温针灸结合西医常规疗法对慢性心力衰竭患者心功能的影响

Improvement of cardiac function in CHF patients treated with acupuncture and moxibustion and western conventional medicine

目的探讨针灸联合西医常规疗法对慢性心力衰竭(chronic heart failure,CHF)患者心功能的影响。方法将符合入选标准的120例CHF患者采用随机数字表法分为2组,每组60例。西医组采用西医常规疗法治疗,中西医组在西医组基础上配合温针灸。2组均治疗4周。采用彩色多普勒超声诊断仪检测左室射血分数(left ventricular ejection fraction,LVEF)、左室舒张末期内径(left ventricle end-diastolic diameter,LVEDd)、左室收缩末期内径(left ventricular end systolic diameter,LVESd)、6 min步行距离。采用ELISA法检测血清氨基末端脑钠肽前体(plasma amino-terminal brain natriuretic peptide precursor,NT-proBNP),评价临床疗效。结果中西医组总有效率为95.0%(57/60)、西医组为90.0%(54/60),2组比较差异有统计学意义(Z=-2.218,P=0.027)。治疗后,中西医组LVEF[(49.5±4.7)%比(47.0±4.5)%,t=2.976]、6 min步行距离[(348.9±38.1)m比(319.7±35.0)m,t=5.107]均高于西医组(P<0.01),LVEDd[(47.3±4.0)mm比(50.0±4.6)mm,t=-3.431]、LVESd[(38.5±3.5)mm比(40.8±3.9)mm,t=-3.400]、血清NT-proBNP水平[(750.2±158.5)ng/L比(900.4±183.7)ng/L,t=4.960]低于西医组(P<0.01)。结论温针灸结合西医常规疗法可有效改善CHF患者的心功能,提高疗效。

Objective To investigate the effect of warm acupuncture combined with Western medicine on cardiac function in patients with CHF.Methods A total of 120 patients with CHF who met the inclusion criteria were randomly divided into two groups,60 in each group.The control group was treated with conventional medicine,and the Chinese and western medicine group was combined with warm acupuncture on the basis of the control group.Both groups were treated for 4 weeks.The 6 min walking distance were compared.The LVEF%,LVEDd,and LVESd were measured by color Doppler ultrasound.The Plasma NT-proBNP was detected by ELISA.Results The total effective rate was 95.0%(57/60)in the Chinese and western medicine group and 90.0%(54/60)in the Western medicine group.The difference was statistically significant(Z=-2.218,P=0.027).After treatment,the LVEF%level of the Chinese and western medicine group(49.5%±4.7%vs.47.0%±4.5%,t=2.976),6 min walking distance(348.9±38.1 m vs.319.7±35.0 m,t=5.107)were significantly higher than those of the Western medicine group(P<0.01);and the LVEDd(47.3±4.0 mm vs.50.0±4.6 mm,t=-3.431),LVESd(38.5±3.5 mm vs.40.8±3.9 mm,t=-3.400),NT-proBNP(750.2±158.5 ng/L vs.900.4±183.7 ng/L,t=4.960)were significantly lower than those of the western medicine group(P<0.01).Conclusions Warm acupuncture combined with Western medicine can improve the heart function of CHF patients.