益气温阳利水法辅助治疗急性心力衰竭有创机械通气患者的疗效评价

Curative Evaluation of Applying“Invigorating Qi and Warming Yang to Promote Dieresis”Method in the Adjuvant Treatment of Invasive Mechanical Ventilation in Patients with Acute Heart Failure

目的:评价益气温阳利水法辅助治疗急性心力衰竭有创机械通气患者的疗效。方法:将中国中医科学院广安门医院南区重症医学科32例患者按随机数字表法随机分为治疗组和对照组各16例,均以常规对症治疗,治疗组加用益气温阳利水中药汤剂胃管鼻饲1周。比较两组患者治疗前及治疗1周后的心指数(CI)、血管外肺水指数(ELWI)、血浆BNP水平的变化、心脏超声指标。结果:与常规治疗组比较,益气温阳利水中药辅助治疗急性心力衰竭有创通气患者可提高心指数及左心室射血分数,可以有效降低患者的血管外肺水指数及左心室舒张末期内径(LVEDD),但对BNP无明显影响。结论:益气温阳利水中药辅助治疗急性心力衰竭有创通气患者具有积极的临床作用,改善患者预后。

Objective： To evaluate the efficacy of invasive mechanical ventilation in patients with acute heart failure through the method of adjuvant therapy of invigorating Qi and warming Yang to promote diuresis. Methods： Thirty- two patients admitted to the ICU of south division of Guanganmen Hospital,China Academy of Traditional Chinese Medicine were randomly divided into treatment group and controlled group with 16 cases in each according to the random number table method. Each group was treated with conventional therapy. The treatment group was treated with invigorating Qi and warming Yang to promote diuresis decoction through nasal feeding tube for one week. The changes of the index of Cardiac Index（ CI）,Extravascular Lung Water Index（ ELWI）,Plasma BNP and Cardiac Ultrasound between two groups were compared before and after 1week. Results： The method of invigorating Qi and warming Yang to promote diuresis could improve the cardiac index and left ventricular ejection fraction of acute heart failure patients with invasive mechanical ventilation,and could effectively reduce the patient＇s ELWI and left ventricular end diastolic diameter（ LVEDD）. But it had no significant effect on BNP. Conclusion： The method of adjuvant therapy of invigorating Qi and warming Yang to promote diuresis have positive clinical effect to the efficacy of invasive mechanical ventilation in patients with acute heart failure and it can improve the prognosis of patients.