王耀献教授治疗心肾综合征经验

Summary on Professor WANG Yaoxian's experience in treating cardiorenal syndromes

目的探讨从少阴论治心肾综合征(cardiorenal syndrome,CRS)临床疗效。方法纳入病例60例,随机分为2组。治疗组给予益气温阳、化瘀利水汤剂口服,对照组给予常规治疗。疗程2个月,随访半年。观察2组中医临床证候变化、血清BNP、CRE、BUN变化,六分钟步行距离及明尼苏达生活质量积分的变化以及2组半年内再住院率的差异。结果 1)治疗组治疗后各种中医临床症状明显改善;对照组与治疗前相比胸闷、气短症状有所改善,但腰痛、乏力症状改善不明显。组间比较,治疗组明显优于对照组(P<0.05)。2)与治疗前相比、2组血清BNP、CRE、BUN均明显降低,组间比较治疗组下降程度明显优于对照组(P<0.05)。3)治疗后2组6 min步行距离明显提高,明尼苏达生活质量积分明显下降,组间比较治疗组优于对照组(P<0.05)。4)随访半年,治疗组再住院率明显低于对照组(P<0.05)。结论温阳益气,化瘀利水方药能明显改善心肾功能、提高生活质量,降低再住院率。

Objective This paper aimed at summarizing Professor WANG Yaoxian＇s experience in treating cardiorenal syndrome. Methods Totally 60 patients with CRS were randomly divided into two groups. The treatment group was additionally given oral Wenyang Yiqi Huayu Lishui decoction with one dose daily while the control group was given symptomatic treatment in western medicine. Both groups were treated tor 2 months and followed up 24 months. After treatment, traditional Chinese medicine symptoms, serum brain natriuretic peptide （BNP）, serum creatinine （CRE）, blood urea nitrogen （BUN）, six-minute walking distance, the Minnesota living with heart failure questionnaire scores （MLHF）, the and the rehospitalization rate in a half year of the two groups were compared. Results 1）After treatment, The TCM symptoms of patients improved significantly in the treatment group, the symptoms of chest discomfort and dyspnea were improved compared with those before treatment, but the symptoms of low back pain and fatigue were not significantly improved. There were significant differences between the two groups （P 〈 0.05）; 2） Compared with before treatment, serum BNP, CRE, and BUN were significantly lower in the two groups. Serum BNP, CRE, and BUN were significantly decreased in the treatment group than the control group （P 〈 0.05）. 3） Compared with before treatment, the six-minute walking distance of the two groups of patients was longer significantly and the Minnesota living with heart failure questionnaire scores decreased significantly. Compared with the control group, the treatment group was better than control group （P 〈 0.05）. 4） Follow-up six months, the rehospitalization rate in the treatment group was significantly lower than the control group （P 〈 0.05） Conclusion The method of Wenyang Yiqi Huayu Lishui decoction can significantly improve the heart and kidney function of patients with CRS, the quality of life and reduce the rehospitalization rate of patients.