桂姜枳实汤加味联合常规西药治疗冠心病合并慢性心力衰竭31例

Thirty-One Cases of Coronary Atherosclerotic Heart Disease Combined with Chronic Heart Failure Treated with Flavored Cinnamon and Rhizoma Zingiveris Recens and Immature Bitter Orange Decoction and Conventional Western Medicine

目的:观察桂姜枳实汤加味联合常规西药治疗冠状动脉粥样硬化性心脏病(简称冠心病)合并慢性心力衰竭的临床疗效。方法:将62例冠心病合并慢性心力衰竭患者按照随机数字表法分为对照组和观察组,每组各31例。对照组给予常规西药治疗,观察组在对照组治疗的基础上联合桂姜枳实汤加味治疗。比较两组患者的临床疗效及治疗前后中医证候评分、超声心动图指标[左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左室收缩末期内径(Left ventricular end systolic diameter,LVESD)、左心室射血分数(left ventricular ejection fraction,LVEF)]、心率变异性指标、6分钟步行试验距离、明尼苏达心力衰竭生活质量问卷(minnesota living with heart failure questionnaire,MLHFQ)评分的变化情况。结果:观察组有效率为90.32%,对照组有效率为70.97%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后中医证候评分均低于本组治疗前,且观察组治疗后中医证候评分均低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后LVEDD、LVESD低于本组治疗前,LVEF高于本组治疗前,观察组治疗后LVEDD、LVESD低于对照组,LVEF高于对照组,差异均有统计学意义(P<0.05)。两组患者治疗后心率变异性水平均高于本组治疗前,且观察组治疗后心率变异性水平高于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后6分钟步行试验距离高于本组治疗前,MLHFFQ评分低于本组治疗前,观察组治疗后6分钟步行试验距离高于对照组,MLHFFQ评分低于对照组,差异具有统计学意义(P<0.05)。结论:桂姜枳实汤加味联合西药治疗冠心病合并慢性心力衰竭,可改善患者的临床症状、心功能及心率变异性水平。

Objective:To observe the clinical curative effect of Flavored Cinnamon and Rhizoma Zingiveris Recens and Immature Bitter Orange Decoction and Conventional Western Medicine on coronary atherosclerotic heart disease combined with chronic heart failure.Methods:A total of 62 patients with coronary heart disease combined with chronic heart failure were randomly divided into the control group and the observation group,with 31 cases in each group.The control group was treated with conventional Western medicine,while the observation group was treated with Flavored Cinnamon and Rhizoma Zingiveris Recens and Immature Bitter Orange Decoction on the basis of the control group.The changes of clinical efficacy,TCM syndrome score,echocardiographic indexes[left ventricular end diastolic diameter(LVEDd),left ventricular end systolic diameter(LVESD),left ventricular ejection fraction(LVEF)],heart rate variability index,heart rate variability index,left ventricular end systolic diameter(LVESD),left ventricular ejection fraction(LVEF)],6-minute walking test distance and Minnesota living with heart failure questionnaire(MLHFQ)score before and after treatment were compared between the two groups.Results:The effective rate of the observation group was 90.32%,while that of the control group was 70.97%,and the difference was statistically significant(P<0.05).The TCM syndrome scores of the two groups after treatment were lower than those of the same group before treatment,and the TCM syndrome scores of the observation group after treatment were lower than those of the control group,the difference was statistically significant(P<0.05).LVEDD and LVESD in the two groups were lower than those of the same group before treatment;LVEDD and LVESD in the observation group were lower than those of the control group,but its LVEF was higher than that of the control group,and all the differences were statistically significant(P<0.05).SDNN,SDANN and RMSSD of the two groups after treatment were higher than those of the same group before treatment,and the heart rate variability index of the observation group after treatment was higher than that of the control group,and all the differences were statistically significant(P<0.05).The distance of six-minute-walk test in the two groups was higher than that before treatment,KLHFFQ score was lower than that of the same group before treatment in the observation group,and the distance of six-minute-walk test after the treatment in observation group was higher than that of the control group,and the MLHFFQ score was lower than that of the control group,and all the differences were statistically significant(P<0.05).Conclusion:In terms of coronary atherosclerotic heart disease combined with chronic heart failure,Flavored Cinnamon and Rhizoma Zingiveris Recens and Immature Bitter Orange Decoction and Western medicine can improve the clinical symptoms,cardiac function and heart rate variability.