温胆汤合瓜蒌薤白半夏汤辅助治疗冠心病心力衰竭临床观察

Clinical Observation of Wendan Tang Combined with Gualou Xiebai Banxia Tang on the Adjuvant Treatment for CHD Heart Failure

目的:观察温胆汤合瓜蒌薤白半夏汤辅助治疗冠状动脉粥样硬化性心脏病(CHD)心力衰竭的临床疗效。方法:选取100例CHD心力衰竭患者,随机分为观察组与对照组各50例。对照组给予常规西药治疗,观察组在对照组用药基础上辅以温胆汤合瓜蒌薤白半夏汤治疗。比较2组临床疗效,观察治疗前后心功能指标、血清氨基末端脑钠肽前体(NT-proBNP)含量、6 min步行试验(6 MWT)距离及中医证候积分的变化,比较2组不良反应发生情况。结果:观察组治疗总有效率88.89%,高于对照组的70.83%(P<0.05)。治疗后,2组左心室射血分数(LVEF)、每搏输出量(SV)均较治疗前升高(P<0.05,P<0.01),2组左心室舒张末径(LVDED)和观察组的左心室收缩末径(LVSED)均较治疗前缩小(P<0.05,P<0.01);观察组LVEF、SV均高于对照组(P<0.05),LVSED、LVDED均小于对照组(P<0.05)。治疗后,2组血清NT-proBNP含量及中医证候积分均较治疗前降低(P<0.05,P<0.01),6 MWT距离均较治疗前延长(P<0.05,P<0.01);观察组血清NT-proBNP含量及中医证候积分均低于对照组(P<0.05),6 MWT长于对照组(P<0.05)。治疗前后,2组血、尿常规及肝功能等检查均未见异常。结论:温胆汤合瓜蒌薤白半夏汤辅助治疗CHD心力衰竭,可有效改善患者的心功能指标和血清NT-proBNP水平,缓解心力衰竭症状,提高患者的自主步行能力,效果优于常规西药治疗,且安全性高。

Objective： To observe the clinical effect of Wendan tang combined with Gualou Xiebai Banxia tang on the adjuvant treatment for heart failure of coronary heart disease（CHD）. Methods：Selected 100 patients with CHD heart failure,and randomly divided them into the observation group and the control group being 50 cases in each. The control group was given routine treatment of western medicine, and the observation group was given Wendan tang combined with Gualou Xiebai Banxia tang based on the treatment of the control group. Compared clinical effect and incidence of adverse reaction of the two groups, and observed change of cardiac function index, content of serum N-temrina probarin natriuretic peptide（NT-proBNP）,distance of six minutes walking test and score of Chinese medicine syndrome in the two groups before and after treatment. Results：The total effective rate was 88.89% in the observation group,which was higher than the 70.83% in the control group（P〈0.05）. After treatment,left ventricular ejection fraction（LVEF）,stroke volume（SV） of the two groups were both higher than those before treatment（P〈0.05,P〈0.01）,left ventricular diastolic end diameter（LVDED） of the two groups and the left ventricular systolic diameter（LVSED） of the observation group were all smaller than those before treatment（P〈0.05,P〈0.01）. LVEF and SV of the observation group were both higher than those of the control group（P〈0.05）,LVSED and LVDED of the observation group were both smaller than those of the control group（P〈0.05）. After treatment,content of serum NT-proBNP and scores of Chinese medicine syndrome in the two groups were all lower than those before treatment（P〈0.05,P〈0.01）,distance of 6 minutes walking test of the two groups was longer than that before treatment（P〈0.05,P〈0.01）. Content of serum NT-proBNP and scores of Chinese medicine syndrome in the observation group were both lower than those in the control group（P〈0.05）,distance of 6 minutes walking test of the observation group was longer than that of the control group（P〈0.05）. There was no abnormity in the blood routine and urinalysis and liver function before and after treatment. Conclusion：Wendan tang combined with Gualou Xiebai Banxia tang can improve cardiac function index and levels of serum NT-proBNP, relieve heart failure, improve autonomous walking ability of patients effectively in the adjuvant treatment of CHD,which is safe and has better effect than routine western medicine.