通脉汤治疗心梗后心力衰竭患者82例临床观察

Clinical Observation on 82 Cases of Tongmai Decoction in Treating Heart Failure Patients Due to Myocardial Infarction

目的:观察通脉汤对心梗后心力衰竭患者的临床疗效。方法:选取2016年11月至2018年6月昌平区中医医院收治的心梗后心力衰竭患者82例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组41例,对照组给予常规西药治疗,观察组给予常规西药治疗+通脉汤加减,中药治疗疗程为12周,每2周记录患者主要临床症状和中医证候积分,并分别于治疗前、治疗12周及1年后,检测患者肾素、血管紧张素Ⅱ及醛固酮水平。结果:1)治疗12周后2组中医证候积分总有效率分别为71.05%、29.73%,1年后2组中医证候积分总有效率分别为71.05%、32.43%,观察组疗效均明显优于对照组(P<0.01)。2)与本组治疗前比较,治疗12周、1年后观察组肾素水平均明显下降(P<0.01),对照组肾素水平与治疗前比较,差异无统计学意义(P>0.05);观察组治疗12周后肾素水平与对照组比较,差异有统计学意义(P<0.05);2组治疗12周、1年后血管紧张素Ⅱ、醛固酮水平均较治疗前下降(P<0.01),观察组治疗12周后血管紧张素Ⅱ、醛固酮水平与对照组比较,差异有统计学意义(P<0.05)。结论:通脉汤可以显著改善心梗后心力衰竭患者的临床症状,能有效改善患者肾素、血管紧张素Ⅱ及醛固酮水平。

Objective:To observe the clinical effects of Tongmai Decoction in treating heart failure patients due to myocardial infarction.Methods:A total of 82 cases of patients of heart failure patients due to acute myocardial infarction in Changping Hospital of Traditional Chinese Medicine of Beijing City from November 2016 to June 2018 were selected and randomly divided into a control group(41 cases)and an observation group(41 cases)according to random number table.The treatment group patients were treated by Modified Tongmai Decoction and conventional western medicine,while the control group patients were treated by conventional western medicine only.The treatment course of TCM was 12 weeks.The main TCM clinical symptoms and TCM syndrome integral were recorded every 2 weeks.The levels of renin,angiotensin II and aldosterone were detected before treatment,12 weeks and 1 year after treatment.Results:1)After 12 weeks′treatment,the total effective rates of TCM syndrome integral of the 2 groups were 71.05%and 29.73%.After 1 year′s treatment,the total effective rates of TCM syndrome integral of the 2 groups were 71.05%and 32.43%.The observation group was obviously better than the control group(P<0.01).2)Compared with before treatment,the levels of renin were decreased significantly after 12 weeks′and 1 year′s treatment(P<0.01),but the control group has no significant difference in renin levels before and after the treatment(P>0.05).Compared with the control group,the renin levels of the observation group after 12 weeks′treatment were statistically significant(P<0.05).After 12 weeks′and 1 year′s treatment,the levels of angiotensin II and aldosterone were all better than before treatment(P<0.01).Compared with the control group,the levels of angiotensin II and aldosterone of the observation group after 12 weeks′treatment were statistically significant(P<0.05).Conclusion:After treated by Tongmai Decoction,the clinical symptoms of patients with heart failure due to myocardial infarction are significantly improved,and it can effectively improve the levels of renin,angiotensin II and aldosterone.