利水活血温阳方治疗血瘀阻络、水液停聚型慢性心力衰竭临床观察

Clinical observation of Lishui-Huoxue-Wenyang prescription in treating congestive heart failure with blood stasis blocking collateral type and aqueous fluid stopping type

目的观察利水活血温阳方治疗血瘀阻络、水液停聚型慢性心力衰竭(CHF)的临床疗效。方法将95例血瘀阻络、水液停聚型CHF患者随机分为2组。对照组48例予西医常规治疗;治疗组47例在对照组治疗基础上应用利水活血温阳方治疗。2组均治疗14 d。观察2组临床疗效、中医证候疗效;比较2组治疗前后心功能指标[血浆B型脑钠肽(BNP)、左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、舒张早期血流峰值速度/舒张晚期血流峰值速度(E/A)]变化及中医证候积分变化;观察2组安全性指标变化。结果临床疗效:治疗组总有效率91.5%,对照组总有效率77.1%,治疗组临床疗效优于对照组(P<0.05)。中医证候疗效:治疗组总有效率89.4%,对照组总有效率79.2%,治疗组中医证候疗效优于对照组(P<0.05)。2组治疗后BNP、LVEDD、LVESD均较本组治疗前降低(P<0.05),LVEF、E/A均较本组治疗前升高(P<0.05);治疗后治疗组BNP、LVEDD、LVESD均低于对照组(P<0.05),LVEF、E/A均高于对照组(P<0.05)。2组治疗后中医证候积分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。结论利水活血温阳方治疗血瘀阻络、水液停聚型CHF疗效显著,能更好地改善患者心功能和中医证候。

Objective To observe the clinical effects of Lishui-Huoxue-Wenyang prescription in treating congestive heart failure(CHF) with blood stasis blocking collateral type and aqueous fluid stopping type.Methods95 CHF patients with blood stasis blocking collateral type and aqueous fluid stopping were randomly divided into two groups.48 cases in control group were treated by routine treatment of western medicine,and 47 cases in treatment group were treated by Lishui-Huoxue-Wenyang prescription on the basis of control group treatment.The treatment course was 14 d.The clinical efficacy and the effects of TCM syndromes in two groups were observed.The heart function parameters including B-type natriuretic peptide(BNP),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular contraction End-diastolic diameter(LVESD),peak diastolic blood flow velocity/peak diastolic blood flow velocity(E/A),and changes of TCM syndromes scores before and after treatment were compared in two groups.The changes of safety indexes in the two groups were observed.Results The total effective rate of the clinical efficacy in treatment group(91.5%) was superior to that in control group(77.1%).The clinical efficacy in the treatment group was better than that in the control group(P < 0.05).The total effective rate of TCM syndromes in treatment group(89.4%) was superior to that in control group(79.2%).The curative effect of TCM syndromes in the treatment group was better than that in the control group(P < 0.05).The BNP,LVEDD and LVESD after treatment were lower than those before treatment in two groups(P < 0.05).The LVEF and E/A were higher than those before treatment(P <0.05).The BNP,LVEDD and LVESD after treatment in the treatment group were lower than those in the control group(P < 0.05),and the levels of LVEDD and LVESD in the treatment group were higher than those in the control group(P < 0.05).The TCM syndrome scores after treatment in two groups were lower than that before treatment(P < 0.05),and the treatment group decreased more significantly(P < 0.05).Conclusion On the basis of routine western medicine treatment,using Lishui-Huoxue-Wenyang prescription has significant effect on CHF with blood stasis blocking collateral type and aqueous fluid stopping type,and it can better improve the patient's heart function and TCM syndromes.