严氏苍山太阳炷燎穴位敷贴治疗阳虚血瘀型慢性心力衰竭的临床研究

Clinical study on the efficacy of Yan's Cangshan Taiyang Moxibustion Acupoint Application in treating chronic heart failure with yang deficiency and blood stasis syndrome

目的观察严氏苍山太阳炷燎穴位敷贴治疗阳虚血瘀型慢性心力衰竭的临床疗效。方法将145例阳虚血瘀型慢性心力衰竭患者随机分为对照组73例、治疗组72例,两组均给予标准化西药治疗,对照组加用空白自发热贴膏,治疗组加用“严氏苍山太阳炷燎穴位敷贴”药物自发热贴膏,两组疗程均为90 d。观察临床疗效,比较中医证候积分、中医主次症与兼症分层、明尼苏达心力衰竭生活质量量表(MLHFQ)评分、纽约心脏病协会(NYHA)心功能分级、6 min步行试验(6MWT)距离以及B型钠尿肽(BNP)水平等指标的变化情况。结果①试验过程中,对照组脱落8例、治疗组脱落7例,最终完成试验者130例,其中治疗组65例、对照组65例。②治疗前后组内比较,两组中医证候积分均降低(P<0.05);组间治疗后比较,治疗组积分下降更为明显(P<0.05)。③治疗后,治疗组中医主次症与兼症分层得到改善(P<0.05),且治疗组的改善情况优于对照组(P<0.05)。④治疗前后组内比较,两组MLHFQ评分均降低(P<0.05);组间治疗后比较,治疗组MLHFQ评分较对照组显著降低(P<0.05)。⑤治疗后,两组NYHA心功能分级均得到改善(P<0.05),且治疗组的改善情况优于对照组(P<0.05)。⑥治疗前后组内比较,两组6MWT距离均较治疗前增加(P<0.05);组间治疗后比较,治疗组6MWT距离增加较对照组更明显(P<0.05)。⑦治疗前后组内比较,两组BNP水平均降低(P<0.05);组间治疗后比较,治疗组BNP水平显著低于对照组(P<0.05)。⑧两组各项安全性指标均未见明显异常。结论严氏苍山太阳炷燎穴位敷贴对阳虚血瘀型慢性心力衰竭患者临床症状与BNP的改善、运动耐量的提升及生活质量的提高都具有积极促进作用,且安全性好。

Objective To evaluate the clinical efficacy of Yan's Cangshan Taiyang Moxibustion Acupoint Application in treating patients with chronic heart failure(CHF)with yang deficiency and blood stasis syndrome.Methods A total of 145 CHF patients with yang deficiency and blood stasis syndrome were randomly divided into a control group(n=73)and a treatment group(n=72).Both groups received standardized western medical treatment.The control group received additional treatment with blank self-heating patches,whereas the treatment group received medicated self-heating patches–Yan's Cangshan Taiyang Moxibustion Acupoint Application.The duration of treatment for both groups was 90 days.The study assessed clinical efficacy,compared the changes in traditional Chinese medicine(TCM)syndrome scores,classification of TCM primary and secondary symptoms,and concomitant symptoms,Minnesota Living with Heart Failure Questionnaire(MLHFQ)scores,New York Heart Association(NYHA)Functional Classification,6-minute walk test(6MWT)distance,B-type natriuretic peptide(BNP)levels,and so on.Results①During the trial,8 cases from the control group and 7 cases from the treatment group dropped out,leaving 130 participants who completed the trail,including 65 in the treatment group and 65 in the control group.②Intra-group comparisons before and after treatment showed decrease in TCM syndrome scores for both groups(P<0.05),and the treatment group showed a more significant decrease than the control group after treatment(P<0.05).③Improvements in the classification of TCM primary and secondary symptoms and concomitant symptoms were observed in the treatment group after treatment(P<0.05),which were more significant than those in the control group(P<0.05).④Intra-group comparisons before and after treatment showed that MLHFQ scores decreased in both groups(P<0.05).Inter-group comparisons after treatment indicated that the treatment group experienced a significantly greater decrease in MLHFQ scores than the control group(P<0.05).⑤After treatment,both groups showed improvement in NYHA functional classification(P<0.05),with the treatment group experiencing greater improvement than the control group(P<0.05).⑥Intra-group comparisons before and after treatment showed an increase in the 6-minute walk test(6MWT)distance for both groups(P<0.05).Inter-group comparisons after treatment indicated that the increase in 6MWT distance was more significant in the treatment group than that in the control group(P<0.05).⑦Intra-group comparisons before and after treatment showed that BNP levels decreased in both groups(P<0.05).Inter-group comparisons after treatment indicated that BNP levels in the treatment group were significantly lower than those in the control group(P<0.05).⑧No obvious abnormality was found in the safety indexes of the two groups.Conclusion Yan's Cangshan Taiyang Moxibustion Acupoint Application significantly improves clinical symptoms,reduces BNP levels,enhances exercise tolerance,and improves quality of life in patients with CHF failure with yang deficiency and blood stasis syndrome,demonstrating good safety.