中药坎离方结合西药治疗慢性心力衰竭对患者心功能、不良情绪及生活质量的影响分析

Analysis of Effect of Applying Traditional Chinese Medicine Kanli Prescription Combined with Western Medicine on Cardiac Function, Adverse Emotions and Quality of Life in the Treatment of Chronic Heart Failure

目的:观察中药坎离方结合西药治疗慢性心力衰竭(CHF)对患者心功能、不良情绪及生活质量的影响。方法:将我院心病科及上海市杨浦区长白社区卫生服务中心、上海市杨浦区延吉社区卫生服务中心、上海市杨浦区大桥社区卫生服务中心共同收治的120例CHF患者采用密封信封法根据1∶2比例进行分组,分为对照组40例与联合组80例,对照组患者应用常规西药治疗,联合组患者应用中药坎离方(剂型为免煎颗粒制剂)联合西药治疗,分析两组患者临床疗效、中医证候积分、心功能指标、不良情绪及生活质量方面的差异。结果:经治疗,联合组患者临床治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,两组中医证候积分及B型脑钠肽(BNP)水平较治疗前降低,心功能指标左心室射血分数(LVEF)值、6min步行实验距离(6MWT)水平较治疗前提高,且联合组治疗后的中医证候积分、BNP水平低于对照组,LVEF水平高于对照组,差异有统计学意义(P<0.05),而两组患者治疗后的6MWT水平比较,差异无统计学意义(P>0.05);治疗后,两组患者抑郁自评量表(SDS)较治疗前显著降低,且联合组低于对照组(P<0.05);两组患者明尼苏达心力衰竭生活质量量表(LHFQ)体力、情绪、社会、经济维度评分及总分较治疗前均显著降低(P<0.05),且联合组低于对照组(P<0.05)。结论:中药坎离方结合西药治疗慢性心力衰竭具有良好疗效,可缓解患者临床症状,改善心功能,从而调节患者不良情绪、提高生活质量。

Objective:To explore the effect of traditional Chinese medicine Kanli prescription combined with western medicine on cardiac function, adverse emotions and quality of life in the treatment of chronic heart failure(CHF).Methods:120 patients with CHF admitted to department of cardiology of our hospital, Changbai Community Health Service Center, Yanji Community Health Service Center and Daqiao Community Health Service Center, Yangpu District, Shanghai were grouped by sealed envelope method according to the ratio of 1:2, and were divided into controlled group(40 cases) and combined group(80 cases).The controlled group was treated with conventional western medicine while the combined group was given traditional Chinese medicine Kanli Prescription(self-made granule preparation) combined with western medicine.The clinical efficacy, TCM symptoms scores, cardiac function indicators, adverse emotions and quality of life were analyzed in the two groups.Results:After treatment, the total effective rate of clinical treatment in the combined group was significantly higher than that in the controlled group(P<0.05).After treatment, the TCM syndromes scores and level of B-type natriuretic peptide(BNP) in the two groups were significantly decreased compared with those before treatment while the levels of cardiac function indicators of left ventricular ejection fraction(LVEF)] and 6 min walking distance(6 MWT) were significantly increased compared with those before treatment, and the TCM syndromes scores and level of BNP in the combined group after treatment were lower than those in the controlled group while the LVEF level was higher than that in the controlled group(P<0.05), and there was no significant difference in the 6 MWT level between the two groups after treatment(P>0.05).After treatment, the scores of self-rating depression scale(SDS) in the two groups were significantly decreased compared with those before treatment, and the score in the combined group was lower than that in the controlled group(P<0.05).The scores of physical, emotional, social and economic dimensions and total score of Minnesota Living with Heart Failure Questionnaire(LHFQ) in the two groups were significantly decreased compared with those before treatment(P<0.05), and the scores in the combined group were lower than those in the controlled group(P<0.05).Conclusion:Traditional Chinese medicine Kanli prescription combined with western medicine has a good efficacy on chronic heart failure, and it can alleviate clinical symptoms and improve cardiac function, thus regulating adverse emotions and improving quality of life of patients.