舒心通脉组方治疗慢性心衰心肺气虚证患者的临床观察与药学监护

Clinical observation and pharmaceutical care of Shuxin Tongmai compound prescription in the treatment of chronic heart failure patients with syndrome of qi deficiency of heart and lung

目的观察舒心通脉组方用于慢性心力衰竭(心衰)心肺气虚证中西医结合治疗的效果以及药学监护的作用。方法 82例慢性心衰心肺气虚证患者,随机分为对照组与观察组,各41例。对照组给予西医常规治疗,观察组在西医常规治疗基础上加用舒心通脉组方治疗,两组在治疗过程中均给予药学监护。根据中医症候评分情况评价疗效,统计两组患者治疗前后纽约心脏协会(NYHA)心功能分级情况,以及静脉血N末端B型利钠肽原(NT-pro BNP)水平,并进行比较。结果观察组患者中医证候疗效明显优于对照组(P<0.05),两组治疗后的NYHA心功能分级Ⅱ级例数较治疗前均显著增加(P<0.05),且观察组显著多于对照组(P<0.05),两组治疗后的静脉血NT-pro BNP水平均较治疗前显著下降(P<0.05),且观察组NT-pro BNP水平[(1019.6±316.9)ng/L]较对照组更低[(1645.8±278.1)ng/L](P<0.05)。结论舒心通脉组方可提高慢性心衰心肺气虚证患者的疗效,临床药师参与药物治疗,提供药学监护,有利于提高患者依从性,促进安全合理用药,利于治疗。

Objective To observe effect by combined treatment of traditional Chinese and Western medicine through Shuxin Tongmai compound prescription for chronic heart failure patients with syndrome of qi deficiency of heart and lung. Methods A total of 82 chronic heart failure patients with syndrome of qi deficiency of heart and lung were randomly divided into control group and observation group, with 41 cases in each group. The control group received conventional Western therapy, and the observation group also received additional Shuxin Tongmai compound prescription for treatment. Both groups received pharmaceutical care during treatment. Summary was made on New York Heart Association（NYHA） cardiac functional classification and venous blood N-terminal pro brain natriuretic peptide（NT-pro BNP） level for comparison, in accordance with traditional Chinese medicine syndrome score for curative effect evaluation. Results The observation group had obviously better traditional Chinese medicine syndrome curative effect than the control group（P〈0.05）. After treatment, both groups had increased cases with grade Ⅱ NYHA cardiac functional classification（P〈0.05）, and the observation group had more cases than the control group（P〈0.05）. Both groups had much lower venous blood NT-pro BNP levels after treatment than those before treatment（P〈0.05）, and the observation group had lower NT-pro BNP level [（1019.6±316.9）ng/L] than the control group [（1645.8±278.1）ng/L]（P〈0.05）. Conclusion Shuxin Tongmai compound prescription can improve curative effect for chronic heart failure patients with syndrome of qi deficiency of heart and lung. Anticipation of clinical pharmacists in drug therapy with pharmaceutical care is beneficial for improving compliance in patients. This method promotes safe and rational drug use and is helpful for treatment.