常规治疗加用温阳活血方对冠心病合并心衰患者心功能及远期预后的影响观察

Effects of Routine Treatment Plus Wenyang Huoxue Recipe on Cardiac Function and Long-term Prognosis of Patients with Coronary Heart Disease Complicated with Heart Failure

目的:观察常规治疗加用温阳活血方治疗冠心病合并心衰,对患者心功能及远期预后的影响。方法:60例冠心病合并心衰患者随机分为对照组(30例,常规西医治疗及心功能康复)和观察组(30例,对照组基础上联合温阳活血方)治疗3个月。比较两组患者治疗前后的心功能、6 min步行距离(6 MWD)、西雅图心绞痛量表(SAQ)评分变化,观察两组临床疗效及随访1年内因心衰再住院率和死亡率。结果:治疗后,两组左室射血分数(LVEF)均较前增加,血浆N末端脑钠肽前体(NT-proBNP)水平则较前下降,SAQ各维度评分均较前升高(P<0.05);且观察组各项指标均明显优于对照组(P<0.05)。观察组治疗1~3个月及对照组治疗2、3个月的6 MWD均明显高于治疗前(P<0.05),且观察组治疗1~3个月的6 MWD均高于对照组(P<0.05)。观察组总有效率显著高于对照组(P<0.05);1年随访期间,观察组因心衰再住院率低于对照组(P<0.05),但两组死亡率差异无统计学意义(P>0.05)。结论:常规治疗基础上加用温阳活血方可更明显改善冠心病合并心衰患者的心功能,提高其运动耐力,改善患者机体功能状态,降低因心衰再住院率。

Objective:To observe the effects of routine treatment plus Wenyang Huoxue Recipe on cardiac function and long-term prognosis of patients with coronary heart disease complicated with heart failure.Methods:Totally 60 patients with coronary heart disease complicated with heart failure were randomly divided into control group(30 cases,routine Western medicine treatment and cardiac function rehabilitation)and observation group(30 cases,combined with Wenyang Huoxue Recipe on the basis of control group),and treated for 3 months.The changes of cardiac function,6-min walking distance(6 MWD)and SAQ score were compared between the two groups before and after treatment.The clinical efficacy,rehospitalization rate and mortality due to heart failure within one year of follow-up were observed as well.Results:After treatment,left ventricular ejection fraction(LVEF)increased,plasma N-terminal pro brain natriuretic peptide(NT proBNP)decreased,and SAQ scores increased in both groups(P<0.05);the indexes of the observation group were significantly better than those of the control group(P<0.05).The 6 MWD of the observation group for 1-3 months and the control group for 2 and 3 months were significantly higher than that before treatment(P<0.05),and the 6 MWD of the observation group for 1-3 months was higher than that of the control group(P<0.05).The total effective rate of the observation group was significantly higher than that of the control group(P<0.05);during one-year follow-up,the rehospitalization rate of the observation group was lower than that of the control group(P<0.05),but there was no significant difference in mortality between the two groups(P>0.05).Conclusion:On the basis of routine treatment,adding Wenyang Huoxue Recipe can significantly improve cardiac function of patients with coronary heart disease complicated with heart failure,improve exercise endurance,improve functional state of patients,and reduce rehospitalization rate due to heart failure.