强心方治疗心肾阳虚型慢性心力衰竭回顾性队列研究

Chinese medicine Qiangxin Decoction in treatment of chronic heart failure of heart-kidney yang deficiency type

目的 回顾性分析强心方治疗心肾阳虚型慢性心力衰竭(chronic heart failure,CHF)的短期与长期临床疗效。方法 观察2015年1月—2020年12月上海中医药大学附属市中医医院收治的217例CHF患者,并根据是否服用强心方治疗分为治疗组(119例)与对照组(98例)两组队列。比较两组患者NYHA分级疗效、中医证候积分、心超、BNP、cTnl指标以及生存预后情况、不良反应发生率等指标。结果 治疗组患者治疗期间NYHA心功能评分、中医证候、心超、BNP指标等改善情况显著优于对照组(P<0.05)。截至2023年10月最后随访时间,治疗组患者生存率显著高于对照组(P<0.05),且在高钾血症、肾功能损害、乏力、咳嗽等不良反应发生率显著低于对照组(P<0.05)。结论 强心方联合西医治疗不仅能够改善CHF短期症状,同时有效增强了CHF患者长期生活质量及生存率,并在一定程度上缓解长期CHF治疗所导致的不良反应。

Objective To analyze the efficacy and safety of Chinese medicine Qiangxin Decoction in treatment of chronic heart failure(CHF) of heart-kidney yang deficiency type.Methods A total of 217 patients with CHF treated at Shanghai Traditional Chinese Medicine Hospital from January 2015 to December 2020 were enrolled in the study.All patients were treated with conventional Western medicine for CHF;in addition,119 cases received Qiangxin Decoction(study group) and 98 cases did not receive Qiangxin Decoction(control group).The efficacy of NYHA(New York Heart Association) functional classification,traditional Chinese medicine syndrome score,echocardiography,serum B-type natriuretic peptide(BNP) and cardiac troponin I(cTnl) levels,long-term survival and incidence of adverse reactions were compared between the two groups.Results Compared to the control group,the study group showed significant better improvements in NYHA functional score,traditional Chinese medicine syndrome,echocardiography,and BNP levels(P<0.05).By the last follow-up in October 2023,the survival rate of the study group was significantly higher than that of the control group(P<0.05).Additionally,the study group had significantly lower incidence of adverse reactions including hyperkalemia,renal function impairment,fatigue,and cough compared to the control group(P<0.05).Conclusion The combination of Chinese medicine Qiangxin Decoction and Western medicine can improves the symptoms of CHF the long-term quality of life and survival rate of CHF patients with lower incidence of adverse reactions.