参芪强心汤辅助治疗气阴血亏兼血瘀水停型慢性心力衰竭的效果

Study on the effect of Shenqi Qiangxin Decoction in the Treatment of Chronic Heart Failure with Qi and Yin Deficiency and Blood Stasis and Water Stasis

目的:研究参芪强心汤联合常规西药在气阴血亏兼血淤水停型慢性心力衰竭(CHF)患者治疗中的应用价值。方法:选取鲁山健民医院2019年3月—2021年1月收治的106例气阴血亏兼血瘀水停型CHF患者作为研究对象,按照随机数字表法将患者分为研究组和对照组,每组53例。对照组予以西药治疗,研究组予以参芪强心汤联合西药治疗。比较两组临床疗效、心功能[心脏指数(CI)、每搏输出量(SV)、左心室射血分数(LVEF)]、中医证候总评分、6 min步行距离试验(6 MWT)、血管内皮功能指标[内皮素-1(ET-1)、血管紧张素Ⅱ(ANGⅡ)、一氧化氮合酶(NOS)]及随访6个月不良事件发生情况。结果:研究组总有效率为94.33%,高于对照组的79.25%(P<0.05);治疗后,研究组CI、LVEF、SV、NOS高于对照组,中医证候总积分、ET-1、ANGⅡ低于对照组,6 MWT距离远于对照组(P<0.05);研究组不良事件总发生率为9.80%,低于对照组的26.53%(P<0.05)。结论:参芪强心汤联合常规西药治疗气阴血亏兼血淤水停型CHF效果显著,能恢改善血液循环,恢复患者心功能,同时有助于增强运动耐力,减轻临床症状,且能降低不良事件发生风险。

Objective:To study the application value of Shenqi Qiangxin Decoction combined with conventional western medicine in the treatment of patients with chronic heart failure(CHF)of Qi and Yin deficiency and blood stasis and water stasis.Methods:A total of 106 patients with CHF of Qi and Yin deficiency and blood stasis and water stasis who were admitted to Lushan Jianmin Hospital from March 2019 to January 2021 were selected as the study subjects,and the patients were divided into study group and control group according to the method of random number table,with 53 patients in each group.The control group was treated with western medicine,while the study group was treated with Shenqi Qiangxin Decoction combined with western medicine.The clinical eficacy,cardiac function[cardiac index(CI),stroke output(SV),left ventricular ejection fraction(LVEF)],total score of TCM syndromes,6-minute walking distance test(6MWT),vascular endothelial function index[endothelin-1(ET-1),angiotensin Ⅱ(ANGⅡ),nitric oxide synthase(NOS)]and adverse events were compared between the two groups.Results:The total effective rate of the study group was 94.33%,which was higher than 79.25% of the control group(P<0.05).After treatment,the CI,LVEF,SV and NOS of the study group were higher than those of the control group,the total score of TCM syndromes,ET-1,and ANGⅡ were lower than those of the control group,and the distance of 6 MWT was far higher than that of the control group(P<0.05).The total incidence of adverse events in the study group was 9.80%,which was lower than 26.53% in the control group(P<0.05).Conclusion:Shenqi Qiangxin Decoction combined with conventional western medicine has a significant effect on the treatment of CHF of Qi and Yin deficiency and blood stasis and water stasis,which can restore and improve blood circulation,recover patients'heart function.Meanwhile,it help to enhance exercise endurance,reduce clinical symptoms,and reduce the risk of adverse events.