芪苈强心胶囊联合西药治疗慢性心力衰竭阳虚水停证临床研究

Clinical Study on Qili Qiangxin Capsules Combined with Western Medicine for Chronic Heart Failure with Yang Deficiency and Water Retention Syndrome

目的:观察芪苈强心胶囊联合西药治疗慢性心力衰竭阳虚水停证的临床疗效。方法:采用随机数字表法将96例慢性心力衰竭阳虚水停证患者分为观察组、对照组各48例。对照组给予常规西药治疗,观察组在对照组基础上联合芪苈强心胶囊治疗,2组疗程均为3个月。比较2组治疗前后心功能指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、二尖瓣心室充盈早期血流速度峰值(E峰)与晚期心室充盈收缩血流速度峰值(A峰)比值(E/A)]、中医证候积分、明尼苏达心力衰竭生活质量调查表评分(MLHFQ)、6 min步行试验(6MWT)、氨基末端脑钠肽前体(NT-proBNP)、脑钠肽(BNP)水平,评估2组临床疗效及不良反应发生情况。结果:观察组总有效率93.75%,对照组总有效率70.83%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医证候积分、MLHFQ评分、LVEDD、LVESD、NT-proBNP、BNP水平均较治疗前降低(P<0.05),LVEF、E/A、6MWT均较治疗前升高(P<0.05),且观察组治疗后LVEF、E/A、6MWT高于对照组(P<0.05),中医证候积分、MLHFQ评分、LVEDD、LVESD、NT-proBNP、BNP水平低于对照组(P<0.05)。对照组不良反应发生率4.17%,观察组不良反应发生率2.08%,2组比较,差异无统计学意义(P>0.05)。结论:芪苈强心胶囊联合西药治疗慢性心力衰竭阳虚水停证,能够改善患者心功能,提高生活质量,临床疗效显著,安全性较高。

Objective:To observe the clinical effect of Qili Qiangxin Capsules combined with western medicine on chronic heart failure with yang deficiency and water retention syndrome.Methods:A total of 96 cases of patients with chronic heart failure with yang deficiency and water retention syndrome were divided into the observation group and the control group according to the random number table method,with 48 cases in each group.The control group was treated with routine western medicine,and the observation group was additionally treated with Qili Qiangxin Capsules based on the treatment of the control group.Both groups were treated for 3 months.The heart function indexes left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),the ratio of peak blood flow velocity(peak E)at the early stage of ventricular filing in bicuspid to peak atrial systolic blood flow velocity(peak A)at the late stage of ventricular filling(E/A),traditional Chinese Medicine(TCM)syndrome scores,Minnesota Living with Heart Failure Questionnaire(MLHFQ),Six-minute Walk Test(6MWT),and the levels of N-terminal pro-brain natriuretic peptide(NT-proBNP)and brain natriuretic peptide(BNP)were compared before and after treatment between the two groups;clinical effects and incidence of adverse reactions in the two groups were evaluated.Results:The total effective rate was 93.75%in the observation group and 70.83%in the control group,the difference being significant(P<O.05).After treatment,TCM syndrome scores,MLHFQ scores,LVEDD,LVESD,and the levels of NT-proBNP and BNP in the two groups were decreased when compared with those before treatment(P<0.05),and LVEF,E/A and 6MWT were increased(P<0.05).After treatment,LVEF,E/A and 6MWT in the observation group were higher than those in the control group(P<0.05),and TCM syndrome score,MLHFQ score,LVEDD,LVESD,and the levels of NT-proBNP and BNP were lower than those in the control group(P<0.05).The incidence of adverse reactions was 4.17%in the control group and 2.08%in the observation group,there being no significant difference between the two groups(P>0.05).Conclusion:Qili Qiangxin Capsules combined with western medicine for chronic heart failure with yang deficiency and water retention syndrome can improve heart function of patients and quality of life,with a significant clinical effect and high safety.