加味参芪益心方治疗射血分数保留心力衰竭心肾阳虚证的临床观察

Clinical Observation of Modified Shenqi Yixin Decoction in the Treatment of Heart Failure and Heart-kidney Yang Deficiency Syndrome with Retained Ejection Fraction

目的观察加味参芪益心方治疗射血分数保留心力衰竭心肾阳虚证的临床疗效。方法选取2019年1月—2019年11月黑龙江中医药大学附属第一医院收治的射血分数保留心力衰竭心肾阳虚证病人72例,随机分为对照组与观察组,每组36例。对照组采用常规西药治疗,观察组在对照组的基础上加用加味参芪益心方,两组均治疗8周。比较两组临床疗效、氨基末端脑钠肽前体(NT-proBNP)、6 min步行试验(6MWT)距离、舒张早期二尖瓣血流峰值(E)、舒张晚期二尖瓣血流峰值(A)、E/A、左房容积指数(LAVI)、左室质量指数(LVMI)、二尖瓣舒张早期血流峰值与二尖瓣环运动速度比值(E/E′)。结果观察组治疗总有效率为94.4%,明显高于对照组的83.3%(P<0.05)。治疗后,两组中医证候积分、NT-proBNP、A、LAVI、LVMI、E/E′均较治疗前下降,且观察组下降更明显(P<0.05);两组6MWT距离、E/A均较治疗前增加,且观察组增加更明显(P<0.05);观察组E值较对照组增加明显。结论与单纯西医常规治疗相比,联合加味参芪益心方能提高射血分数保留心力衰竭心肾阳虚证的治疗效果。

Objective To observe the clinical effect of modified Shenqi Yixin prescription on heart failure and heart-kidney Yang deficiency syndrome with retained ejection fraction.Methods A total of 72 patients with heart failure and heart-kidney Yang deficiency syndrome with ejection fraction retention admitted to First Affiliated Hospital,Heilongjiang University of Chinese Medicine from January 2019 to November 2019 were selected and randomly divided into control group and observation group,with 36 patients in each group.The patients in control group were treated with conventional western medicine,and the patients in observation group were additionally treated with Jiawei Shenqi Yixin Decoction on the basis of control group.The treatment period of both groups was 8 weeks.After treatment,the clinical curative effect,NT-proBNP,6 minutes walk test(6MWT),peak early diastolic mitral valve blood flow(E),peak late diastolic mitral valve blood flow(A),the ratio E/A,left atrial volume index(LAVI),left ventricular mass index(LVMI),mitral valve flow spectrum peak value of speed and tissue Doppler mitral annulus velocity ratio of early diastolic peak value(E/E′)were compared.Results After 8 weeks of treatment,the total effective rate of observation group was significantly higher than that of control group(94.4%and 83.3%,P<0.05).Compared with control group,the syndrome scores,NT-proBNP,A,LAVI,LVMI,and E/E′in observation group decreased significantly(P<0.05),and the 6MWT,E,E/A in observation group increased significantly(P<0.05).Conclusion Compared with conventional western medicine treatment alone,the combination of Shenqi Yixin Decoction can further improve the effect in the treatment of patients with heart failure with preserved ejection fraction and heart-kidney Yang deficiency syndrome.