柴桂剂治疗慢性心衰伴焦虑状态的临床研究

Clinical Study of Chaigui Decoction in Treating CHF with Anxiety

目的:探讨应用柴桂剂治疗慢性心衰伴焦虑状态的临床疗效,并探索其初步作用机制。方法:选取符合纳入标准的慢性心力衰竭伴焦虑状态患者62例,依随机数字表法随机分为对照组和治疗组。对照组31例给予慢性心衰常规西医治疗,治疗组31例在对照组基础上予以经验方柴桂剂治疗,治疗疗程为4周。比较两组患者治疗前后中医证候积分、心功能分级、氨基末端脑钠肽前体(NT-proBNP)、左室射血分数(LVEF)、汉密尔顿焦虑状态量表(HAMA)及明尼苏达心力衰竭生活质量量表(MLHFQ)的情况,并对临床疗效进行评估。结果:治疗组心功能疗效、焦虑疗效总有效率均高于对照组(P<0.05);两组患者治疗后中医证候积分、HAMA评分、MLHFQ评分、LVEF及NT-proBNP水平均得到改善(P<0.05,P<0.01);治疗后治疗组中医证候积分、HAMA、MLHFQ评分均低于对照组(P<0.05,P<0.01);两组治疗后LVEF比较无统计学意义(P>0.05);治疗后治疗组NT-proBNP水平明显低于对照组(P<0.01)。结论:柴桂剂治疗慢性心衰伴焦虑状态,能明显改善患者的心衰症状与焦虑状态,降低NT-proBNP水平,提高患者的生活质量,临床疗效显著。

Objective:To explore the clinical efficacy of Chaigui Decoction in the treatment of chronic heart failure(CHF)with anxiety state and to explore its primary mechanism.Methods:62 patients with CHF and anxiety were randomly divided into the treatment group(n=31)and the control group(n=31).The control group was treated with conventional western medication;on which basis,the treatment group was also treated with Chaigui Decoction.The treatment duration was four weeks.TCM symptoms score,cardiac functional grade,NT-proBNP,LVEF,the scores of HAMA and MLHFQ were compared before and after the treatment in the two groups.Clinical efficacy was also compared between the two groups.Results:The curative effect of cardiac function and the total effective rate of anxiety were higher in the observation group than those in the control group(P<0.05).The scores of TCM symptoms,HAMA scale and MLHFQ,as well as the levels of LVEF and NT-proBNP were all significantly improved after the treatment in the two groups(P<0.05,P<0.01);TCM symptom score,HAMA scale score and MLHFQ score were lower in the treatment group than those in the control group after the treatment(P<0.05,P<0.01);there was no statistical difference in LVEF between the two groups after the treatment(P>0.05);NT-proBNP level was significantly lower in the treatment group than that in the control group after the treatment(P<0.01).Conclusion:Chaigui Decoction can significantly improve the symptoms of CHF and anxiety,reduce NT-proBNP and improve the life quality of the patients,with its significant clinical effect.