真武汤合血府逐瘀汤治疗心肾阳虚、血瘀水停证心衰病的临床观察

Clinical Observation on Zhenwu Decoction and Xuefu Zhuyu Decoction in Treating Cardiac Failure of Heart and Kidney Yang Deficiency and Blood Stasis Water Stopping

目的观察真武汤合血府逐瘀汤对心肾阳虚,血瘀水停证心衰病的治疗效果。方法选取2015年10月—2018年2月在我院老年病科住院的慢性心力衰竭证型属心肾阳虚,血瘀水停证的患者140例作为研究对象,随机分为对照组和治疗组,每组70例患者。对照组给予针对心衰的综合治疗(利尿剂、ACEI、β受体阻剂、醛固酮受体拮抗剂、血管扩张剂),治疗组在对照组的治疗基础上加用真武汤合血府逐瘀汤加减治疗。在治疗后的第5天和第15天,进行中医症候改善临床疗效、6 min步行试验、氨基末端B型利钠肽前体(NT-proBNP)、左室射血分数(LVEF)和左室舒张末期容积分析,观察对照组和治疗组的疗效。结果治疗组中医症候改善疗效明显高于对照组(P<0.05);经过治疗,对照组和治疗组6 min步行试验和左室射血分数(LVEF)均明显提高,同时治疗组明显高于对照组(P<0.05);2组治疗后氨基末端B型利钠肽前体(NT-proBNP)、左室舒张末期容积均明显下降,治疗组比对照组下降更显著(P<0.05)。结论真武汤合血府逐淤汤治疗慢性心力衰竭中医症候属心肾阳虚,血瘀水停证的疗效显著。

Objective To observe the therapeutic effect of Zhenwu decoction and Xuefu Z huyu decoction on heart-kidney yang deficiency and blood stasis water stopping syndrome. Methods A total of 140 patients with chronic heart failure belonging to heart- kidney yang deficiency and blood stasis water stopping syndrome who were hospitalized in our department of geriatrics from October 2015 to February 2018 were randomly assigned to the control group and the treatment group, and each group had 70 patients. The control group was given comprehensive treatment for heart failure (diuretics, ACEI, B receptor blockers, aldosterone receptor antagonists, vasodilators), and the treatment group was not only treated with the same therapeutic method of the control group but also was treated with Zhenwu decoction and Xuefu Zhuyu decoction. On the 5th and 15th day after treatment, the clinical efficacy of TCM symptom improvement, 6-minute walk test, amino-terminal B-type natriuretic peptide precursor (NT-proBNP), left ventricular ejection fraction (LVEF) and Left ventricular end-diastolic volume were performed to assess efficacy of treatment in the control group and the treatment group. Results The improvement effect of TCM symptom in the treatment group was significantly higher than that in the control group (P<0.05). After treatment, although the 6-minute walk test and left ventricular ejection fraction (LVEF) of the control group and the treatment group were significantly improved, the efficacy of the treatment group was obviously better than the control group (P<0.05). After treatment, the amino-terminal B-type natriuretic peptide precursor (NT-proBNP) and left ventricular end- diastolic volume decreased significantly in both the control group and the treatment group, and the treatment group decreased more significantly than the control group (P< 0.05). Conclusion Zhenwu decoction and Xuefu Zhuyu decoction is significantly effective in the treatment of chronic heart failure belonging to heart-kidney yang deficiency and blood stasis water stopping syndrome of TCM syndrome.