慢性心力衰竭伴利尿剂抵抗中医诊疗方案

TCM diagnosis and treatment plan for chronic heart failure with diuretic resistance

慢性心力衰竭是心血管疾病的终末期表现和最主要的死因,给患者及社会带来沉重的负担。容量负荷过重是导致慢性心力衰竭急性加重的关键因素,恰当使用利尿剂是治疗取得成功的关键和基础。然而,过度使用利尿剂极易导致利尿剂抵抗。中医药治疗慢性心力衰竭疗效确切,尤其在降低利尿剂毒副作用、改善患者利尿剂抵抗方面优势明显。为进一步提高慢性心力衰竭利尿剂抵抗的中医药疗效,由湖南中医药大学第一附属医院心血管病科牵头,依托国家重大疑难疾病慢性心力衰竭中西医临床协作试点项目,以中国中西医结合学会发布的《慢性心力衰竭伴利尿剂抵抗中西医结合诊疗专家共识》为蓝本,结合慢性心力衰竭伴利尿剂抵抗的研究进展,更新、修订形成了《慢性心力衰竭伴利尿剂抵抗中医诊疗方案》,为慢性心力衰竭伴利尿剂抵抗的中医预防、辨证治疗提供依据。

As the end-stage manifestation and the predominant cause of death in cardiovascular diseases,chronic heart failure(CHF)has brought a heavy burden to both patients and society.Capacity overload is a critical factor leading to acute exacerbation of CHF,and the appropriate use of diuretics is the key and foundation for the successful treatment.However,excessive use of diuretics can easily lead to diuretic resistance.TCM is effective in treating CHF,especially in reducing the toxic and side effects of diuretics and relieving the diuretic resistance of patients.In order to further improve the efficacy of TCM in CHF with diuretic resistance,led by the Cardiovascular Department of the First Hospital of Hunan University of Chinese Medicine,relying on the National Collaboration Pilot Project with Chinese and Western Medicine Treatment on Major Refractory Disease of CHF,and combined with the research progress of CHF with diuretic resistance,the Chinese Medicine Diagnosis and Treatment Plan for Chronic Heart Failure with Diuretic Resistance has been updated,revised,and finally formulated based on the prototype of Expert Consensus on the Diagnosis and Treatment of Chronic Heart Failure with Diuretic Resistance issued by the Chinese Association of Integrated Chinese and Western Medicine,providing a basis for the TCM prevention as well as the pattern differentiation and treatment of CHF with diuretic resistance.