五苓散合桂枝茯苓丸对慢性心力衰竭患者心功能的影响

Effect of Wuling SAN and Guizhi Fuling Pill on Cardiac Function in Patients with Chronic Heart Failure

目的:探讨五苓散合桂枝茯苓丸对阳虚血瘀水停型慢性心力衰竭患者临床疗效和安全性。方法:我们共收集了证型为“心阳亏虚,血瘀水停”的慢性心力衰竭患者共60例,采用随机数字表的方法分为试验组和对照组。两组均按照西医基础治疗,试验组在基础治疗上联用五苓散合桂枝茯苓丸,观察时间持续28d。比较试验前后脑钠肽(NT-ProBNP)、左室射血分数(LVEF)、NYHA心功能分级、6min步行试验和安全性指标。结果:结果显示两组患者NT-ProBNP、LVEF组内对比具有统计学意义(P<0.05),LVEF组间比较具有统计学意义(P<0.05),但NT-ProBNP组间比较无统计学意义(P>0.05)。试验组NYHA心功能分级有效率53.33%,对照组有效率27.59%,两组对比具有统计学意义(P<0.05)。两组患者6min步行试验组内、组间对比具有统计学意义(P<0.05)。6min步行试验两组患者有效率组间进行比较,有效率差异具有统计学意义(P<0.05)。结论:五苓散合桂枝茯苓丸能改善“心阳亏虚,血瘀水停”型慢性心力衰竭患者的心功能及生活质量,具有较好的安全性。

Objective:To investigate the clinical efficacy and safety of Wuling San combined with Guizhi Fuling pill in patients with chronic heart failure of Yang Deficiency Blood Stasis water withdrawal type.Methods:We collected a total of 60 patients with chronic heart failure with the syndrome type“”deficiency of heart Yang and arrest of blood stasis and water“”,which were divided into test and control groups using a random number table.Both groups were treated according to the basic therapy of Western medicine,and the test group combined five Ling San combined with Guizhi Fuling pills on the basic therapy,and the observation time lasted 28 d.Brain natriuretic peptide(NT proBNP),left ventricular ejection fraction(LVEF),NYHA functional class,6-min walk test and safety measures were compared before and after the test.Results:the results showed that the intragroup comparison of NT proBNP and LVEF was statistically significant(P<0.05),and the intergroup comparison of LVEF was statistically significant(P<0.05),but the intergroup comparison of NT proBNP was not statistically significant(P>0.05).The effective rate was 53.33% in NYHA functional class in the test group and 27.59% in the control group,and the comparison between the two groups was statistically significant(P<0.05).The within-and between group comparisons of the 6-min walk test between the two groups were statistically significant(P<0.05).The effective rate was compared between the two groups of patients in the 6-min walk test,and the difference between the effective rates was statistically significant(P<0.05).Conclusion:five Ling San combined with Guizhi Fuling pill can improve cardiac function and quality of life in patients with chronic heart failure type“”heart Yang deficient deficiency and blood stasis water withdrawal“”,with a good safety profile.