补肾泄浊活血汤治疗老年高尿酸血症兼慢性心功能不全临床研究

Clinical Study on Treating Elderly Patients with Hyperuricemia and Chronic Heart Failure with Bushen Xiezhuo Huoxue Decoction

目的 :观察补肾泄浊活血汤治疗老年高尿酸血症兼慢性心功能不全的临床疗效。方法 :收集老年高尿酸血症兼慢性心功能不全肾虚水停证患者66例,按随机数字表法分为治疗组和对照组各33例。对照组给予常规西医治疗,治疗组在对照组的基础上加用补肾泄浊活血汤口服,两组均治疗两个月。观察两组治疗前后的血浆N末端B型钠尿肽前体(NT-pro BNP)、血尿酸(SUA)、血肌酐(Scr)、血尿素氮(BUN)水平及左室射血分数(LVEF),评价两组心功能及中医证候疗效。结果:66例患者入组,脱落5例,61例完成临床研究,其中治疗组33例,对照组28例。治疗两个月后,治疗组SUA水平明显下降,与本组治疗前及对照组治疗后比较,差异均有统计学意义(P<0.05);两组NT-pro BNP水平较治疗前均有改善,差异有统计学意义(P<0.05),且治疗组改善优于对照组,差异有统计学意义(P<0.05);治疗组的心功能与中医证候疗效均优于对照组,差异有统计学意义(P<0.05)。两组治疗前后BUN、Scr、LVEF比较,差异无统计学意义(P>0.05)。结论 :补肾泄浊活血汤能明显改善老年高尿酸血症兼慢性心功能不全肾虚水停证患者的心功能、降低SUA水平,改善临床症状,且无明显不良反应。

Objective：To observe the efficacy of Bushen Xiezhuo Huoxue decoction （BSXZHXD,Decoction for invigorating the kidney,purging turbid and promoting blood circulation） on elderly patients with hyper- uricemia and chronic heart failure,so as to verify the feasibility of treating the disease from the kidney. Methods ：A total of 66 elderly patients with hyperuricemia and chronic heart failure of kidney deficiency and water retention syndrome were divided into the treatment group and the control group by the random number table method,with 33 cases in each group. The control group was given conventional western medicine ther- apy and the treatment group was treated with BSXZHXD on the basis of conventional western medicine therapy. Both the two groups were treated for two months. The levels of serum N-terminal prohormone of brain natriuretie peptide （NT-proBNP）, serum uric acid （SUA）, serum creatinine （Set）, blood urea nitrogen （BUN） and score of left ventricular ejection fraction（LVEF） of the two groups were observed before and af- ter treatment. The efficacy of BSXZHXD on improving the cardiac function and traditional Chinese medicine （TCM） syndromes were evaluated. Results：Among the 66 patients,5 cases were eliminated and 61 cases fi- nally completed the study,33 in the treatment group and 28 in the control group. After treating for 2 months,the SUA level of the treatment group was significantly decreased. The differences of the comparison both in and among the groups were statistically significant（P〈0.05）. The levels~ of serum NT-proBNP of thetwo groups were significantly improved,compared with those before treatment,the differences were statistically significant （P 〈 0.05 ）. Furthermore, the improvement of the treatment group was better than that of the control group,and the differences were statistically significant（P〈0.05）. The curative effi- cacy of the TCM syndromes and cardiac functionin the treatment group was better than that in the control group, and the difference was statistically signifi cant（P〈0.05）. The differences of Scr and BUN level and LVEF score between the two groups were not statistically significant（P〉0.05）. Conclusion：For treatment of elderly patients with hyperuricemia and chronic heart failure of kidney deficiency and water retention syndrome,BSXZHXD can signifcantly improve the car- diac function,reduce the SUA level,improve the clinical symptoms and without obvious adverse reactions.