment group than in the control group（P 0.01）.There was statistical difference in left ventricular ejection fraction（LVEF）,carotid intima-media thickness（IMT）,LDL-C,TC,TG in the treatment group between before and after treatment（P 0.05）.LDL-C and TG also decreased in the control group after treatment（P 0.05）.There was no significant difference in the left ventricular ejection fraction,carotid IMT,or TC in the control group between before and after treatment（P0.05）.There was no significant difference in stroke volume,left ventricular end-diastolic diameter,the area of carotid artery plaque,or HDL-C in the two groups between before and after treatment（P 0.05）.Conclusions YHTXR could effectively improve cardiac functions of CAHD-CHF patients of QDPSS with carotid plaque,reduce blood lipids and IMT.It had no significant adverse reactions for elderly patients in short term.