五苓散联合呋塞米治疗慢性心力衰竭阳虚水泛证90例临床观察

Clinical effect of Wuling powder combined with furosemide in treatment of chronic heart failure with edema syndrome due to Yang deficiency: An analysis of 90 cases

目的:观察五苓散联合呋塞米治疗慢性心力衰竭阳虚水泛证的临床疗效。方法:将180例慢性心力衰竭阳虚水泛证患者随机分为2组,每组各90例。2组均行常规治疗,治疗组在常规治疗基础上给予呋塞米联合五苓散治疗,对照组仅予呋塞米治疗。2组均以4周为1个疗程。观察2组治疗后、出院3个月末及6个月末的6min步行距离、射血分数、氨基末端脑钠肽前体(NT-pro BNP)、再入院率、呋塞米用量及利尿剂抵抗发生率。结果:2组6min步行距离、射血分数、NT-pro BNP与本组治疗前及对照组治疗后各观察时间点比较,差异均有统计学意义(P <0. 05);治疗后3、6个月再入院率治疗组分别为33. 3%、44. 4%,对照组分别为40. 0%、50. 0%,差异有统计学意义(P <0. 05);2组治疗后3、6个月呋塞米用量比较,差异均有统计学意义(P <0. 05);2组治疗后3、6个月利尿剂抵抗发生率治疗组分别为7. 78%、14. 44%,对照组分别为17. 78%、23. 33%,差异均有统计学意义(P <0. 05)。结论:五苓散能较好地改善心功能,并减少利尿剂抵抗发生率,进一步改善了远期预后。

Objective: To investigate the clinical effect of Wuling powder combined with furosemide in the treatment of chronic heart failure with edema syndrome due to Yang deficiency. Methods: A total of 180 patients with chronic heart failure with edema syndrome due to Yang deficiency were randomly divided into treatment group and control group,with 90 patients in each group. In addition to conventional treatment,the patients in the treatment group were given furosemide combined with Wuling powder,and those in the control group were given furosemide alone. Each course of treatment was 4 weeks for both groups. The two groups were compared in terms of 6-minute walk distance,ejection fraction,N-terminal pro-brain natriuretic peptide(NT-proBNP),readmission rate,amount of furosemide used,and incidence rate of diuretic resistance after treatment and at 3 and 6 months after discharge. Results: Both groups had significant changes in 6-minute walk distance,ejection fraction,and NT-proBNP after treatment,and there were significant differences in these indices between the two groups after treatment(P <0. 05). There were significant differences between the two groups in readmission rate at 3 and 6 months after treatment(33. 3%/44. 4% vs 40. 0%/50. 0%,P < 0. 05). There was a significant difference in the amount of furosemide used between the two groups at 3 and 6 months after treatment(P < 0. 05). There was a significant difference between the two groups in the incidence rate of diuretic resistance at 3 and 6 months after treatment(7. 78%/14. 44% vs 17. 78%/23. 33%,P < 0. 05). Conclusion: Wuling powder can improve cardiac function,reduce the incidence rate of diuretic resistance,and further improve long-term prognosis.