桂枝茯苓丸合真武汤治疗慢性心功能不全心肾阳虚证临床研究

Clinical Study on Guizhi Fuling Pills Combined with Zhenwu Tang for Chronic Heart Failure with Heart-kidney Yang Deficiency Syndrome

目的:探究桂枝茯苓丸合真武汤治疗慢性心功能不全(CHF)心肾阳虚证的临床疗效。方法:选取130例CHF心肾阳虚证患者作为研究对象,按随机数字表法分为观察组和对照组各65例。对照组行常规西药治疗,观察组在对照组基础上给予桂枝茯苓丸合真武汤治疗。观察2组临床疗效,检测心功能、脑尿钠肽(BNP)、一氧化氮(NO)等指标。结果:观察组总有效率为92.31%,高于对照组64.62%(P<0.05)。治疗前,2组中医证候积分比较,差异无统计学意义(P>0.05)。治疗后,2组中医证候积分较治疗前下降(P<0.05),且观察组中医证候积分低于对照组(P<0.05)。治疗前,2组左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室射血分数(LVEF)、6分钟步行距离(6MWD)水平比较,差异均无统计学意义(P>0.05)。治疗后,2组LVEDD较治疗前下降(P<0.05),而LVEF、6MWD较治疗前升高(P<0.05);且观察组LVEDD低于对照组(P<0.05),而LVEF、6MWD高于对照组(P<0.05)。治疗前,2组肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)、BNP、NO水平比较,差异均无统计学意义(P>0.05)。治疗后,2组TNF-α、hs-CRP、BNP、NO水平较治疗前降低(P<0.05),且观察组hs-CRP、TNF-α、BNP、NO水平均低于对照组(P<0.05)。结论:桂枝茯苓丸合真武汤能够改善CHF心肾阳虚证患者心功能,降低血浆BNP和NO水平,改善患者临床症状,值得临床推广应用。

Objective:To explore the clinical effect of Guizhi Fuling pills combined with Zhenwu tang for chronic heart failure(CHF)with heart-kidney yang deficiency syndrome.Methods:Selected 130 cases of CHF with heart-kidney yang deficiency patients as the study subjects and divided them into the observation group and the control group according to the random number table,with 65 cases in each group.Both groups were treated with routine western medicine and the observation group was additionally given Guizhi Fuling pills combined with Zhenwu tang.Observed the clinical effect in the two groups and detected the indexes including the cardiac function,brain natriuretic peptide(BNP)and nitric oxide(NO).Results:The total effective rate in the observation group was 92.31%,being higher than that of 64.62%in the control group(P<0.05).Before treatment,there was no significant difference being found in the comparison of Chinese medicine syndrome scores in the two groups(P>0.05).After treatment,the Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment(P<0.05),and the Chinese medicine syndrome scores in the observation group were lower than those in the control group(P<0.05).Before treatment,there were no significant differences being found in the comparison of the levels of left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF)and 6-minute walking distance(6MWD)in the two groups(P>0.05).After treatment,LVEDD in the two groups was decreased when compared with that before treatment(P<0.05),while LVEF and 6MWD were increased when compared with those before treatment(P<0.05);and LVEDD in the observation group was lower than that in the control group(P<0.05),while LVEF and 6MWD in the observation group were higher than those in the control group(P<0.05).Before treatment,there were no significant differences being found in the comparison of the levels of tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP),BNP and NO in the two groups(P>0.05).After treatment,the levels of TNF-α,hs-CRP,BNP and NO in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of hs-CRP,TNF-α,BNP and NO in the observation group were all lower than those in the control group(P<0.05).Conclusion:The application of Guizhi Fuling pills combined with Zhenwu tang can improve the cardiac function of CHF patients with heart-kidney yang deficiency syndrome,reduce the levels of plasma BNP and NO and improve the clinical symptoms of patients,which is worthy of clinical promotion and application.