补肾益气活血汤治疗心肾气虚血瘀型慢性心力衰竭的疗效观察

Therapeutic Effect Observation of Bushen Yiqi Huoxue Decoction in the Treatment of CHF of Heart and Kidney Qi Deficiency and Blood Stasis Type

目的:观察慢性心力衰竭(CHF)心肾气虚血瘀证患者应用补肾益气活血汤的治疗效果。方法:将2020年6月-2022年6月于河北省中医院就诊且符合纳入条件的136例CHF患者作为实验对象,根据不同用药方案分为对照组和补肾益气活血汤组,每组68例。对照组行CHF西药基础治疗,补肾益气活血汤组在此治疗方案上加用补肾益气活血汤,治疗时间均为28 d。分析两组患者治疗前后中医证候积分、LVEF值及血清中NT-proBNP水平,计算并比较两组临床有效率及不良事件发生率。结果:对照组治疗有效率为76.47%(52/68),补肾益气活血汤组治疗有效率为94.12%(64/68),两组比较,差异有统计学意义(P<0.05)。治疗后两组NT-proBNP水平均降低(P<0.05),LVEF数值均提高(P<0.05),补肾益气活血汤组变化更明显(P<0.05)。治疗后两组患者中医证候积分均降低(P<0.05),补肾益气活血汤组下降更明显(P<0.05)。两组不良事件发生率无明显差异(P>0.05)。结论:补肾益气活血汤可有效缓解CHF患者的临床症状,提高CHF患者临床治疗有效率,其作用可能与增强CHF患者心功能及降低血清中NT-proBNP水平密切相关,且补肾益气活血汤毒副作用小,安全性高,值得临床推广。

Objective:To observe the therapeutic effects of Bushen Yiqi Huoxue Decoction(BYHD)on patients with chronic heart failure of heart-kidney qi deficiency and blood stasis syndrome.Methods:A total of 136 CHF patients eligible for inclusion were recruited from June 2020 to June 2022 in Hebei Provincial Hospital of Traditional Chinese Medicine.The patients were divided into control and BYHD groups according to their medication regimens,with 68 patients in each group.The control group received the basic treatment for CHF with Western medicine,and BYHD group received Bushen Yiqi Huoxue Decoction in addition to the same Western medicine treatment,for 28 days.The differences in TCM syndrome scores,LVEF values,and serum NT-proBNP levels were analyzed for the two groups before and after the treatment,and the clinical effective rate and adverse event rate were calculated and compared between the two groups.Results:The effective rate of the control group was 76.47%(52/68),and the effective rate of BYHD group was 94.12%(64/68).The difference between the two groups was statistically significant(P<0.05).After the treatment,the levels of NT-proBNP in both groups decreased(P<0.05),and the values of LVEF increased(P<0.05),which are more significant in BYHD group(P<0.05).TCM syndrome scores of both groups decreased(P<0.05),and the degrease is more significant for BYHD group(P<0.05).There was no significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusion:BYHD can effectively relieve the clinical symptoms of CHF patients,and improve treatment efficiency.These effects may be closely related enhancing cardiac function in CHF patients and reducing the level of NT proBNP in serum.Moreover,BYHD has little toxic side effects and high safety,which is worthy of clinical promotion.