西医联合芪苈真武汤加味合隔物灸治疗慢性心力衰竭58例临床观察

Clinical Observation on 58 Cases of Chronic Heart Failure Treated by Western Medicine Combined with Qili Zhenwu Decoction and Flavored Compound Moxibustion

目的:探讨西医联合芪苈真武汤加味合隔物灸治疗慢性心力衰竭(CHF)的临床疗效及安全性。方法:将120例CHF患随机分为对照组(60例,脱落3例,西医治疗)、观察组(60例,脱落2例,西医联合芪苈真武汤加味合隔物灸治疗)。比较两组患者治疗前后体重变化、住院期间24 h平均尿量、NT-ProBNP水平、6分钟步行距离(6 MWD),评估临床疗效及安全性。结果:治疗后,两组体重低于同组治疗前、入院时24 h平均尿量低于住院期间,差异有统计学意义(P<0.01);治疗后对照组体重高于同期治疗组、住院期间24 h平均尿量低于同期观察组,差异有统计学意义(P<0.01)。治疗后,两组血浆NT-ProBNP含量低于同组治疗前、6 MWD水平高于同组治疗前,差异有统计学意义(P<0.01);治疗后观察组血浆NT-ProBNP含量低于对照组、6 MWD水平高于对照组,差异有统计学意义(P<0.01)。观察组总有效率98.3%、对照组总有效率85.9%,差异有统计学意义(P<0.05)。总不良反应观察组6.9%、对照组24.6%,差异有统计学意义(P<0.01)。结论:在西医规范治疗基础上,芪苈真武汤加味合隔物灸治疗CHF在增效减毒作用明显,为临床治疗CHF提供更优治疗方案。

Objective To investigate the clinical efficacy and safety of western medicine combined with Qili Zhenwu decoction plus flavor separated moxibustion in the treatment of chronic heart failure(CHF).Methods 120 patients with CHF were randomly divided into control group(60 cases,3 cases of exfoliation,western medicine treatment)and observation group(60 cases,2 cases of exfoliation,western medicine combined with Qili Zhenwu decoction and flavored compound moxibustion).The weight change,Average 24-hour urine volume during hospitalization,NT-ProBNP level and 6-minute walking distance(6 MWD)of the two groups before and after treatment were compared to evaluate the clinical efficacy and safety.Results After treatment,the body weight of the two groups was lower than that of the same group before treatment and the average urine volume in 24 hours at admission was lower than that during hospitalization,the difference is statistically significant(P<0.01);After treatment,the body weight of the control group was higher than that of the observation group at the same time,and the average urine volume in 24 hours during hospitalization was lower than that of the observation group at the same time,the difference is statistically significant(P<0.01).After treatment,the content of NT-ProBNP in plasma of the two groups was lower than that of the same group before treatment,and the level of 6 MWD was higher than that of the same group before treatment,the difference is statistically significant(P<0.01);After treatment,the content of NT-ProBNP in plasma of the control group was higher than that of the observation group,and the level of 6MWD was lower than that of the observation group,the difference is statistically significant(P<0.01).The total effective rate was 85.9%in the control group and 98.3%in the observation group,the difference is statistically significant(P<0.05).The total adverse reactions were 24.6%in the control group and 6.9%in the observation group,the difference is statistically significant(P<0.01).Conclusion On the basis of the standardized treatment of western medicine,Qilizhenwu decoction combined with separated moxibustion has an obvious effect of enhancing efficacy and reducing toxicity in the treatment of CHF,providing a better treatment plan for clinical treatment of CHF.