益气温阳化瘀方联合西药治疗慢性充血性心力衰竭临床观察

Clinical Observation of Yiqi Wenyang Huayu Prescription Combined with Western Medicine for Chronic Congestive Heart Failure

目的:观察益气温阳化瘀方联合西药治疗慢性充血性心力衰竭(CHF)阳气亏虚兼血瘀证老年患者的疗效。方法:将本院收治的110例患者随机分为对照组和治疗组各55例。对照组口服缬沙坦胶囊、螺内酯片、卡维地洛片、单硝酸异山梨酯片、地高辛片治疗,治疗组在对照组基础上用益气温阳化瘀方治疗。2组疗程均为6周。治疗前后评定Lee氏心衰评分和阳气亏虚兼血瘀证评分,用彩色多普勒超声检测系统测定左心室射血分数(LVEF)、心输出量(CO)和舒张早期/舒张晚期最大血流速度(E/A)值,进行6 min步行试验;治疗前后采用明尼苏达心衰生活质量调查表(MLHFQ)评价生活质量。结果:治疗后,治疗组总有效率为94.55%,高于对照组的81.82%,2组比较,差异有统计学意义(P<0.05)。2组Lee氏心衰评分、阳气亏虚兼血瘀证评分和MLHFQ评分均较治疗前下降(P<0.01),治疗组3项评分值均低于对照组(P<0.01)。2组LVEF、CO、E/A和6 min步行距离均较治疗前增加(P<0.01),治疗组4项指标值均高于对照组(P<0.01)。结论:在常规西药基础上加用益气温阳化瘀方治疗可有效改善CHF阳气亏虚兼血瘀证老年患者的症状、心功能和生活质量,临床疗效优于单纯西药治疗。

Objective：To observe the clinical effect of Yiqi Wenyang Huayu prescription combined with western medicine for chronic congestive heart failure（CHF） in senile patients with yang-qi depletion accompanied with blood stasis syndrome.Methods：Divided 110 cases of patients admitted in our hospital into the control group and the treatment group randomly. The control group was given oral valsartan capsules,spironolactone tablets,carvedilol tablets,isosorbide mononitrate tablets and dioxin tablets for treatment,while the treatment group was additionally given Yiqi Wenyang Huayu prescription based on the treatment of the control group. The treatment of both groups lasted for six weeks. Evaluated Lee＇s heart failure score and scores of yang-qi depletion accompanied with blood stasis syndrome before and after treatment. Applied color doppler ultrasound testing system to determine values of left ventricular ejection fraction（LVEF）,cardiac output（CO） and the ratio value of peak systolic velocity in early diastolic phase by peak systolic velocity in late diastolic phase（E/A）,and conducted a walking test of six minutes. Assessed the quality of life by adopting minnesota living with heart failure questionnaire（MLHFQ） before and after treatment. Results：After treatment,the total effective rate was 94.55% in the treatment group,higher than that in the control group which was 81.82%,the difference being significant（P〈0.05）. The Lee＇s heart failure scores,scores of yang-qi depletion accompanied with blood stasis syndrome in both groups and scores of MLHFQ in both groups were decreased when compared with those before treatment（P〈0.01）. These three scores in the treatment group were lower than those in the control group（P〈0.01）. Values of LVEF,CO,E/A and walking distance of six minutes in both groups were increased when compared with those before treatment（P〈0.01）. These four indexes in the treatment group were higher than those in the control group（P〈0.01）. Conclusion：The additional application of Yiqi Wenyang Huayu prescription based on the treatment of western medicine can effectively improve the symptoms,cardiac function and the quality of life in senile patients with CHF with yang-qi depletion accompanied with blood stasis syndrome. The clinical effect of this therapy is superior to treatment of simple western medicine.