益心通脉方联合西医常规治疗阳虚血瘀型慢性心力衰竭临床研究

Clinical study of Yixin Tongmai Formula combined with conventional Western medicine on chronic heart failure patients with Yang deficiency and blood stasis type

目的观察益心通脉方联合西医常规治疗阳虚血瘀型慢性心力衰竭(CHF)患者的临床疗效。方法将74例阳虚血瘀型CHF患者按照随机数字表法分为2组,对照组37例予西医常规治疗,治疗组37例在对照组基础上联合益心通脉方治疗。2组均治疗8周后统计疗效,比较2组治疗前后中医症状评分、明尼苏达州心功能不全生命质量量表(MLHFQ)评分及血清高敏肌钙蛋白I(hs-cTnI)、脑钠肽(BNP)、左室射血分数(LVEF)变化情况。结果治疗组总有效率86.5%(32/37),对照组总有效率62.2%(23/37),治疗组总有效率高于对照组(P<0.05)。与本组治疗前比较,2组治疗后中医症状评分均降低(P<0.05),且治疗组治疗后中医症状评分低于对照组(P<0.05)。与本组治疗前比较,2组治疗后MLHFQ评分均降低(P<0.05),且治疗组治疗后MLHFQ评分低于对照组(P<0.05)。与本组治疗前比较,2组治疗后血清hs-cTnI及BNP水平均降低(P<0.05),LVEF均升高(P<0.05),且治疗组治疗后hs-cTnI及BNP水平均低于对照组(P<0.05),但LVEF水平与对照组治疗后比较差异无统计学意义(P>0.05)。结论益心通脉方联合西医常规治疗阳虚血瘀型CHF患者临床疗效确切,可有效改善患者中医症状,提高生活质量,改善心功能,发挥了中西医结合互补的优势。

Objective To explore the application value of Yixin Tongmai Formula combined with conventional Western medicine in patients with chronic heart failure(CFH)of Yang deficiency and blood stasis type.Methods Totally 74 CFH patients with Yang deficiency and blood stasis type treated were randomly allocated to treatment group(n=37)and control group(n=37).All patients were given conventional Western medicine treatment,and the patients of treatment group were additionally given Yixin Tongmai Formula.The efficacy of both groups was calculated after 8 weeks of treatment.The scores of traditional Chinese medicine(TCM)symptom,and Minnesota Living with Heart Failure Questionnaire(MLHFQ),and the levels of high-sensitivity cardiac troponin I(hs-cTnI),brain natriuretic peptide(BNP)and left ventricular ejection fraction(LVEF)were included as comparisons.Results The total effective rate in the observation group was better than in the control group(86.5%[28/37]vs 62.2%[23/37],P<0.05).After treatment,the scores of TCM symptoms and MLHFQ in the two groups were significantly decreased(both P<0.05),and the decrease in the treatment group was more significant than that in the control group(both P<0.05).The levels of hs-cTnI and BNP in both groups were significantly reduced after treatment(P<0.05),and which in the treatment group were more lower than those in the control group(P<0.05).The level of LVEF was increased in the both groups(P<0.05),but the treatment group was comparable to the control group(P>0.05).Conclusion For CHF patients with Yang deficiency and blood stasis type,Yixin Tongmai Formula Combined with Western medicine has a definite clinical effect.It can effectively improve TCM symptoms,improve quality of life and cardiac function,playing a complementary role in the integration of Chinese and Western medicine therapy.