真武汤联合西药治疗心肾阳虚型慢性心力衰竭的临床疗效及安全性研究

Study on clinical efficacy and safety of Zhenwu decoction combined with western medicine in treating chronic heart failure of heart-kidney yang deficiency

目的评价真武汤联合西药治疗心肾阳虚型慢性心力衰竭患者的临床有效性及安全性。方法80例心肾阳虚型慢性心力衰竭患者,采用随机数字表法分为常规组和试验组,每组40例。常规组采用常规西药治疗,试验组在常规组治疗基础上联合真武汤治疗。比较两组患者治疗前后纽约心脏病协会(NYHA)心功能分级、中医症状积分、心功能参数[左心室射血分数(LVEF)、每搏输出量(SV)、心输出量(CO)]以及治疗效果、不良反应(恶心、呕吐、头晕、肝损害)发生率。结果治疗后,试验组患者NYHA心功能分级(1.42±0.18)级低于常规组的(2.13±0.57)级,差异具有统计学意义(P<0.05)。治疗后,试验组患者气短、浮肿、乏力、畏寒肢冷症状积分分别为(1.67±0.53)、(1.27±0.53)、(1.87±0.56)、(1.74±0.52)分,均低于常规组的(3.26±1.03)、(2.06±0.43)、(2.85±0.52)、(2.74±0.46)分,差异均具有统计学意义(P<0.05)。试验组治疗总有效率97.50%高于常规组的82.50%,差异具有统计学意义(P<0.05)。治疗后,试验组患者LVEF(56.85±7.12)%、SV(76.84±7.85)ml、CO(6.67±1.53)L/min均高于常规组的(45.16±5.28)%、(65.48±6.52)ml、(5.26±1.03)L/min,差异均具有统计学意义(P<0.05)。试验组不良反应发生率5.00%与常规组的12.50%比较,差异无统计学意义(P>0.05)。结论心肾阳虚型慢性心力衰竭使用真武汤联合西药治疗能够改善患者中医症状、心功能,且并未增加不良反应的发生,值得临床推广应用。

Objective To evaluate the clinical effectiveness and safety of Zhenwu decoction combined with western medicine in treating chronic heart failure of heart-kidney yang deficiency.Methods A total of 80 patients with chronic heart failure of heart-kidney yang deficiency were divided into conventional group and experimental group according to the random numerical table,with 40 cases in each group.The conventional group was treated with conventional western medicine,and the experimental group was treated with Zhenwu decoction on the basis of conventional treatment.Both groups were compared in terms of New York Heart Association(NYHA)cardiac function grading,traditional Chinese medicine symptom score,cardiac function parameters[left ventricular ejection fraction(LVEF),stroke volume(SV),cardiac output(CO)]before and after treatment,therapeutic effect,and incidence of adverse reactions(nausea,vomiting,dizziness,liver damage).Results After treatment,the NYHA cardiac function grading of(1.42±0.18)grades in the experimental group was lower than that of(2.13±0.57)grades in the conventional group,and the difference was statistically significant(P<0.05).After treatment,the scores of shortness of breath,swelling,weakness and coldness were(1.67±0.53),(1.27±0.53),(1.87±0.56)and(1.74±0.52)points in the experimental group,which were lower than those of(3.26±1.03),(2.06±0.43),(2.85±0.52)and(2.74±0.46)points in the conventional group,and the differences were statistically significant(P<0.05).The total effective rate of treatment was 97.50%in the experimental group,which was higher than that of 82.50%in the conventional group,and the difference was statistically significant(P<0.05).After treatment,the experimental group had LVEF of(56.85±7.12)%,SV of(76.84±7.85)ml,and CO of(6.67±1.53)L/min,which were higher than those of(45.16±5.28)%,(65.48±6.52)ml,and(5.26±1.03) L/min in the conventional group, and the differences were all statistically significant (P<0.05). The incidenceof adverse reactions in the experimental group was 5.00%,and the difference was not statistically significant when compared with that of 12.50%in the conventional group(P>0.05).Conclusion Zhenwu decoction in combination with western medicine can improve the traditional Chinese medicine symptoms,and cardiac function of patients with chronic heart failure of heart-kidney yang deficiency,and does not increase the occurrence of adverse reactions,which is worthy of clinical promotion.