养心益气汤治疗慢性心力衰竭45例

Forty-Five Cases of Chronic Heart Failure Treated with Heart-Nourishing and Qi-Activating Decoction

目的:观察养心益气汤治疗慢性心力衰竭(chronic heart failure,CHF)的临床疗效及其对患者N末端钠尿肽前体(brain natriuretic titanium precursor detection,NT-Pro-BNP)含量及心肌酶谱的影响。方法:将90例CHF患者随机分为观察组和对照组,每组各45例。对照组给予常规治疗,观察组在对照组的基础上加用养心益气汤。比较两组患者的临床疗效,观察两组患者治疗前后Lee氏心衰计分、NT-Pro-BNP、6分钟步行距离(6 minute walk test,6MWT)、心功能指标[左心室射血分数(left ventricular ejection fraction,LVEF)、二尖瓣E峰/A峰(E/A)]、心肌酶谱指标[肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)]、明尼苏达心功能不全生活量表(MHL)水平。结果:观察组有效率为91.11%,高于对照组的75.56%,差异有统计学意义(P<0.05)。两组患者治疗后Lee氏心衰计分、NT-Pro-BNP、E/A、CK、CK-MB均低于同组治疗前,6MWT、LVEF均高于同组治疗前,且治疗后观察组与对照组比较,差异有统计学意义(P<0.05)。两组患者治疗后MHL各项评分均低于同组治疗前,差异有统计学意义(P<0.05);观察组治疗后体力限制、情绪、症状评分均低于对照组,差异有统计学意义(P<0.05)。结论:养心益气汤治疗CHF临床疗效确切,可显著改善患者的临床症状及心功能。

Objective：To observe the clinical curative effect of Heart-Nourishing and Qi-Activating Decoction on chronic heart failure（CHF） and the influence on brain natriuretic titanium precursor detection（NT-Pro-BNP） content and myocardial enzyme spectrum change.Methods：Ninety patients with CHF were randomly divided into the observation group and the control group,with45 cases in each group.The ones in the control group were given routine treatment,and the ones in the observation group were added Heart-Nourishing and Qi-Activating Decoction to based on the treatment of the control group.Then the clinical efficacies of two groups were compared.The score of Lee＇s heart failure,NT-pro BNP,6-minute walk test（6 MWT）,heart function indexes including left ventricular ejection fraction（LVEF）,mitral E peak/A（E/A） ],the myocardial enzyme spectrum index [creatine kinase（creatine kinase CK）,creatine kinase isoenzyme（CK-MB） ],Minnesota heart failure life scale（MHL） level.Results：The effective rate of the observation group was 91.11%,which was higher than that of the control group（75.56%）,and the difference was statistically significant（P〈0.05）.After the treatment,the two groups＇ Lee heart failure score,NT-pro BNP,E/A,CK,CK-MB were lower than those in the same group before the treatment,6 MWT and LVEF were higher than those in the same group before the treatment.After the treatment,The scores of MHL in the two groups after the treatment were all lower than those in the same group before the treatment,and the difference was statistically significant（P〈0.05）.The scores of physical limitations,emotions and symptoms in the observation group were all lower than those in the control group,and all the difference were statistically significant（P〈0.05）.Conclusion：Heart-Nourishing and Qi-Activating Decoction has a remarkable clinical curative effect on CHF,can significantly improve the clinical symptoms and cardiac function of the patients.