加味真武汤治疗阳虚水泛型慢性心力衰竭临床观察

Clinical Observation on the Curative Effect of Zhenwu Decoction in the Treatment of Chronic Heart Failure with Yang Deficiency and Water Accumulation Syndrome

目的观察加味真武汤治疗阳虚水泛型慢性心力衰竭的临床疗效。方法随机将101例收治的阳虚水泛型慢性心力衰竭的患者分成2组,对照组(50例)按《中国心力衰竭诊断治疗指南2014》中拟定的治疗方案:利尿剂、醛固酮受体抑制剂、血管紧张素转化酶抑制剂(ACEI)或者血管紧张素受体拮抗剂(ARB)和β受体阻滞剂等标准化治疗。治疗组(51例)在对照组的基础上加用加味真武汤,100 ml/次,每日2次,口服。2组均治疗6周,观察患者治疗前后临床疗效、临床症状评分、NT-proBNP、左室射血分数等指标。结果治疗组阳虚水泛型慢性心力衰竭患者总有效率94. 1%,对照组总有效率82. 0%,2组差异有统计学意义(P <0. 05)。治疗组较对照组治疗后临床症状评分明显改善,NT-proBNP明显下降,左室射血分数提高。结论在西医常规治疗慢性心力衰竭的基础上,加味真武汤在阳虚水泛型慢性心力衰竭治疗中疗效明显,优于单纯的西医治疗。

Objective To observe the clinical efficacy of modified Zhenwu decoction in the treatment of chronic heart failure with yang deficiency and water accumulation syndrome. Methods 101 patients with chronic heart failure with Yang deficiency and water accumulation syndrome were randomly divided into two groups. The control group( n = 50) was given standardized treatment such as diuretic agents,aldosterone receptor inhibitors,angiotensin converting enzyme inhibitors( ACEI) or angiotensin receptor antagonists( ARB) and beta blockers,according to the treatment plan formulated in the 2014 guidelines for diagnosis and treatment of Chinese heart failure. In addition to the therapy of control group,patients in the treatment group were also given Zhenwu decoction,100ml/time,twice daily. Both groups were treated for 6 weeks. The clinical efficacy,clinical symptom score,NT-proBNP and left ventricular ejection fraction were observed before and after treatment. Results The total effective rate of the treatment group was 94. 1% in the treatment of patients with chronic heart failure with yang deficiency and water accumulation syndrome and the total effective rate in the control group was 82. 0%,and the difference was statistically significant( P < 0. 05). Compared with the control group,the clinical symptom score of the treatment group was significantly improved,NT-proBNP was significantly decreased,and the left ventricular ejection score was increased. Conclusions Based on routine western medicine,Zhenwu decoction is effective in the treatment of chronic heart failure with yang deficiency and water accumulation syndrome,which is better than the simple treatment of Western medicine.