黄芪建中汤治疗慢性心力衰竭临床观察

Clinical observation of HuangqiJianzhong Decoction in treating chronic heart failure

目的:探讨黄芪建中汤在慢性心力衰竭治疗中的应用价值。方法:选取我院2016年6月~2017年6月收治的84例慢性心力衰竭患者为研究对象,采用随机数表法将其分为对照组和观察组,两组各42例。对照组根据《心血管病治疗指南和建议》给予常规标准治疗,观察组在对照组基础上加用黄芪建中汤治疗,15天1疗程,持续治疗4个疗程。观察两组治疗前后中医证候积分变化情况并评估临床效果,治疗后均随访1年,比较两组心血管事件情况。结果:观察组治疗后心悸、气短气喘、咳嗽/咳痰、胸闷/痛、怕冷/喜温、浮肿6项证候积分较治疗前均有显著降低,且其中第1、2、4项证候评分显著低于对照组,差异均具有统计学意义(P<0.05);观察组中医证候总有效率95.24%(40/42)高于对照组78.57%(33/42),差异具有统计学意义(P<0.05);两组治疗安全性均较好,观察组加用黄芪建中汤并未增加副反应;随访6个月~1年,平均随访(9.4±2.1)个月,随访总有效率96.43%(81/84)。两组心因性死亡率相较差异无统计学意义(P>0.05),但观察组心因性再住院率5.00%(2/40)、心血管事件率7.50%(3/40)分别低于对照组19.51%(8/41)、24.39%(10/41),差异具有统计学意义(P<0.05)。结论:黄芪建中汤可有效缓解慢性心衰的临床症状和优化临床疗效,安全性较好,同时能降低近期心因性再住院和心血管事件风险,临床应用价值显著。

Objective to explore the application value of HuangqiJianzhongDecoction in the treatment of chronic heart failure. Methods 84patients with chronic heart failure treated in our hospital in June^2017June 2016were selected as the subjects. The random number table was used to divide them into the control group and the observation group,with 42cases in each group of two groups. The control group was given conventional standard treatment according to the guide and suggestion of cardiovascular disease treatment. The observation group was treated with HuangqiJianzhong Decoction on the basis of the control group,15d/course of treatment,and 4courses of continuous treatment. The changes of TCM syndromes in two groups before and after treatment were observed,and the clinical effects were evaluated. After treatment,all patients were followed up for 1years,and the cardiovascular events in two groups were compared. Results after treatment,the scores of 6syndromes of palpitation,asthma, cough /expectoration,cough /cough,chest tightness/pain,cold /warm and swelling were significantly lower than those before treatment,and first,second,fourth of them were significantly lower than those in the control group ( P<0.05),and the total effective rate of TCM syndrome in the observation group was 95. 24%( 40/42) higher than the control group 78. 57%( 33/42),the difference was statistically significant ( P<0. 05);the two groups of treatment safety were better,the observation group added AstragalusJianzhong soup did not increase the side reaction;followed up for 6months ~ 1years,the average follow-up (9.4±2.1) months,the total effective rate of 96. 43%( 81/84). There was no significant difference in the mortality of the two groups ( P> 0.05),but the rate of 5%(2/40) and 7.50%(3/40) of cardiovascular events in the observation group were 19. 51%(8/41) and 24. 39%(10/41) in the control group,respectively,and the difference was statistically significant (P<0.05). ConclusionsHuangqiJianzhong Decoction can effectively alleviate the clinical symptoms of chronic heart failure and optimize the clinical efficacy,and it has good safety. It can also reduce the risk of cardiac rehospitalization and cardiovascular events in the near future. The clinical value is significant.