益气养阴法治疗老年心力衰竭的疗效观察

Observation of Effects of Yiqi Yangyin Therapy on Senile Heart Failure

目的:探讨益气养阴法治疗老年心力衰竭(CHF)的疗效及对血清炎性反应因子、脑钠尿肽水平及生命质量的影响。方法:选取2016年1月至2017年12月辽宁中医药大学附属第四医院收治的老年CHF患者80例作为研究对象,按照随机数字表法随机分为对照组(n=20)、安慰剂组(n=30)和观察组(n=30)。对照组患者给予基础西药治疗,安慰剂组在对照组基础上给予安慰剂及穴位透药治疗,观察组在对照组基础上给予归脾汤口服及归脾汤穴位透药治疗。比较3组治疗前后心功能指标、IL-6、IL-1β、NT-proBNP、生命质量改善情况及临床疗效。结果:治疗后,3组患者LVEDD、LVESD、IL-6、IL-1β、NT-proBNP均降低,LVEF、生命质量评分均升高,差异有统计学意义(P<0.05);治疗后LVEDD、LVESD、IL-6、IL-1β、NT-proBNP水平由低到高依次为:观察组<安慰剂组<对照组,LVEF、生命质量评分由高到低依次为:观察组>安慰剂组>对照组,差异均有统计学意义(P<0.05);观察组总有效率为93.33%,安慰剂组为76.67%,对照组为65.00%,3组比较,差异有统计学意义(P<0.05);随访1年,3组再入院率比较,观察组(10.00%)<安慰剂组(23.33%)<对照组(40.00%),差异有统计学意义(P<0.05)。结论:益气养阴法可显著改善老年CHF患者心功能,降低血清中IL-6、IL-1β、NT-proBNP指标,提高生命质量,治疗后患者再入院率低,临床疗效确切,在老年CHF患者的临床治疗中具有重要的应用价值。

Objective:To explore the effects of Yiqi Yangyin Therapy on senile heart failure(CHF)and its influence on serum inflammatory factors,brain natriuretic peptide levels and quality of life.Methods:A total of 80 elderly patients with CHF admitted to Liaoning University of Traditional Chinese Medicine Subsidiary Fourth from January 2016 to December 2017 were selected.According to the random number table method,they were randomly divided into a control group(n=20),a placebo group(n=30)and an observation group(n=30).The patients in the control group were treated with basic Western medicine,while the patients in the placebo group were treated with placebo and acupoint penetration on the basis of the control group.The patients in the observation group were treated with Guipi Oral Decoction and Guipi Decoction acupoint penetration on the basis of the control group.The indexes of cardiac function,IL-6,IL-1β,NT-proBNP,improvement of quality of life and clinical efficacy of the 3 groups were compared before and after treatment.Results:After treatment,the levels of LVEDD,LVESD,IL-6,IL-1β,NT-proBNP in the 3 groups all decreased,while the scores of LVEF and quality of life all increased(P<0.05).After treatment,the levels of LVEDD,LVESD,IL-6,IL-1βand NT-proBNP ranked in the order from low to high were:observation group<placebo group<control group,LVEF and quality of life score ranked in the order from high to low were:observation group>placebo group>control group(P<0.05).The total effective rate of the observation group was 93.33%>76.67%in the placebo group>65.00%in the control group,(P<0.05);After 1 year of follow up,the readmission rate of the observation group was 10.00%<23.33%in the placebo group<40.00%in the control group,(P<0.05).Conclusion:Yiqi Yangyin Therapy can significantly improve the cardiac function of elderly patients with CHF,reduce the serum levels of IL-6,IL-1β,NT-proBNP,and improve the quality of life.After treatment,the readmission rate of patients is low and the clinical effects is definite.It has important application value in the clinical treatment of elderly patients with CHF.