苓桂术甘汤加减治疗阳虚水泛证老年慢性心力衰竭的效果及安全性

Effect and safety of Linggui Zhugan decoction in the treatment of senile chronic heart failure with Yang-deficiency water syndrome

目的探究苓桂术甘汤加减治疗老年慢性心力衰竭的效果及安全性。方法选取2019年8月至2021年1月本院收治的87例确诊为阳虚水泛证慢性心力衰竭老年患者作为研究对象,按照顺序编码法分为对照组(n=43)与观察组(n=44)。对照组行对症西药治疗,观察组在对照组基础上联合苓桂术甘汤加减治疗,比较两组超声心动图[左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、心指数(CI)、心排血量(CO)及心搏出量(SV)]、血清脑钠肽(BNP)水平、纽约心脏学会(NYHA)心功能分级及预后情况。结果治疗后,两组LVEDD、LVESD均短于治疗前,LVEF、CI均高于治疗前,CO、SV均多于治疗前,且观察组LVEDD、LVESD均小于对照组,LVEF、CI均高于对照组,CO、SV均多于对照组,差异有统计学意义(P<0.05)。两组BNP水平组间、时间、交互比较差异有统计学意义(P<0.05);两组治疗后各时间点BNP水平均低于前一时间点,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组NYHA分级优于对照组,差异有统计学意义(P<0.05)。两组药物不良反应率比较差异无统计学意义;观察组主要心血管不良事件(MACE)发生率、住院率均低于对照组,差异有统计学意义(P<0.05)。结论苓桂术甘汤加减治疗阳虚水泛证老年慢性心力衰竭,可明显改善患者的根本病机,提升心脏功能,减轻心肌损伤,降低不良预后的发生风险,值得临床推广应用。

Objective To explore the effect and safety of Linggui Zhugan decoction in the treatment of senile chronic heart failure with Yang-deficiency water syndrome.Methods 87 elderly patients diagnosed with chronic heart failure with Yang-deficiency water syndrome admitted to our hospital from August 2019 to January 2021 were selected as the research subjects,and they were divided into the control group(n=43)and the observation group(n=44)according to the sequential coding method.The control group was treated with symptomatic Western medicine,and the observation group was treated with Linggui Zhugan decoction on the basis of the control group,the echocardiography(left ventricular end-diastolic dimension[LVEDD],left ventricular end-systolic diameter[LVESD],left ventricular ejection fraction[LVEF],cardiac index[CI],cardiac output[CO],stroke volume[SV]),serum brain natriuretic peptide(BNP)level,New York Heart Association(NYHA)cardiac function classification and prognosis were compared between the two groups.Results After treatment,LVEDD and LVESD of the two groups were less than those before treatment,LVEF and CI were higher than those before treatment,CO and SV were more than those before treatment,and LVEDD and LVESD in the observation group were less than those in the control group,LVEF and CI were higher than those in the control group,CO and SV were more than those in the control group,the differences were statistically significant(P<0.05).There were significant differences in BNP levels between the groups,time and interaction between the two groups(P<0.05),the levels of BNP of the two groups at each time point after treatment were lower than those of the previous time point,and the observation group was lower than the control group,and the differences were statistically significant(P<0.05).NYHA classification in the observation group was better than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the rate of adverse reactions between the two groups.The incidence of major adverse cardiovascular events(MACE)and hospitalization rate in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusions Linggui Zhugan decoction in the treatment of senile chronic heart failure with Yang-deficiency water syndrome can significantly improve the underlying pathogenesis,improve cardiac function,reduce myocardial injury,and reduce the risk of poor prognosis,which is worthy of clinical promotion and application.