调脾护心方治疗慢性心力衰竭心脾两虚型临床研究

Clinical effect of Tiaopi Huxin Fang on Chronic heart failure patients with deficiency of both heart and spleen

目的:探讨调脾护心方对慢性心力衰竭(心脾两虚型)的临床疗效及心功能、心衰指标的影响。方法:选择2017年7月-2019年7月辨证为心脾两虚慢性心衰患者60例,采用分层随机法分为对照组和治疗组,两组各30例。两组均给予西药常规抗心衰治疗,治疗组在此基础上加用调脾护心方颗粒剂,每日1剂,早、晚两次温水服用,疗程均为4周。观察两组中医证候及心功能疗效、中医证候积分、B型脑钠肽(BNP)水平、左室舒张末内径(LVEDd)、左室射血分数(LVEF)变化情况。结果:连续治疗4周后,治疗组中医证候及心功能疗效改善优于对照组,具有显著差异(P<0.05);治疗后两组较治疗前BNP均明显降低,具有显著差异(P<0.05),治疗组较对照组下降更为明显(P<0.05);虽然两组LVEDd较治疗前均不同程度下降、LVEF均不同程度升高,但组间差异不显著(P>0.05)。结论:调脾护心方可以显著改善心脾两虚型患者中医证候疗效、NYHA心功能疗效,能够显著降低患者中医症候积分及BNP,从而减轻患者临床症状,改善心功能。

Objective:To investigate the effect of Tiaopi Huxin Fang on clinical efficacy,heart function and heart failure index in patients with Chronic heart failure(heart and spleen deficiency).Methods:Sixty patients with Chronic heart failure who had syndrome differentiation of heart and spleen from July 2017 to July 2019 were enrolled.The patients were divided into control group and treatment group by stratified randomization method,30 cases in each group.Both groups were given conventional anti-heart failure treatment for western medicine.On the basis of this,the treatment group added Granules of Tiaopi Huxin Fang,one dose per day,taking it in warm water once in the morning and once in the evening,and the course of treatment was 4 weeks.The changes of TCM syndrome and cardiac function,TCM syndrome score,B-type brain natriuretic peptide(BNP)level,Left ventricular end diastolic diameter(LVEDd)and Left ventricular ejection fraction(LVEF)were observed.Results:After 4 weeks of continuous treatment,the improvement of TCM syndrome and cardiac function in the treatment group was better than that in the control group,with significant difference(P<0.05).After treatment,the BNP was significantly lower than the pre-treatment BNP,with significant difference(P<0.05),the treatment group decreased more significantly than the control group(P<0.05).Although the LVEDd of the two groups decreased and the LVEF increased to different degrees before treatment,the difference between the groups was not significant(P>0.05).Conclusion:Tiaopi Huxin Fang can significantly improve the efficacy of TCM syndromes and NYHA cardiac function in patients with heart and spleen deficiency,and can significantly reduce TCM syndrome scores and BNP,thus reducing clinical symptoms and improving heart function.