拯阳理劳汤加味联合西药治疗阳气亏虚血瘀兼痰饮型慢性心力衰竭临床研究

Clinical Study on Modified Zhengyang Lilao Decoction Combined with Western Medicine for Chronic Heart Failure of Yang Qi Depletion and Blood Stasis Complicated with Phlegm Rheum Type

目的:观察拯阳理劳汤加味联合西药治疗阳气亏虚血瘀兼痰饮型慢性心力衰竭(CHF)的临床疗效。方法:将68例阳气亏虚血瘀兼痰饮型CHF患者按随机数字表法分为对照组和治疗组各34例。对照组予常规西药治疗,治疗组在对照组的基础上予拯阳理劳汤加味治疗。比较2组临床疗效及治疗前后左心室射血分数(LVEF)、心输出量、6 min步行试验(6MWT)、中医证候积分。结果:治疗后,治疗组总有效率显著高于对照组(P<0.05)。治疗后,2组LVEF、心输出量、6MWT较治疗前明显增加(P<0.05),气短、乏力、心悸、怕冷、口唇紫暗中医证候积分明显减少(P<0.05),且治疗组治疗后上述指标改善较对照组更明显(P<0.05)。结论:拯阳理劳汤加味联合西药治疗阳气亏虚血瘀兼痰饮型CHF疗效明显,可有效改善患者心功能。

Objective:To observe the clinical effect of modified Zhengyang Lilao Decoction combined with western medicine for chronic heart failure(CHF) of yang qi depletion and blood stasis complicated with phlegm rheum type.Methods:A total of 68 cases of CHF patients of yang qi depletion and blood stasis complicated with phlegm rheum type were divided into the control group and the treatment group according to the random number table method,with 34 cases in each group.The control group was treated with routine western medicine treatment,and the treatment group was additionally treated with modified Zhengyang Lilao Decoction based on the treatment of the control group.Scores of left ventricular ejection fraction(LVEF),cardiac output,6-minute walking test(6MWT),and traditional Chinese medicine(TCM)syndrome scores before and after treatment,as well as clinical effects,were compared between the two groups.Results:After treatment,the total effective rate in the treatment group was significantly higher than that in the control group(P<0.05).After treatment,LVEF,cardiac output,and 6MWT in the two groups were significantly increased when compared with those before treatment(P<0.05),and the TCM syndrome scores including shortness of breath,fatigue,palpitations,sensation of cold,and purple and dusky lips were significantly decreased when compared with those before treatment(P<0.05);after treatment,the improvement of the above indexes in the treatment group was more significant than that in the control group(P<0.05).Conclusion:Modified Zhengyang Lilao Decoction combined with western medicine for CHF of yang qi depletion and blood stasis complicated with phlegm rheum type has an obvious curative effect and can effectively improve the heart function of patients.