葶苈大枣泻肺汤联合依那普利治疗充血性心力衰竭临床研究

Clinical Study on Tingli Dazao Xiefei Tang Combined with Enalapril for Congestive Heart Failure

目的:观察葶苈大枣泻肺汤联合依那普利治疗充血性心力衰竭的临床疗效。方法:将100例充血性心力衰竭患者按随机数字表法分为对照组和试验组各50例。2组均给予抗心衰基础治疗,对照组予以依那普利治疗,试验组予以葶苈大枣泻肺汤联合依那普利治疗。比较2组临床疗效、中医证候评分、心脏彩超指标[二尖瓣舒张早期时心室充盈速度峰值(E)/舒张晚期心室充盈速度峰值(A)比值、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)]及用药安全性。结果:治疗后,试验组总有效率为90.00%,对照组为74.00%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组中医证候评分比较,差异无统计学意义(P>0.05);治疗后,2组气短、畏寒、心悸及下肢水肿等证候评分均较治疗前降低(P<0.05),且试验组上述各项评分均低于对照组(P<0.05)。治疗前,2组E/A、LVEF、LVEDD水平比较,差异无统计学意义(P>0.05)。治疗后,2组E/A、LVEF水平均较治疗前升高(P<0.05),LVEDD水平较治疗前降低(P<0.05);且试验组上述各项指标改善较对照组更显著(P<0.05)。治疗后,试验组不良反应发生率为4.00%,对照组为16.00%,2组比较,差异有统计学意义(P<0.05)。结论:葶苈大枣泻肺汤联合依那普利治疗充血性心力衰竭疗效显著,有助于改善中医证候及心功能,且用药安全性良好。

Objective:To observe the clinical effect of the therapy of Tingli Dazao Xiefei tang combined with enalapril on congestive heart failure.Methods:A total of 100 patients with congestive heart failure were divided into the control group and the experiment group according to the random number table method,with 50 cases in each group.Both group were treated with basic treatment for heart failure.The control group was additionally treated with enalapril,and the experiment group was additionally treated with Tingli Dazao Xiefei tang combined with enalapril.The clinical effects,Chinese medicine syndrome scores,indexes of echocardiography,including the ratio of peak blood flow velocity of early moral ventricular filling(E)to peak blood flow velocity of late ventricular filling and atrial contraction(A),left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDD),and safety in the two groups were compared and analyzed.Results:After treatment,the total effective rate was 90.00%in the experiment group and 74.00%in the control group,the difference being significant(P<0.05).Before treatment,there was no significant difference being found in the comparison of Chinese medicine syndrome scores between the two groups(P>0.05);after treatment,the syndrome scores of shortness of breath,fear of cold,palpitation and edema of lower limbs in the two groups were decreased when compared with those before treatment(P<0.05),and the above four scores in the experiment group were lower than those in the control group(P<0.05).Before treatment,there was no significant difference being found in the comparisons of levels of E/A,LVEF and LVEDD between the two groups(P>0.05).After treatment,the levels of E/A and LVEF were increased when compared with those before treatment(P<0.05),and the levels of LVEDD were decreased(P<0.05);the improvement of above three levels in the experiment group was significant than that in the control group(P<0.05).After treatment,the incidence of adverse reactions was 4.00%in the experiment group and 16.00%in the control group,the difference being significant(P<0.05).Conclusion:The therapy of Tingli Dazao Xiefei tang combined with enalapril has a significant curative effect on congestive heart failure,which can improve the Chinese medicine syndromes and the heart function,with good administration safety.