自拟救心汤在终末期肥厚型非梗阻性心肌病心力衰竭治疗中的应用效果

Clinical effect of serf - made Jiuxin decoction in the treatment of end - stage hypertrophic non - obstructive cardiomyopathy

目的观察自拟救心汤联合常规西医疗法治疗终末期肥厚型非梗阻性心肌病心力衰竭的I临床疗效。方法将2016年7月至2017年10月杭州市余杭区第一人民医院终末期肥厚型非梗阻性心肌病心力衰竭患者60例按照随机数字表法分为两组，每组30例。对照组采用常规西医疗法，观察组加用自拟救心汤治疗1周。观察两组患者治疗前后体质量、水肿程度、心功能分级、心力衰竭积分、B型钠尿肽、血管紧张素Ⅱ、血钾、血钠、血氯含量等的变化情况。结果治疗1周后两组心功能和心力衰竭积分均有显著改善（观察组：t=10．527、15．358，均P〈0．01；对照组：f=7．504、12．417，均P〈0．01），且观察组优于对照组，差异均有统计学意义（t=3．772、4．446，均P〈0．01）。治疗后，两组B型利尿肽含量较治疗前明显降低（观察组：t=5．628，对照组：t=11．423，均P〈0．05）。观察组患者的血管紧张素和肾素水平和治疗前相比明显下降（t=4．355、6．418，均P〈0．05），与对照组治疗后差异均有统计学意义（t=3．521、4．275，均P〈O．05）。观察组不良反应发生率为3．3％，显著低于对照组的23．3％（X2=5．192，P=O．023）。结论自拟救心汤能够显著改善终末期肥厚型非梗阻性心肌病患者的心脏功能，且安全性较高。

Objective To observe the clinical effect of self - made Jiuxin decoction in the treatment of end - stage hypertrophic non - obstructive cardiomyopathy. Methods From July 2016 to October 2017,60 patients with end- stage hypertrophic non -obstructive cardiomyopathy in the First People＇s Hospital of Yuhang District were randomly divided into two groups according to digital table ,with 30 cases in each group. The control group was treated with conventional western medicine, and the observation group was treated with self - made Jiuxin soup for a week. The changes of body weight, degree of edema, NYHA class, Lee score, B -type natriuretic peptide, blood angiotensin II , blood potassium, sodium, chlorine content and other indicators before and after treatment were observed in the two groups. Results After one - week treatment, the cardiac function and heart failure indicators of the two groups were all significantly improved （the observation group： t = 10. 527,15. 358, all P 〈 0.01 ; the control group： t = 7. 504, 12. 417,all P 〈0.01 ） ,and the indicators of the observation group were better than those of the control group,and the differences between the two groups were statistically significant（ t = 3. 772,4.446, all P 〈 0.01 ）. After treatment, the levels of B - type natriuretic peptide of the two groups were significantly lower than those before treatment （the observation group ： t = 5. 628, the control group ： t = 11. 423, all P 〈 0.05 ）. The angiotensin and renin levels in the observation group were all significantly lower than those before treatment（ t = 4. 355,6. 418, all P 〈 0.05 ）, and the indicators of the observation group were all significantly lower than those of the control group（ t = 3. 521,4. 275, all P 〈 0.05 ）. The incidence rate of adverse reaction of the observation group was significantly lower than that of the control group（ 3.3% vs. 23.3%, X2 = 5. 192 ,P = 0. 023）. Conclusion Self- made Jiuxin decoction can significantly improve the cardiac function in patients with end - stage hypertrophic non - obstructive cardiomyopathy and it is a safe way of treatment.