真武汤合桃红四物汤治疗阳虚血瘀型慢性射血分数降低性心力衰竭的疗效观察

Observation of efficacy of Zhenwu decoction and Taohong Siwu decoction in the treatment of chronic heart failure with reduced ejection fraction of Yang deficiency and blood stasis type

目的观察真武汤合桃红四物汤治疗阳虚血瘀型慢性射血分数降低性心力衰竭的临床疗效。方法 110例阳虚血瘀型慢性射血分数降低性心力衰竭患者,按治疗方式不同分为西医组及中西医结合组,每组55例。西医组给予血管紧张素转换酶抑制剂、β-受体阻滞剂、醛固酮受体拮抗剂治疗,中西医结合组在西医组基础上加用真武汤合桃红四物汤治疗。观察两组患者的临床治疗效果,对比两组患者治疗前后左心室射血分数(LVEF)、左室舒张末期内径(LVED)及氨基末端脑利钠肽前体(NTpro BNP)、超敏C反应蛋白(hs-CRP)、胱抑素C(Cys C)的水平。结果中西医结合组总有效率为96.4%,其中显效41例,有效12例,无效2例;西医组总有效率为85.5%,其中显效38例,有效9例,无效8例;中西医结合组临床治疗总有效率高于西医组,差异有统计学意义(P<0.05)。治疗前,两组LVEF和LVED比较差异无统计学意义(P>0.05);治疗后,中西医结合组LVEF高于西医组,LVED低于西医组,差异有统计学意义(P<0.05)。治疗前,两组患者NT-pro BNP、hs-CRP、Cys C水平比较差异无统计学意义(P>0.05);治疗后,中西医结合组患者NT-pro BNP、hs-CRP、Cys C水平低于西医组,差异具有统计学意义(P<0.05)。结论中西医结合治疗阳虚血瘀型慢性射血分数降低性心力衰竭患者具有良好的临床效果,可增加LVEF,改善患者心功能。

Objective To observe the clinical efficacy of Zhenwu decoction and Taohong Siwu decoction in the treatment of chronic heart failure with reduced ejection fraction of Yang deficiency and blood stasis type. Methods A total of 110 chronic heart failure patients with reduced ejection fraction of Yang deficiency and blood stasis type were divided by different treatment methods into Western medicine group and integrated traditional and Western medicine group, with 55 cases in each group. Western medicine group was treated with angiotensin converting enzyme inhibitor, β-blocker, aldosterone receptor antagonist, and integrated traditional and Western medicine group was treated with Zhenwu decoction and Taohong Siwu decoction on the basis of Western medicine group. The clinical treatment effect in two groups was observed, and left ventricular ejection fraction（LVEF）, left ventricular end-diastolic diameter（LVED） and N-terminal pro-brain natriuretic peptide precursor（NT-pro BNP）, high sensitive C reactive protein（hs-CRP） and cystatin C（Cys C） levels before and after treatment between the two groups. Results Integrated traditional and Western medicine group had total effective rate as 96.4%, with 41 excellent cases, 12 effective cases and 2 ineffective cases, which were 85.5%, 38 cases, 9 cases and 8 cases in Western medicine group. Integrated traditional and Western medicine group had higher total effective rate of clinical treatment than Western medicine group, and the difference was statistically significant（P〈0.05）. Before treatment, both groups had no statistically significant difference in LVEF and LVED（P〈0.05）. After treatment, integrated traditional and Western medicine group had higher LVEF than Western medicine group, and the difference was statistically significant（P〈0.05）. Before treatment, both groups had no statistically significant difference in NT-pro BNP, hs-CRP and Cys C level（P〉0.05）. After treatment, integrated traditional and Western medicine group had lower NT-pro BNP, hs-CRP and Cys C level than Western medicine group, and the difference was statistically significant（P〈0.05）. Conclusion Integrated traditional and Western medicine shows excellent clinical effect in the treatment of chronic heart failure patients with reduced ejection fraction of Yang deficiency and blood stasis type, and it can increase LVEF and improve patient＇s cardiacfunction.