脐灸治疗阳虚血瘀水停证慢性心力衰竭的疗效

Clinical observation of umbilical moxibustion in treating chronic heart failure with Yang deficiency syn⁃drome of blood stasis and water withdrawal

目的探讨脐灸治疗阳虚血瘀水停证慢性心力衰竭的临床疗效。方法选取2021年1月1日至2022年12月31日在北京中医药大学深圳医院(龙岗)心病科住院的80例辨证为阳虚血瘀水停证的慢性心力衰竭患者作为研究对象,随机分为对照组(40例,完成治疗40例)和观察组(40例,完成治疗40例)。对照组接受标准的药物治疗,而观察组则在药物治疗的基础上增加脐灸治疗。治疗10 d后,对比两组患者治疗前后NT-proBNP、NYHA心功能分级、心脏彩超指标(包括LVEF、LVEDD、LVESD)、明尼苏达生活质量评分、6分钟步行距离、中医证候积分,监测并记录不良反应发生情况。结果观察组患者的治疗总有效率高于对照组(χ^(2)=3.865,P=0.049)。两组患者的NYHA心功能分级、NT-proBNP、LVEF、LVEDD、LVESD、6分钟步行距离均较治疗前明显改善,且观察组患者以上指标的改善更显著(P<0.05)。两组患者的明尼苏达生活质量评分及中医证候积分较治疗前都有所下降,且观察组患者的下降幅度超过了对照组(P<0.05)。在治疗过程中,两组出现不良反应(如胃肠道反应、低血压、皮肤过敏等),组间比较差异无统计学意义(P>0.05)。结论在药物治疗基础上,加用脐灸治疗阳虚血瘀水停证慢性心力衰竭的疗效优于单纯药物治疗,可改善慢性心力衰竭患者的心功能及生存质量。

Objective To explore the clinical effect of umbilical moxibustion on chronic heart failure with yang deficiency and blood stasis and water retention syndrome.Methods 80 patients with chronic heart failure who were hospitalized in the Department of Cardiology,Shenzhen Hospital(Longgang),Beijing University of Chinese Medicine from January 1,2021 to December 31,2022 were selected as research samples and randomly divided into control group(40 cases,40 cases completed)and observation group(40 cases,40 cases completed).The control group received standard drug treatment,while the observation group received umbilical moxibustion treatment on the basis of drug treatment.Ten days after treatment,NT-proBNP,NYHA cardiac function classification,cardiac color Doppler indexes(including LVEF,LVEDD,LVSD),Minnesota quality of life score,6-minute walking distance and TCM syndrome score were compared between the two groups before and after treatment,and the occurrence of adverse reactions was monitored and recorded.Results The total effective rate in the observation group was higher than that in the control group(χ^(2)=3.865,P=0.049).NYHA cardiac function classification,NT-proBNP,LVEF,LVEDD,LVESD and 6-minute walking distance in both groups were significantly improved compared with those before treatment,and the improvement of the above indexes in the observation group was more significant(P<0.05).The Minnesota quality of life score and TCM syndrome score of the two groups decreased compared with those before treatment,and the decline of the patients in the observation group exceeded that of the control group(P<0.05).During the treatment,the two groups had adverse reactions(such as gastrointestinal reaction,hypotension,skin allergy,etc.),and there was no difference between the two groups(P>0.05).Conclusion On the basis of drug therapy,umbilical moxibustion is better than simple drug therapy in treating chronic heart failure with yang deficiency,blood stasis and water stagnation,which can improve the cardiac function and quality of life of patients with chronic heart failure.