益气温阳汤联合西医常规疗法与康复训练治疗慢性心力衰竭临床研究

Clinical Study of Yiqi Wenyang Tang Combined with Routine Treatment of Western Medicine in Treating Chronic Heart Failure

目的:观察益气温阳汤联合西医常规疗法与康复训练治疗慢性心力衰竭的效果。方法:选择162例心肾阳虚型慢性心力衰竭患者为研究对象,随机分为对照组与观察组各81例,对照组采取常规西医疗法和康复训练治疗,观察组在对照组治疗基础上加益气温阳汤治疗,2组均以1月为1疗程,治疗2疗程。对2组患者的治疗效果、超声心动图变化、心肺功能变化及用药安全性进行观察。结果:治疗后,观察组总有效率88.89%,对照组总有效率67.90%,2组比较,差异有统计学意义(P<0.01)。2组超声心动图指标左室射血分数(LVEF)、左室舒张末径(LVEDD)、每搏量(SV)均较治疗前改善(P<0.05),观察组各指标的改善均优于对照组(P<0.05)。2组心肺功能指标运动时间、最大心率、最大耗氧量及最大运动负荷均较治疗前升高(P<0.05),观察组各指标值均高于对照组(P<0.05)。观察组与对照组用药后不良反应发生率分别为3.70%、12.35%,2组比较,差异有统计学意义(P<0.05)。结论:益气温阳汤联合西医常规疗法与康复训练治疗心肾阳虚型慢性心力衰竭效果满意,能促进心功能改善,有效降低不良反应发生风险,具有较高的临床应用价值。

Adjective： To observe clinical effect of Yiqi Wenyang tang combined with routine treatment of western medicine and rehabilitation training in treating chronic heart failure. Method：Selected 162 chronic heart failure patients of kidney yang deficiency type as study objects, and divided them into the control group and the observation group being 81 cases in each. The control group was given routine treatment of western medicine and rehabilitation training, while the observation group was given Yiqi Wenyang tang based on the treatment of the control group. One course of treatment lasted for one month, and the two groups both received two courses of treatment. Observed clinical effect, change of echocardiography and cardiopulmonary function, and the safty of the medicinals. Results- After treatment, the total effective rate was 88.89% in the observation group, and was 67.90% in the control group, the difference being significant （P〈 0.01）. Left ventricular ejection fraction （LVEF） and left ventricular end-diastolic pressure（LVEDD） and stroke volume（SV） of both groups were improved, and the improvement of every index of the observation group was better than that of the control group（P〈0.05）. Exercise time, maximal heart rate, maximal oxygen consumption and maximal work load of both groups were higher than those before treatment（P〈 0.05）, and scores of the every index of the observation group were higher than those of the control group（P〈 0.05）. The adverse reaction rate was 3.70% and 12.35% in the observation group and the control group respectively, the difference being significant（P〈 0.05）. Conclusion= Yiqi Wenyang tang combined with routine treatment of western medicine has satisfactory effect in treating chronic heart failure of heart and kidney yang deficiency type, which can improve cardiac function, reduce incidence of adverse reaction rate effectively and has significant value for clinicalpractice.