益气活血方治疗慢性心力衰竭的临床研究

Clinical Observation on Yiqi Huoxue Decoctions for the Treatment of Chronic Heart Failure

目的观察益气活血方联合西医基础治疗慢性心力衰竭的临床疗效。方法选取2013年10月—2014年5月我院收治的慢性心力衰竭病人60例,根据双盲随机化的原则,将病人分为对照组和治疗组。治疗组采用益气活血方联合西医基础治疗,对照组采用常规西医治疗。观察两组病人治疗前后中医证候、6 min步行试验、心功能指标、肾素、血管紧张素Ⅱ、醛固酮、脑钠肽(BNP)及血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)变化,并评定临床疗效。结果治疗后,两组病人的心力衰竭程度均得到较大改善,中医症候表现为胸闷胸痛、心悸、小便清少、喘促憋气等相关症状消失或缓解。临床疗效和6 min步行试验,治疗组优于对照组(P<0.05);治疗组治疗后左室射血分数(LVEF)和舒张早期和舒张晚期最大血流速度之比(E/A)均优于对照组(P<0.05)。治疗后,两组病人的肾素、血管紧张素Ⅱ、醛固酮水平均明显下降(P<0.05),但两组治疗后比较差异无统计学意义;两组病人血浆BNP水平及血清TNF-α、IL-6水平均明显下降(P<0.05),且两组治疗后BNP和TNF-α差异有统计学意义(P<0.05)。结论益气活血方联合西医基础治疗慢性心力衰竭疗效明确,治疗效果明显优于常规西医基础治疗。

Objective To observe the effect of Yiqi Huoxue decoctions（YHD） and western medicine routine treatment for the treatment of chronic heart failure（CHF）.Methods Sixty patients with CHF were randomly divided into two groups：The control group treated with western medicine routine treatment, and the treatment group treated with YHD plus western medicine routine treatment.The changes in traditional Chinese medicine （TCM） syndrome and 6 min walking experiment were observed.The levels of plasma renin, angiotension, aldosterone, brain natriuretic peptide（BNP）, serum tumor necrosis factor-α （TNF- α） and interleukin- 6 （IL- 6） were measured.Results After treatment,TCM syndromes were improved obviously.The duration and distance of walking were significantly increased in 6 min walking experiment.The levels of plasma BNP and serum TNF- α in treatment group were decreased,which were lower than that in control group（ P 〈0.05）.Conclusion The effect of YHD plus western medicine routine treatment is better than western medicine routine treatment only in patients with CHF.