自拟益气活血利水强心方对气虚血瘀型慢性心力衰竭患者心功能及运动耐量的影响

Effect of Self-made Yiqi Huoxue Lishui Qiangxin Prescription on Cardiac Function and Exercise Tolerance for Patients with Qi-deficiency Blood-stasis Type Chronic Heart Failure

目的:观察自拟益气活血利水强心方对气虚血瘀型慢性心力衰竭(CHF)患者心功能及运动耐量的影响。方法:选取2018年1月~2019年9月于红安县人民医院心血管内科收治的102例CHF伴抑郁症患者作为研究对象,随机划分为对照组(51例)和观察组(51例)。其中对照组采用常规西药抗心衰治疗,观察组在对照组基础上加用自拟益气活血利水强心方治疗,对比两组治疗后总有效率,治疗前后心悸等症候积分、血浆N终端脑钠肽(NT-pro BNP)水平、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)、6min步行距离、运动峰耗氧量(PVO2),每搏耗氧量(VO2/HR),治疗期间不良反应发生率。结果:治疗后,观察组患者的总有效率显著高于对照组(χ^(2)=5.299,P<0.05);观察组患者心悸、胸闷胸痛、气短乏力、下肢水肿症状积分均明显低于对照组(P<0.05),LVEDD、LVESD和NT-pro BNP均低于对照组(P<0.05),LVEF、6min步行距离、PVO2和VO2/HR均明显高于对照组(P<0.05),两组患者治疗期间用药副反应发生率无明显差异(χ^(2)=0.543,P>0.05)。结论:在常规抗心衰治疗基础上加用自拟益气活血利水强心方治疗CHF患者,可有效改善患者心功能和心悸、胸闷、水肿等证候表现,提升临床治疗疗效和患者的运动耐量。

Objective:To observe the effects of Self-made Yiqi Huoxue Lishui Qiangxin Prescription on cardiac function and exercise tolerance for patients with chronic heart failure(CHF)of Qi-deficiency blood-stasis type.Methods:A total of 102patients with CHF and depression who were admitted to cardiovascular medicine of Hong’an County People’s Hospital from January 2018to September 2019were enrolled as study objects.They were randomly divided into controlled group(51cases)and observation group(51cases).The controlled group was given routine western medicine for anti-heart failure treatment,while the observation group was additionally treated with Self-made Yiqi Huoxue Lishui Qiangxin Prescription.The total response rate after treatment,scores of palpitation and other symptoms,level of plasma N-terminal pro-brain natriuretic peptide(NT-pro BNP),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF),6-minute walking distance(6MWD),peak oxygen consumption(PVO2)and oxygen uptake per stroke(VO2/HR)before and after treatment,and incidence of adverse reactions during treatment were compared between the two groups.Results:After treatment,the total response rate in the observation group was significantly higher than that in the controlled group(χ^(2)=5.299,P<0.05).The scores of symptoms such as palpitation,chest tightness and chest pain,shortness of breath and weakness,and lower limb edema in the observation group were significantly lower than those in the controlled group(P<0.05),LVEDD,LVESD and NT-pro BNP were all lower than those in the controlled group(P<0.05),while LVEF,6MWD,PVO2 and VO2/HR were significantly higher than those in the controlled group(P<0.05).There was no significant difference in incidence of medication side effects during treatment between the two groups(χ^(2)=0.543,P>0.05).Conclusion:Using Self-made Yiqi Huoxue Lishui Qiangxin Prescription in treatment of CHF patients on basis of routine anti-heart failure treatment can effectively improve cardiac function and symptoms such as palpitation,chest tightness and edema,and improve clinical curative effect and exercise tolerance.