中药穴位贴敷治疗肾阳虚衰型冠心病合并心衰的临床研究

Clinical study on acupoint application of Chinese medicine in treating patients with renal Yang deficiency coronary heart disease complicated with heart failure

目的观察中药穴位贴敷联合地高辛治疗肾阳虚衰型冠心病合并心衰患者的临床效果。方法病例选取2021年1月至2022年2月南阳医学高等专科学校第一附属医院收治的116例冠心病合并心衰患者为研究对象,采用抽签法,将入组患者均分为中西医组和西医组,每组58例,两组患者均予以含地高辛在内的常规西药治疗,中西医组采用中药穴位贴敷配合治疗,比较两组患者的中医证候积分、心功能改善情况、心血管不良事件发生情况及生活质量。结果经不同方式治疗后,中西医组的心悸怔忡、胸闷喘息等中医主证以及腰膝酸软、恶寒怕冷等中医次证积分均低于西医组(P<0.05);治疗前,两组患者心功能及相关评分差异无统计学意义(P>0.05);治疗后,中西医组的左室射血分数(LVEF)高于西医组,左室舒张末期内径(LVDD)、N末端B型利尿钠肽原(NT-proBNP)低于西医组,6 min步行试验(6MWT)高于西医组,6MWT后Brog评分低于西医组;心血管不良事件发生率5.17%(3/58)低于西医组17.24%(10/58),明尼苏达州心功能不全生命质量量表(MLHFQ)身体领域、情绪领域评分均低于西医组(P<0.05)。结论采用中医穴位贴敷辅助含地高辛在内西药治疗肾阳虚衰型冠心病合并心衰可有效促进患者临床证候恢复,对促进其心功能改善、降低心血管不良事件发生风险并提升生活质量均有积极意义。

Objective To observe the clinical effect of acupoint application of traditional Chinese medicine combined with Digoxin in the treatment of coronary heart disease with heart failure due to renal Yang deficiency.Methods A total of 116 patients with coronary heart disease and heart failure admitted to the First Affiliated Hospital of Nanyang Medical College from January 2021 to February 2022 were selected as the study subjects.The enrolled patients were divided into the traditional Chinese and Western medicine group and the western medicine group by the method of drawing lots,with 58 patients in each group.Both groups of patients were treated with conventional Western medicine including Digoxin.The traditional Chinese and Western medicine group was treated with acupoint application of traditional Chinese medicine,and the TCM syndrome scores,improvement of cardiac function,occurrence of cardiovascular adverse events,and quality of life of the two groups were compared.Results After treatment with different methods,the scores of major TCM syndromes such as palpitations,chest tightness,wheezing,and secondary TCM syndromes such as waist and knee tenderness,aversion to cold,and fear of cold in the Chinese and Western medicine group were lower than those in the Western medicine group(P<0.05);Before treatment,there was no significant difference in cardiac function and related scores between the two groups(P>0.05);After treatment,the left ventricular ejection fraction(LVEF)in the Chinese and Western medicine group was higher than that in the Western medicine group,the left ventricular end diastolic diameter(LVDD),N-terminal B-type natriuretic natriuretic peptide(NT-proBNP)were lower than those in the Western medicine group,the 6-minute walking test(6MWT)was higher than that in the Western medicine group,and the Brog score after 6MWT was lower than that in the Western medicine group;The incidence of cardiovascular adverse events was 5.17%(3/58)lower than 17.24%(10/58)and in the Western medicine group.The Minnesota Living with Heart Failure Questionnaire(MLHFQ)scores in the physical and emotional fields were lower than those in the Western medicine group(P<0.05).Conclusion The acupoint application of traditional Chinese medicine assisted by Western medicine including Digoxin in the treatment of renal Yang deficiency coronary heart disease complicated with heart failure can effectively promote the recovery of clinical symptoms,improve the cardiac function,reduce the risk of cardiovascular adverse events and improve the quality of life.