真武汤加味联合西药治疗慢性心力衰竭临床研究

Clinical Study of Modified Zhenwu Tang Combined with Western Medicine in Treating Chronic Heart Failure

目的:观察真武汤加味联合西药治疗慢性心力衰竭(CHF)的临床疗效,及对患者血浆脑钠肽(BNP)和生活质量的影响。方法:选取120例CHF患者,按照随机数字表法分为观察组和对照组各60例。对照组按患者病情给予西药治疗,观察组在对照组用药基础上联合真武汤加味治疗。治疗后观察2组主次要症状、血浆BNP、心功能及生活质量的改善情况。结果:观察组心功能疗效总有效率78.3%,对照组心功能疗效总有效率55.0%,2组比较,差异有统计学意义(P<0.01)。观察组中医证候疗效总有效率51.7%,对照组中医证候疗效总有效率30.0%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组血浆BNP含量及明尼苏达州心衰量表(MHFQ)积分均较治疗前降低(P<0.05),观察组的血浆BNP含量及MHFQ积分均低于对照组(P<0.05)。治疗后,2组左心室射血分数(LVEF)、心输出量(CO)及心脏指数(CI)均较治疗前升高(P<0.05),每搏输出量(SV)均较治疗前降低(P<0.05);观察组LVEF、CO、CI升高比对照组明显(P<0.05),SV降低比对照组明显(P<0.05)。治疗前,2组健康调查简表(SF-36)各维度评分比较,差异均无统计学意义(P>0.05)。治疗后,除躯体疼痛(BP)评分无改善外(P>0.05),SF-36其余各维度评分均较治疗前改善(P<0.05),且观察组的改善作用均优于对照组(P<0.05)。结论:真武汤加味联合西药治疗CHF患者,治疗效果显著,能有效改善患者的临床症状、心功能和生活质量,是一种有效的治疗方法。

Objective：To observe the clinical curative effect of modified Zhenwu tang combined with western medicine in treating chronic heart failure（CHF） and its effects on plasma Brain natriuretic peptide（BNP） and quality of life. Methods：One hundred and twenty cases of CHF patients were randomly divided into the observation and the control group,60 cases in each group. Both groups were treated with western medicine,while the observation group received modified Zhenwu tang additionally. After treatment,observed the improvement of major and minor symptoms,BNP in plasma,cardiac function and quality of life in both groups. Results： The total effective rate of cardiac function curative efficacy was 78.3% in the observation group and was 55.0% in the control group,the difference being significant（P〈0.01）. The total effective rate of Chinese Medicine（CM） syndrome was 51.7% in the observation group and was 30.0% in the control group,the difference being significant（P〈0.05）. After treatment,BNP in plasma and scores of Minnesota living with heart failure questionnaire（MHFQ） were lower in both groups than those before treatment（P〈0.05）. BNP in plasma and scores of MHFQ in the observation group were lower than those in the control group（P〈0.05）. Left ventricular ejection fraction（LVEF）,cardiac output（CO） and cardiac index（CI） in both groups were all increased,while stroke volume（SV） was decreased,compared with those before treatment（P〈0.05）. The increase of LVEF,CO,CI and decrease of SV were more obvious in the observation group than those in the control group（P〈0.05）. Before treatment,there was no significant difference of scores of the MOS item short from health survey（SF-36） between the two groups（P〉0.05）. After treatment,results in all dimension of SF-36 were improved except the score of bodily pain（BP）（P〈0.05） and the improvement in the observation group was greater than that in the control group（P〈0.05）. Conclusion：Modified Zhenwu tang combined with western medicine has a significant curative effect for CHF patients, which can effectively improve clinical symptoms, cardiac function and quality of life. It is an effective therapy.