中西医结合治疗老年永久性房颤并射血分数保留的心力衰竭的疗效观察

Clinical effects of traditional Chinese medicine combined with western medicine in the treatment of patients with Heart failure with preserved ejection fraction in elderly permanent atrial fibrillation

目的观察中西医结合治疗老年永久性房颤并射血分数保留的心力衰竭的疗效。方法将150例老年永久性房颤合并射血分数保留的心力衰竭(HFpEF)患者随机分为治疗组和对照组,每组75例。对照组给予常规西医治疗,治疗组在西医治疗基础上按中医辨证分型加用中药治疗,均治疗12周。观察两组患者均于治疗前和治疗后中医证候积分、NT-BNP及左心室舒张功能等指标变化。结果治疗组总有效率显著高于对照组(P<0.05)。两组患者治疗后Lee氏心衰积分、中医证候积分、E/e′、NT-BNP均比治疗前明显降低(P<0.05);治疗后,治疗组患者Lee氏心衰积分、中医证候积分、E/e′、NT-BNP比对照组显著降低(P<0.05)。结论常规西药加用中药治疗老年永久性房颤并射血分数保留的心力衰竭的疗效良好且优于单纯的西医治疗。

Objective To investigate the Clinical Efficacy of traditional Chinese medicine combined with western medicine in the treatment of patients with Heart failure with preserved ejection fraction in elderly permanent atrial fibrillation.Methods 150 elderly patients with permanent atrial fibrillation and preserved ejection fraction were randomly assigned to treatment or control groups of 75 patients in each group.The control group was treated conventionally with western medicine,and the treatment group was divided into traditional Chinese medicine syndrome differentiation on the basis of western medicine,with the addition of traditional Chinese medicine.Both groups were treated for 12 weeks.Observe the TCM symptom scores,NT-BNP,and left ventricular diastolic parameters of two groups of patients before and after treatment.Results The overall response rate was significantly higher in the treatment group than in the control group(P<0.05).Both the posttreatment Lee heart failure score,TCM syndrome score,E/e′,and NT-BNP were significantly lower in the control group than in the pretreatment group(P<0.05).After treatment,Lee heart failure score,TCM score,E/e′,and NT-BNP were significantly lower in the treatment group than in the control group(P<0.05).Conclusion Both conventional west-drug therapy and traditional Chinese medicine combined with western medicine in elderly patients with permanent atrial fibrillation and heart failure with preserved ejection fraction are effective.Traditional Chinese medicine combined with western medicine for permanent atrial fibrillation and preserved ejection fraction is superior to Western medicine treatment alone.