自拟益气活血利水方治疗扩张型心肌病并发慢性心力衰竭(气虚血瘀兼水湿内阻)的临床效果观察

Clinical Effect of Self-Made Yiqi Huoxue Lishui Formula on Dilated Cardiomyopathy complicated with Chronic Heart Failure(Qi Deficiency,Blood Stasis and Internal Resistance of Water Dampness)

目的探讨自拟益气活血利水方治疗扩张型心肌病(DCM)并发慢性心力衰竭(CHF)(气虚血瘀兼水湿内阻)的临床疗效。方法将60例DCM并发CHF(气虚血瘀兼水湿内阻型)的患者用随机数字表法中的奇偶法分为观察组和对照组,每组各30例。对照组采用常规治疗,观察组在对照组的基础上加用自拟益气活血利水方。比较治疗前和治疗结束时心肌功能[左心室收缩末期内径(LVESD)、左室收缩末期内径(LVEDD)、左室射血分数(LVEF)]、心肺功能情况[6分钟步行距离(6MWT)]、心力衰竭标志物[血浆N端脑钠肽前体(NT-proBNP)、心肌肌钙蛋白(cTnI)]及中医证候积分差异。结果治疗结束时,两组患者部分心肌功能(LVESD、LVEDD)、心力衰竭标志物(NT-proBNP、cTnI)、各项中医证候积分较治疗前均降低,且观察组低于对照组(P均<0.05);治疗后,部分心肌功能(LVEF)水平、6MWT距离较治疗前均有提升(P均<0.05),且观察组高于对照组(P<0.05)。结论自拟益气活血利水方对治DCM并发CHF(气虚血瘀兼水湿内阻)有较好的疗效,可以提高心功能,减轻不适症状。

Objective To explore the clinical efficacy of self-made Yiqi Huoxue Lishui formula in the treatment of dilated cardiomyopathy(DCM)complicated with chronic heart failure(CHF).Methods 60 patients with DCM complicated with CHF(Qi deficiency,blood stasis and internal resistance of water dampness)were randomly divided into observation group and control group with 30 cases in each group.The control group was treated with routine treatment,and the observation group was added with self-made Yiqi Huoxue Lishui formula on the basis of the control group.The differences of myocardial function[left ventricular end systolic diameter(LVESD),left ventricular end systolic diameter(LVEDd),left ventricular ejection fraction(LVEF)],cardiopulmonary function[6-minute walking distance(6 MWT)],heart failure markers[plasma N-terminal pro brain natriuretic peptide(NT proBNP),cardiac troponin(cTnI)]and TCM syndrome scores were compared before and 1 month after treatment.Results one month after treatment,some myocardial function(LVESD,LVEDd),heart failure markers(NT proBNP,cTnI)and TCM syndrome scores in the two groups were lower than those before treatment,and the observation group was lower than those in the control group(P<0.05);After one month of treatment,the level of partial myocardial function(LVEF)and 6 MWT distance were higher than those before treatment(all P<0.05),and the level of observation group was higher than that of control group(P<0.05).Conclusion the self-made Yiqi Huoxue Lishui formula has a good effect on the treatment of DCM complicated with CHF(Qi deficiency,blood stasis and water dampness internal resistance type),which can improve cardiac function and reduce discomfort symptoms.