益气温阳利水方辅助治疗对经导管主动脉瓣置换术后患者生活质量及预后的影响

Effect of Yiqi Wenyang Lishui Formula (益气温阳利水方) on the Quality of life and Prognosis of Patients Undergoing Transcatheter Aortic Valve Replacement

目的探讨益气温阳利水方辅助治疗对经导管主动脉瓣置换术(TAVR)术后患者心功能、症状及生活质量的影响。方法选取接受TAVR治疗的主动脉瓣重度狭窄患者100例,将其随机分为治疗组和对照组各50例。对照组进行常规西药治疗,治疗组在对照组基础上联合中药益气温阳利水方治疗,两组疗程均为8周。治疗后观察临床疗效、中医证候疗效,治疗前后比较两组中医症状积分、氨基末端B型钠尿肽原(NT-pro BNP)、6分钟步行距离、左室射血分数(LVEF)、生活质量评分,统计平均住院日和再住院率。结果治疗组临床疗效总有效率(90%)高于对照组(82%),治疗组中医证候疗效总有效率(86%)高于对照组(68%)(P<0.05)。治疗组治疗后心悸、气短、乏力及中医症状总积分均较治疗前明显降低,而对照组仅气短较治疗前降低(P<0.05或P<0.01)。与对照组治疗后比较,治疗组心悸、气短、乏力、浮肿、中医症状总积分、生活质量评分及NT-pro BNP均明显降低,6分钟步行距离及LVEF值均明显升高(P<0.05或P<0.01)。治疗组平均住院日及再住院率明显低于对照组(P<0.05或P<0.01)。结论益气温阳利水方辅助治疗在TAVR术后稳定病情、提高心功能、改善症状及生活质量方面具有明显优势。

Objective To study the of Yiqi Wenyang Lishui Formula（ 益气温阳利水方） on cardiac function,symptoms and quality of life of patients after transcatheter aortic valve replacement（ TAVR）. Methods A total of100 patients who received AVR from January 2015 to December 2017 were selected and randomly divided into treatment group and control group with 50 cases each. In the control group,conventional western medicine treatment was treated while the treatment group was treated with Yiqi Wenyang Lishui Formula in addition to the control. Both groups were treated for 8 weeks. The indicators before and after treatment were observed including clinical efficacy,symptom score,N-terminal pro-B-type natriuretic peptide（ NT-pro BNP）,6 minute walking distance（ 6 MWT）,left ventriculer ejection factor（ LVEF）,average length of stay（ ALOS）, and rehospitalization rate,quality of life（ QOL）.Results The total effective rate of clinical efficacy in the treatment group（ 90%） was higher than that in the control group（ 82%）. The total effective rate of the TCM syndrome in the treatment group（ 86%） was higher than that in the control group（ 68%）（ P〈0. 05）. After treatment,the total scores of heart palpitations,shortness of breath,fatigue,and TCM symptoms in the treatment group were significantly lower than before treatment,while the shortness of breath in the control group was lower than before treatment（ P〈0. 05 or P〈0. 01）. Compared with the control group,the palpitation,shortness of breath,fatigue,edema,TCM symptom scores,quality of life scores,and NTpro BNP were all significantly reduced in the treatment group,and the 6 MWD and LVEF values were significantly increased（ P〈0. 05 or P〈0. 01）. The ALOS and rehospitalization rate in the treatment group were significantly lower than those in the control group（ P〈0. 05 or P〈0. 01）. Conclusion Yiqi Wenyang Lishui Formula has obvious advantages in the stabling condition,improving heart function,and improving symptoms after TAVR surgery.