自拟强心宁方联合沙库巴曲缬沙坦治疗慢性心力衰竭阳虚水泛证的效果观察

Observation therapeutic effect of self-formulated Qiangxinning prescription combined with sacubitril and valsartan on chronic heart failure with Yang deficiency and flooding syndrome

目的探讨自拟强心宁方联合沙库巴曲缬沙坦钠治疗慢性心力衰竭(CHF)阳虚水泛证的临床疗效。方法抽取2020年1月至2022年9月解放军陆军第八十三集团军医院收治的86例阳虚水泛证CHF患者,采用随机数字表法分为对照组与观察组,每组43例。对照组采用沙库巴曲缬沙坦治疗,观察组在对照组基础上加用自拟强心宁方治疗,均持续治疗3个月。比较两组的临床疗效、中医证候评分、心功能及6 min步行距离(6MWD)。结果观察组临床总有效率(93.02%,40/43)高于对照组(76.74%,33/43),中医证候评分[(7.60±1.71)分]低于对照组[(10.23±2.09)分],P<0.05;治疗3个月时,观察组左室射血分数高于对照组,左心室收缩末期内径、左心室舒张末期内径低于对照组(P<0.05);治疗3个月时,观察组6MWD高于对照组(P<0.05)。结论自拟强心宁方联合沙库巴曲缬沙坦钠治疗阳虚水泛证CHF患者可提高治疗效果,减轻临床症状,改善心功能及6MWD。

Objective To investigate the clinical efficacy of self-formulated Qiangxinning prescription combined with sacubitril and valsartan in the treatment of chronic heart failure(CHF)with Yang deficiency and flooding syndrome.Methods Eighty-six patients with CHF of Yang deficiency and flooding syndrome admitted to No.83 Group Military Hospital of People’s Liberation Army from January 2020 to September 2022 were selected and divided into control group and observation group by random number table method,with 43 cases in each group.The control group was treated with sacubitril and valsartan,while the observation group was treated with self-formulated Qiangxinning prescription based on the treatment of the control group,and both groups were treated for 3 months continuously.The clinical efficacy,traditional Chinese medicine syndrome scores,cardiac function,and 6-minute walking distance(6MWD)were compared between the two groups.Results The total effective rate of the observation group(93.02%,40/43)was higher than that of the control group(76.74%,33/43),while the traditional chinese medicine syndrome score of the observation group(7.60±1.71)was lower than that of the control group(10.23±2.09),P<0.05.After 3 months of treatment,left ventricular ejection fraction in the observation group was higher than that in the control group,while left ventricular end systolic diameter and left ventricular end diastolic diameter in the observation group were lower than those in the control group(P<0.05).After 3 months of treatment,6MWD of the observation group was higher than that of the control group(P<0.05).Conclusions Self-formulated Qiangxinning prescription combined with sacubitril and valsartan,in the treatment of CHF patients with Yang deficiency and flooding syndrome,can improve the therapeutic effect,alleviate clinical symptoms,improve cardiac function and 6MWD.