自拟温阳化瘀利水方对慢性心衰(血瘀水停证)患者临床症状及运动耐量的影响

Effects of Self-made Wenyang Huayu Lishui Decoction on Clinical Symptoms and Exercise Tolerance in Patients with Chronic Heart Failure of Blood-stasis Water Retention Syndrome

目的观察自拟温阳化瘀利水方对慢性心力衰竭(CHF)(血瘀水停证)患者临床症状及运动耐量的影响。方法将328例CHF(血瘀水停证)患者作为研究对象,采用随机数字表法分为观察组与对照组各164例,对照组给予西医常规治疗,观察组在对照组基础上给予自拟温阳化瘀利水方治疗,比较两组临床症状、中医证候评分、运动耐量、心功能水平、心率变异性及不良反应率。结果观察组总有效率为89.02%,显著高于对照组的77.44%(P<0.05)。治疗后观察组患者心悸、胸闷、脉络瘀血、面肢浮肿、腹胀积分低于对照组(P<0.05);治疗后观察组患者6 min步行距离、运动峰耗氧量(PVO2)、每搏耗氧量(VO2/HR)高于对照组(P<0.05);治疗后观察组患者左室射血分数(LVEF)水平高于对照组,左室收缩末期内径(LVESD)、左室收缩末期量容(LVESV)水平低于对照组(P<0.05);治疗后观察组患者正常窦性心搏RR间期的标准差(SDNN)、全程相邻窦性心搏RR间期差值均方根(RMSSD)、高频功率(HF)、低频功率(LF)高于对照组(P<0.05);两组患者总不良反应率比较,差异无统计学意义(P>0.05)。结论自拟温阳化瘀利水方治疗CHF(血瘀水停证)患者疗效显著,可明显患者提高运动耐量,改善心功能,调节自主神经平衡,且安全性较好。

Objective:To explore the effects of self-made Wenyang Huayu Lishui Decoction on clinical symp⁃toms and exercise tolerance in patients with chronic heart failure of blood-stasis water retention syndrome.Meth⁃ods:A total of 328 patients with chronic heart failure of blood-stasis water retention syndrome were enrolled as the research objects.According to random number table method,they were divided into observation group and con⁃trol group,164 cases in each group.The control group was given routine western medicine,while observation group was treated with self-made Wenyang Huayu Lishui Decoction on basis of control group.The clinical symp⁃toms,scores of TCM symptoms,exercise tolerance,cardiac function level,heart rate variability and incidence of ad⁃verse reactions were compared between the two groups.Results:The total effective rate of observation group was higher than that of control group(P<0.05).After treatment,scores of symptoms(palpitation,chest tightness,conges⁃tion of veins,swelling of face and limbs,abdominal distension)in observation group were lower than those in con⁃trol group(P<0.05),6-min walking distance,PVO2 and VO2/HR were higher than those in control group(P<0.05),LVEF was higher than that in control group,LVESD,and LVESV were lower than those in control group(P<0.05),SDNN,RMSSD,HF and LF were higher than those in control group(P<0.05).The difference in total incidence of adverse reactions between the two groups was not statistically significant(P>0.05).Conclusion:The curative effect of self-made Wenyang Huayu Lishui Decoction is significant on patients with chronic heart failure of blood-stasis water retention syndrome,which can significantly improve exercise tolerance and cardiac function,and regulate autonomic nerve balance,with good safety.