益气泻肺汤加减治疗慢性心力衰竭气虚血瘀证的疗效及对心室重构的影响研究

Efficacy of modified Yiqi Xiefei Decoction on chronic heart failure with syndrome of Qi deficiency and blood stasis and its influence on ventricular remodeling

目的观察益气泻肺汤加减治疗慢性心力衰竭气虚血瘀证患者的疗效及对心室重构的影响。方法将2018年7月—2019年10月北京中医药大学东直门医院通州院区收治的150例心力衰竭气虚血瘀证患者随机分为观察组75例和对照组75例,对照组给予常规西医治疗,观察组在对照组治疗基础上给予益气泻肺汤加减治疗,连续治疗4周。比较2组治疗前后临床症状积分、6 min步行试验(6MWT)、超声心动图指标[左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左心室射血分数(LVEF)]及血清相关指标[氨基末端脑钠肽前体(NT-proBNP)、C反应蛋白(CRP)],统计2组临床疗效。结果治疗后,2组临床症状积分,LVEDD、LVESD、LVEDV、LVESV及血清CRP、NT-proBNP水平均较治疗前明显下降(P均<0.05),且观察组治疗后以上指标均明显低于对照组(P均<0.05);2组治疗后6MWT和LVEF较治疗前明显升高(P均<0.05),且观察组治疗后6MWT和LVEF明显高于对照组(P均<0.05)。观察组治疗总有效率为93.3%(70/75),对照组为81.3%(61/75),观察组明显高于对照组(P<0.05)。2组治疗期间均未见明显不良反应。结论益气泻肺汤加减治疗可显著改善心力衰竭气虚血瘀证患者心脏超声指标,明显抑制心室重构。

Objective It is to observe the curative effect of Yiqi Xiefei Decoction in the treatment of patients with chronic heart failure with syndrome of Qi deficiency and blood stasis and its influence on ventricular remodeling.Methods 150 cases of heart failure patients with syndrome of Qi deficiency and blood stasis admitted to Tongzhou Branch of Dongzhimen Hospital from July 2018 to October 2019 were randomly divided into an observation group of 75 cases and a control group of 75 cases.The control group was given conventional western medicine treatment,and the observation group was given Yiqi Xiefei Decoction on the basis of the treatment of the control group,both groups were continuously treated for 4 weeks.The clinical symptom scores,6-minute walk test(6MWT),echocardiographic indicators(left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular end diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF)and serum-related indicators[N-terminal pro-brain natriuretic peptide(NT-proBNP),C-reactive protein(CRP)]before and after treatment were compared between the two groups,the clinical efficacy of the 2 groups was calculated.Results After treatment,the clinical symptom scores,LVEDD,LVESD,LVEDV,LVESV,and the levels of serum CRP,and NT-proBNP were significantly lower than those before treatment in the two groups(P<0.05),and the above indicators in the observation group were significantly lower than those in the control group after treatment(P<0.05);after treatment,6MWT and LVEF in the two groups were significantly higher than those before treatment(P<0.05),and the 6MWT and LVEF in the observation group were significantly higher than those in the control group after treatment(P<0.05).The total effective rate of treatment in the observation group was 93.3%(70/75),and that of the control group was 81.3%(61/75),the observation group was significantly higher than the control group(P<0.05).No obvious side effect was found in the two groups during treatment period.Conclusion Modified Yiqi Xiefei Decoction can significantly improve the cardiac ultrasound indexes and significantly inhibit ventricular remodeling in patients with heart failure with syndrome of Qi deficiency and blood stasis.