加味己椒苈黄汤治疗终末期心力衰竭患者的临床效果

Clinical effect of Jiawei Jijiao Lihuang Decoction on patients with end-stage heart failure

目的 探讨加味己椒苈黄汤治疗终末期心力衰竭患者的临床效果,及其对患者左室射血分数(LVEF)、N末端脑钠肽前体(NT-proBNP)水平及住院周期的影响。方法 连续纳入62例2018年12月至2021年4月入住南京中医药大学沭阳附属医院心病科的终末期心力衰竭患者,采用随机数字表法将其分为中药组(31例)和对照组(31例)。对照组采用指南推荐的规范药物治疗,中药组在此基础上联用加味己椒苈黄汤治疗,治疗周期为7 d。观察两组治疗前后血浆NT-proBNP、LVEF、中医证候积分、住院周期等疗效指标及肝肾功能电解质、血常规等安全性指标。结果 治疗7 d后,中药组临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗前,两组中医症候积分、NT-proBNP、LVEF比较,差异无统计学意义(P>0.05);治疗后,两组中医证候积分均较前降低,且中药组低于对照组(P<0.05)。治疗后,两组NT-proBNP较治疗前降低,且中药组低于对照组(P<0.05)。治疗后,两组LVEF较治疗前升高,且中药组高于对照组(P<0.05)。中药组住院周期短于对照组(P<0.05)。两组肝肾功能电解质、血常规等安全性指标比较,差异无统计学意义(P>0.05)。结论 加味己椒苈黄汤可改善终末期心力衰竭患者的临床症状、体征,改善心功能,缩短住院周期,疗效确切,且无明显不良反应,可供临床参考应用。

Objective To investigate the clinical effect of Jiawei Jijiao Lihuang Decoction on patients with end-stage heart failure,and the effects on left ventricular ejection fraction(LVEF),N-terminal B-type natriuretic peptide(NT-proBNP),and hospitalization period.Methods A total of 62 patients with end-stage heart failure admitted to the Department of Cardiology,Shuyang County Hospital Affiliated to Nanjing University of Chinese Medicine from December 2018 to April2021 were selected and they were divided into the traditional Chinese medicine group(31 cases) and the control group(31cases) by random number table method.The control group was treated with the standard drug therapy recommended by the guideline,while the Chinese medicine group was treated with Jiawei Jijiao Lihuang Decoction on the basis of the standard drug therapy.The treatment period was seven days.Plasma NT-proBNP,LVEF,traditional Chinese medicine syndrome score,hospitalization period,liver and kidney function,electrolytes and blood routine were observed before and after treatment in both groups.Results After 7 days of treatment,the clinical efficacy of the traditional Chinese medicine group was better than that of the control group,and the difference was statistically significant(P0.05);after treatment,traditional Chinese medicine syndrome scores in both groups were lower than before treatment,and traditional Chinese medicine group was lower than control group(P0.05).Conclusion Jijiao Lihuang Decoction is effective in improving the clinical symptoms and signs of patients with end-stage heart failure,decreasing the level of NT-pro BNP,increasing LVEF,and shortening the period of hospitalization.It has a definite curative effect and no obvious adverse reaction,it can use Jijiao Lihuang decoction for clinical reference.