强心利水汤联合贝那普利治疗慢性心力衰竭(气虚血瘀)随机平行对照研究

Randomized Controlled Study of Qiangxin Lishui Decoction combined with Benner Pury in the Treatment of Chronic Heart Failure(Qixu Xueyu)

[目的]观察强心利水汤联合贝那普利治疗慢性心力衰竭(气虚血瘀)疗效。[方法]使用随机平行对照方法,将122住院诊患者按随机数字表方法随机分为两组。对照组61例贝那普利10mg/次,1次/d。治疗组61例强心利水汤方:炮附子(先煎)、白术、桂枝各10g,黄芪、红参(另煎)、泽泻、桑白皮、葶苈子、益母草各20g,浮肿甚者猪苓、车前子;唇色、甲色乌青,舌脉过于迂曲加川芎及丹参;胁下痞块加桃仁、水蛭;纳差、湿盛加厚朴、半夏;高心病加夏枯草、牛膝、菊花;冠心病加葛根、赤芍、丹参,肺心病加桔梗、杏仁、大黄;风湿性心脏病加羌活、防己、独活;心律失常加枣仁、炙甘草、柏子仁,水煎300mL,1剂/d,早晚分服;贝那普利治疗同对照组。连续治疗1周为1疗程。观测临床症状、射血分数(EF)、B型脑钠肽(BNP)、6min步行距离、不良反应。连续治疗2疗程(2周),判定疗效。[结果]治疗组显效49例,有效9例,无效3例,总有效率95.08%;对照组显效31例,有效18例,无效12例,总有效率80.33%;临床疗效治疗组优于对照组(P<0.05)。EF、BNP、6min步行距离两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]强心利水汤联合贝那普利治疗慢性心力衰竭(气虚血瘀),疗效满意,无严重不良反应,值得推广。

[Objective] To observe the curative effect of Qiangxin Lishui decoction combined with benner pury in the treatment of chronic heart failure （Qixu Xueyu）. [Methods] 122 hospitalized patients were randomly divided into two groups according to random digital table method, using random parallel control method. In the control group, 61 cases were Benner Pury 10 mg/times and 1 times/d. The treatment group of 61 cases of Qiangxin Lishui decoction： processed aconite, atractylodes, astragalus, Guizhi 10g, red ginseng （other fried）, alisma, morus alba, Tinglizi, motherwort 20g, swollen what polyporus, plantago; a black color, lip, tongue and pulse is tortuous and Chuanxiong and Danshen; breast lump and peach kernel, hirudo; anorexia, dampness, Banxia Houpu; disease with achyranthes, prunella, chrysanthemum; radix puerariae, radix paeoniae rubra, radix salviae miltiorrhizae and coronary heart disease, pulmonary heart disease and platycodon root, almond, rhubarb; rheumatic heart disease plus notopterygium, tetrandrine and angelica; arrhythmia with jujube, licorice Baiziren, decoction 300mL, 1 agent/d, sooner or later the service;benner pury treatment with the control group. Continuous treatment for 1 weeks was the 1 course of treatment. The clinical symptoms, ejection fraction （EF）, type B brain natriuretic peptide （BNP）, 6min walking distance, and adverse reaction were observed. 2 courses of continuous treatment （2 weeks） were used to determine the curative effect. [Results] The treatment group was markedly effective in 49 cases, effective in 9 cases, invalid in 3 cases, the total effective rate was 95.08%. In the control group, 31 cases were markedly effective, 18 cases were effective, 12 cases were invalid, the total effective rate was 80.33%, the clinical curative effect of the treatment group was better than that of the control group （P〈0.05）. The walking distance of EF, BNP and 6min was improved in two groups （P〈0.01）, and the improvement of the treatment group was better than that of the control group （P〈0.01）. [Conclusion] The effect of Qiangxin Lishui decoction combined with benner pury in the treatment of chronic heart failure （Qixu Xueyu） is satisfactory. There is no serious adverse reaction. It is worth popularizing.