苓桂术甘汤联合西药治疗慢性心力衰竭的疗效及对心室重构指标、血清学指标的影响

Effect of Linggui Zhugan Decoction combined with western medicine on chronic heart failure and its influence on ventricular remodeling index and serological index

目的探讨苓桂术甘汤联合西药治疗慢性心力衰竭的疗效及对心室重构指标、血清学指标的影响。方法选取2016年1月一2018年2月海安市中医院收治的100例慢性心力衰竭患者,釆用计算机产生随机数的分组方法将患者分为观察组50例和对照组50例。对照组行常规西药治疗和护理,观察组则在对照组的基础上联合苓桂术甘汤治疗。观察和分析2组患者的疗效、6min步行距离(6MWD)、生活质量、中医证候积分、心室重构指标及血清学指标的差异。结果观察组总有效率明显高于对照组(92.0%vs.74.0%,P<0.01)o治疗后观察组患者6MWD明显大于对照组(P<0.05),生活质量评分、中医症候积分明显低于对照组(P<0.01);观察组每搏输出量(SV)、左心室射血分数(LVEF)高于对照组(P<0.01),而左心室收缩末期内径(LVSED)、左心室舒张末期内径(LVDED)低于对照组(P<0.01);观察组N末端B型脑钠肽前体(NT-proBNP)、血管紧张素(H)Angll、肿瘤坏死因子-α(TNF-α)均明显低于对照组(P<0.01),而一氧化氮(NO)高于对照组(P<0.01)。结论苓桂术甘汤联合西药治疗慢性心力衰竭疗效显著,可降低炎症水平,改善心肌和心室功能,提高患者生活质量。

Objective To investigate the therapeutic effect of Linggui Zhugan Decoction(a traditional Chinese medicine prescription consisting mainly of poria,bighead atractylodes,cinnamom and licorice,etc.)combined with western medicine on chronic heart failure and its influence on ventricular remodeling index and serological index.Methods A total of 100 patients with chronic heart failure admitted to Hai'an Hospital of Traditional Chinese Medicine from January 2016 to February 2018 were selected and divided into an observation group and a control group(n=50 eachz)by computer generated random number method.The control group received routine western medicine treatment and nursing,while the observation group received Linggui Zhugan Decoction on the basis of the control group.The therapeutic effect,6-minute walking distance(6MWD),quality of life,traditional Chinese medicine(TCM)syndrome score,ventricular remodeling index and serological index of the two groups were observed and analyzed.Results The total effective rate of the observation group was significantly higher than that of the control group(92.0%vs.74.0%,P<0.01).After treatment,the 6MWD in the observation group was significantly higher than that in the control group(P<0.05),while the scores of quality of life and TCM symptoms were significantly lower than those of the control group(P<0.01).The stroke volume(SV)and left ventricular ejection fraction(LVEF)in the observation group were higher than those in the control group(P<0.01),while the left ventricular end systolic diameter(LVSED)and left ventricular end diastolic diameter(LVDED)were significantly lower than those in the control group(P<0.01).The N-terminal-pro-B-type natriuretic peptide(NT-proBNP),angiotensin Ⅱ(Ang Ⅱ)and the cause of tumor necrosis in the observation group,as well as the level of TNF-α were significantly lower than those of the control group(P<0.01),while the level of nitric oxide(NO)was higher than that of the control group(P<0.01).Conclusions Linggui Zhugan Decoction combined with western medicine has a significant therapeutic effect on chronic heart failure.It can reduce the level of inflammation,improve myocardial and ventricular function,and improve the quality of life in patients with chronic heart failure.