摘要
目的:探讨加味茯苓四逆汤联合内科常规治疗对慢性心力衰竭的临床疗效。方法:将来源于海南省中医院2016年8月~2017年12月住院部及门诊部、中医辨证为阳气亏虚血瘀型的60例慢性心力衰竭患者按照随机化分组原则分为对照组30例,治疗组30例。对照组按内科常规给予利尿剂、ACEI、β受体阻滞剂,视患者情况给予洋地黄类强心苷、醛固酮受体拮抗剂治疗,观察组在对照组治疗基础上加用加味茯苓四逆汤,每日二剂,上下午各1剂,一共连续治疗8周,治疗期间嘱托患者清淡饮食,勿剧烈运动,与本研究无关药物禁止使用。在治疗前及治疗8周后分别记录治疗组与对照组患者的中医症状评分、心力衰竭诊断标准积分、心功能分级、6分钟步行试验距离,最后统计分析其临床效果。结果:治疗组与对照组治疗前年龄、性别、平均病程、中医症状评分、心力衰竭诊断标准积分、心功能分级、6分钟步行试验距离经统计学分析,结果显示均无显著性差异(P>0. 05),说明两组可进行疗效差异性比较。经治疗后,比较两组患者心功能疗效,治疗组优于对照组(P <0. 05);两组患者治疗后中医症状积分、心力衰竭诊断标准积分与治疗前对比均有下降(P <0. 05),与对照组比较,治疗组下降更明显(P <0. 05);两组患者治疗后6分钟步行试验距离与治疗前相比,有显著性差异(P<0. 05),与对照组比较,治疗组6分钟步行试验距离增加明显(P<0. 05)。结果提示两组均能有效改善患者心衰症状及心功能,其中加味茯苓四逆汤联合内科常规治疗组的总体疗效明显高于单纯内科常规治疗组。结论:加味茯苓四逆汤联合内科常规治疗组能有效改善心衰症状及心功能,总体临床效果明显优于单纯内科常规治疗。其能提高患者生活质量,降低再住院率及死亡率,值得在临床中运用和推广。
Objective: To explore the effect of Modified Fuling Sini Decoction combined with routine medical treatment in the treatment of chronic heart failure. Methods: The clinical research all cases were from August 2016 to December 2017 in Hainan Provincial Traditional Chinese Medicine Hospital,in line with the criteria for diagnosis of Chinese medicine dialectical to sunny deficiency and blood stasis type of the chronic heart failure. The total number of cases to 60 cases. Which were randomly assigned to controlled group( 30 cases) and observation group( 30 cases). The observation group according to the medical routine for diuretics,ACEI,ssblockers,digitalis,aldosterone receptor antagonist therapy,and the controlled group to Modified Fuling Sini Decoction combined with routine medical treatment,daily two agent,each agent in the morning and afternoon,the course was 8 weeks,for three consecutive period of treatment,during treatment to pay attention to the diet,avoid strenuous exercise,prohibits the use of oral or other had nothing to do with the experimental drugs. The vital indexes such as TCM symptom scores,heart failure diagnosis standard score,cardiac function classification,6 min walking distance were measured before and after treatment. The collected cases were statistically analyzed and the therapeutic effects of the two groups were evaluated. Results:There was no significant difference between the controlled group and the observation group before treatment,age,sex,average course of disease,TCM symptom scores,heart failure diagnosis standard score,cardiac function classification,6 min walking distance,the results telled not obvious difference( P〉0. 05),indicating that differences between the two groups of curative effect can be compared. After treatment,the cardiac function of the two groups was compared,and the treatment group was better than the controlled group( P〈0. 05). The two group of TCM symptom scores,heart failure diagnosis standard score,were apparently decreased,compared with before treatment. The data were tested statistically,P〈0. 05. Compared with the controlled group,the treatment group decreased significantly( P〈0. 05). While the 6 min walking distance between the two groups was significantly different( P〈0. 05),but compared with the controlled group,the 6 min walking distance of the treatment group was significantly increased( P〈0. 05). The results showed that the two groups could effectively improve the symptoms of patients with heart failure and cardiac function. The overall effect of Modified Fuling Sini Decoction combined with routine medical treatment was significantly higher than that of pure routine medical treatment. Conclusion: Modified Fuling Sini Decoction combined with routine medical treatment can effectively improve effectively improve the symptoms of patients with heart failure and cardiac function,reduce ventricular remodeling,the overall clinical effect is better than that of conventional medical treatment. It can improve the patient's quality of life,reduce the rate of rehospitalization and mortality,and it is worthy of being used and popularized in clinic.
作者
毛丽巧
谢毅强
周帆
MAO Liqiao, XIE Yiqiang, ZHOU Fan(Hainan Provincial Traditional Chinese Medicine Hospital (Kaikou Hainan 570203, China))
出处
《四川中医》
2018年第9期54-58,共5页
Journal of Sichuan of Traditional Chinese Medicine
基金
国家自然科学基金(编号:81473618)
关键词
慢性心力衰竭
心功能
加味茯苓四逆汤
阳气亏虚血瘀证
Chronic heart failure
Cardiac function
Modified Fuling Sini Decoction
Yang-Qi deficiency and blood stasis type