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葶苈真武汤联合西药治疗充血性心力衰竭随机平行对照研究 被引量:1

Tinglizi Zhenwu Tang combined with Western Medicine Treatment Congestive Heart failure Randomized Controlled Study
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摘要 [目的]观察葶苈真武汤联合西药治疗充血性心力衰竭疗效。[方法]使用随机平行对照方法,将120例住院患者按病志号抽签法简单随机分为两组。对照组60例利尿剂:双氢克尿噻,25mg/次,1~3次/d;螺内酯,20mg/次,1~2次/d;或呋塞米(Ⅲ级、Ⅳ级),20mg/次,1~3次/d。血管紧张素转化酶抑制剂卡托普利,12.5mg^25mg/次,1~3次/d。洋地黄类(Ⅲ级、Ⅳ级):地高辛,0.125mg/次,1次/d;根据情况西地兰0.2~0.4mg+5%葡萄糖250m L,静注。血管扩张剂:硝酸异山梨酯,10mg/次,3次/d;根据情况联合硝酸甘油,5~10mg/次,1次/d,共注射1~5d。吸氧:间断吸氧,3-4L/h,根据情况吸氧,3-4L/h;注意电解质,必要时补钾;注意24h尿量治疗。治疗组60例葶苈真武汤(葶苈子30g,附片先煎30min、红参各15g,黄芪30g,白术、茯苓各15g,丹参12g;咳嗽甚加紫菀、杏仁各10g;喘甚加苏子、五味子各10g;心悸加龙骨、牡蛎各20g;瘀血重加桃仁15g,红花12g;浮肿重加车前子、泽泻各10g);1剂/d,水煎300m L,早中晚口服,100m L/次;西药治疗同对照组。连续治疗14d为1疗程。观测指临床症状、BNP、不良反应。治疗1疗程,判定疗效。[结果]治疗组显效32例,有效27例,无效1例,死亡0例,总有效率98.33%。对照组显效20例,有效26例,无效12例,死亡2例,总有效率76.67%。治疗组疗效优于对照组(P<0.01)。脑钠肽值两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]葶苈真武汤联合西药治疗充血性心力衰竭疗效满意,无严重不良反应,值得推广。 [Objective]To observe Tinglizi Zhenwutang combined with western medicine treatment of congestive heart failure treatment.[Methods]Randomized parallel controlled method,120 cases of hospitalized patients by disease Zhi No.lottery method is simple and randomly divided into two groups.The control group 60 cases Diuretics: Hydrochlorothiazide,25mg/times,1 to 3 times/d;spironolactone,20mg/times,1 to 2 times/d;or furosemide(Ⅲ grade,Ⅳ grade),20mg/time,1-3 times/d.Angiotensin converting enzyme inhibitors captopril,12.5mg^25 mg/times,1 to 3 times/d.Digitalis(gradeⅢ,gradeⅣ):digoxin,0.125mg/second,1/d;according to the patient's condition cedilanid 0.2~0.4 mg+5% 250 m L glucose intravenously.Vasodilators: isosorbide dinitrate,10mg/time,3 times/d;according to the joint nitroglycerin,5 ~ 10mg/times,1 times/d,a total injection of 1~5d.Oxygen: intermittent oxygen,3-4L/h,depending on the circumstances oxygen,3-4L/h;note electrolytes,potassium,if necessary;Note 24 h urine therapy.Treatment group,60 patients Tinglizi Zhenwu Tang(Tinglizi 30 g,Fupian,Hongshen 15 g,Huangqi 30 g,Baizhu,Fuling 15 g,Danshen 12g;cough even add Ziyuan,Xingren 10g;asthma and Suzi,Wuweizi 10g;palpitations plus Longgu,Muli 20g;bleeding heavier Taoren 15 g,Honghua 12g;edema heavier Cheqianzi,Zexie 10g);1/d,decoction 300 m L,early in the evening oral,100 m L/times.Western medicine with the control group.14 d for a course of continuous treatment.It refers to clinical observation,BNP,adverse reactions.Continuous treatment course of treatment,to determine efficacy.[Results]The treatment group 32 cases,effective 27 cases,ineffective in 1 case,0 cases of death,the total efficiency of 98.33%.The control group 20 cases markedly effective in 26 cases,12 cases,2 deaths,the total efficiency of 76.67%.Treatment group than the control group(P0.01).BNP values improved in both groups(P0.01),the treatment group than the control group improved(P0.01).[Conclusion]Zhen Wu Tang combined with Western medicine treatment of congestive heart failure satisfactory effect,no serious adverse reactions,is worth promoting.
出处 《实用中医内科杂志》 2015年第12期78-81,共4页 Journal of Practical Traditional Chinese Internal Medicine
基金 贵州遵义余庆县中医院2014年市级课题项目(No:qzyy2013-06)
关键词 充血性心力衰竭 心水 喘证 水肿 葶苈真武汤 双氢克尿噻 螺内酯 呋塞米 卡托普利 地高辛 西地兰 硝酸异山梨酯 硝酸甘油 BNP 中西医结合治疗 随机平行对照研究 congestive heart failure Xinshui Chuanzheng Shuizhong Tinglizi Zhenwu Tang HCTZ spironolactone furosemide captopril digoxin cedilanid isosorbide dinitrate nitroglycerin BNP integrative medicine randomized controlled study
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