芪参颗粒治疗2型心肾综合征阳虚血瘀证临床研究

Clinical Study on Qishen Granules in the Treatment of Type 2 Cardio-renal Syndrome with Yang Deficiency and Blood Stasis

目的:观察芪参颗粒治疗2型心肾综合征(cardio-renal syndrome,CRS)阳虚血瘀证的临床疗效。方法:将87例2型CRS阳虚血瘀证患者按照随机数字表法分为对照组43例和观察组44例。两组患者均给予常规西医规范化治疗,观察组给予自拟方剂芪参颗粒,对照组则给予颗粒安慰剂。比较两组患者治疗前后脑钠肽(brain natriuretic peptide,BNP)、肾小球滤过率(estimated glomerular filtration rate,eGFR)及生存质量评分,并比较两组患者临床症状积分及生存质量量表秩均值。结果:观察组各项临床症状秩均值低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后BNP低于本组治疗前,eGFR水平高于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组患者治疗后各项生存质量评分高于本组治疗前,且治疗后观察组高于对照组(P<0.05)。两组患者各项生存质量积分及总分(医疗支持除外)秩均值比较,差异具有统计学意义(P<0.05)。结论:芪参颗粒治疗2型CRS阳虚血瘀证,可改善患者的临床症状及心肾功能,提高患者的生存质量,且采用CHF中西医结合生存质量量表评价2型CRS阳虚血瘀证患者生活质量,内部信度较高。

Objective:To observe the clinical efficacy of Qishen Granules on type 2 cardio-renal syndrome(CRS) with yang deficiency and blood stasis.Methods:A total of 87 patients with type 2 CRS with yang deficiency and blood stasis syndrome were randomly divided into the control group with 43 cases and the observation group with 44 cases respectively according to the random number table method.Both groups were given standardized treatment with conventional Western medicine.The observation group was further given self-made Qishen Granules,while the control group was further given granules placebo.Then the brain natriuretic peptide(BNP),estimated glomerular filtration rate(eGFR),and quality of life scores between two groups of patients before and after treatment,as well as the clinical symptom scores and rank mean of quality of life scales were compared.Results:The rank mean of various clinical symptoms in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the BNP of the two groups was lower than that before treatment,while the eGFR level was higher than that before treatment.The differences between the two groups were statistically significant(P<0.05).The quality of life scores of the two groups were higher than that before treatment,and the observation group′s was higher than that of the control group(P<0.05).The comparison of the rank mean scores of various quality of life scores and total scores(excluding medical support) between the two groups showed statistically significant differences(P<0.05).Conclusion:Qishen Granules can improve the clinical symptoms and heart and kidney function of type 2 CRS patients with yang deficiency and blood stasis syndrome,and enhance their quality of life.The use of the CHF integrated traditional Chinese and Western medicine quality of life scale to evaluate the quality of life of type 2 CRS patients with yang deficiency and blood stasis syndrome has a high internal reliability.