理气强心汤联合常规西药对慢性心力衰竭心肾阳虚证患者心功能及血液流变学的影响

Effects of Liqi Qiangxin Tang(理气强心汤)combined with routine Western medicine on cardiac function and hemorheology of chronic heart failure in patients with asthenia of cardiac and renal yang syndrome

目的观察理气强心汤联合常规西药对慢性心力衰竭(CHF)心肾阳虚证患者心功能及血液流变学的影响。方法将102例CHF心肾阳虚证患者采用随机数字表法分为治疗组和对照组,各51例。2组均给予扩血管、利尿、强心等常规治疗,对照组在常规治疗的基础上口服盐酸贝那普利片,治疗组在对照组治疗方法的基础上联合理气强心汤口服。治疗8周后比较2组治疗前后左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、心输出量(CO)等心功能指标,以及全血高切黏度、全血低切黏度、血浆比黏度、红细胞聚集指数(EAI)等血液流变学指标。结果治疗后2组LVEDD、LVESD均明显降低,LVEF、CO均明显升高,与同组治疗前比较差异有统计学意义(P<0.05或P<0.01),且治疗组对各项指标的改善作用明显优于对照组,2组治疗后比较差异均有统计学意义(P<0.05或P<0.01);治疗后2组全血高切黏度、全血低切黏度、血浆比黏度及EAI均明显降低,与同组治疗前比较差异有统计学意义(P<0.01),且治疗组降低更明显,与对照组治疗后比较差异均有统计学意义(P<0.01)。结论理气强心汤联合常规西药治疗CHF心肾阳虚证疗效显著,可有效改善患者心功能,减轻心脏负荷,降低血液流变学指标,值得临床推广应用。

Objective To observe Liqi Qiangxin Tang(理气强心汤)combined with routine Western medicine on cardiac function and hemorheology of chronic heart failure(CHF)in patients with asthenia of cardiac and renal yang syndrome.Methods Totally 102 CHF in patients with asthenia of cardiac and renal yang syndrome were divided into treatment group and control group according to random number table method,with 51 cases in each.The 2 groups were both given routine treatment,namely vasodilator,diuretic and cardiotonic etc.,on this basis,the control group was given oral administration of benazepril hydrochloride tablets,while the treatment group was combined with oral administration of Liqi Qiangxin Tang on the therapeutic method of the control group.After treatment for 8 weeks,cardiac function indexes including left ventricular end-diastolic dimension(LVEDD),left ventricular endsystolic dimension(LVESD),left ventricular ejection fraction(LVEF)and cardiac output(CO)and hemorheological indexes,namely whole blood high shear viscosity,whole blood low shear viscosity,plasma specific viscosity and erythrocyte aggregation index(EAI)etc.of the 2 groups before and after treatment were compared.Results After treatment,LVEDD and LVESD significantly decreased,LVEF and CO significantly increased in the 2 groups,and the difference was statistically significant compared with the same group before treatment(P<0.05 or P<0.01),and the improvement of each index in the treatment group was significantly better than that in the control group,and the difference was statistically significant between the 2 groups after treatment(P<0.05 or P<0.01).After treatment,the whole blood high shear viscosity,whole blood low shear viscosity,plasma specific viscosity and EAI significantly decreased in the 2 groups and the difference was statistically significant compared with the same group before treatment(P<0.01),moreover,the treatment group decreased more significantly,and the difference was statistically significant compared with the control group after treatment(P<0.01).Conclusion It has significant curative efficacy,can effectively improve the cardiac function,reduce the cardiac load,and reduce the hemorheological indexes to use Liqi Qiangxin Tang combined with routine Western medicine in the treatment of CHF in patients with asthenia of cardiac and renal yang syndrome,which is worthy of clinical promotion and application.