补肾通阳方联合常规疗法治疗心肾阳虚型冠心病慢性心力衰竭临床研究

Clinical Study on Bushen Tongyang Prescription Combined with Routine Therapy for Chronic Heart Failure of Coronary Heart Disease of Heart-Kidney Yang Deficiency Type

目的:观察补肾通阳方联合常规疗法治疗心肾阳虚型冠心病慢性心力衰竭(CHF)的临床效果。方法:将88例心肾阳虚型冠心病CHF患者随机分为研究组和对照组各44例。对照组给予常规疗法治疗,研究组在此基础上加用补肾通阳方,2组均连续治疗4周。观察2组治疗前后中医症状积分、超声心动图指标[左心室射血分数(LVEF)、左室短轴缩短率(FS)、舒张早期最大峰值速度/舒张晚期最大峰值速度(E/A)值]、6 min步行试验距离的变化,对比2组临床疗效及用药安全性。结果:治疗后,2组中医症状积分均较治疗前降低(P <0.05),研究组中医症状积分低于对照组(P <0.05)。治疗后,2组LVEF、FS、E/A水平均较治疗前升高(P <0.05),研究组LVEF、FS、E/A水平均高于对照组(P <0.05)。治疗后,2组6 min步行距离均较治疗前增加(P <0.05),研究组6 min步行距离长于对照组(P <0.05)。对照组总有效率47.73%,研究组总有效率70.45%,2组比较,差异有统计学意义(P <0.05)。治疗期间2组均未出现明显不良反应。结论:补肾通阳方联合常规疗法治疗心肾阳虚型冠心病CHF,能有效缓解患者的临床症状,改善心功能,提高运动耐力,安全性高。

Objective:To observe the clinical effect of Bushen Tongyang prescription combined with routine therapy on chronic heart failure(CHF) of coronary heart disease with of heart-kidney yang deficiency type. Methods:88 cases of CHF patients with coronary heart disease of heart-kidney Yang deficiency type were randomly divided into the study group and the control group with 44 cases in each group. The control group was treated with routine therapy,and the study group was treated with Bushen Tongyang prescription on this basis. Both groups were treated for four weeks. Observed the changes of Chinese medicine symptom scores, echocardiographic indexes including left ventricular ejection fraction(LVEF), left ventricular fractional shortening(FS),the ratio of peak velocity flow in early diastole to peak velocity flow in late diastole(E/A)and 6-minute walk test before and after treatment,and compared the clinical effect and medication safety of the two groups.Results:After treatment,Chinese medicine symptom scores in both groups were lower than those before treatment(P <0.05),while Chinese medicine symptom scores in the study group were lower than those in the control group(P < 0.05). After treatment,the levels of LVEF,FS and E/A in the two groups were higher than those in the control group(P < 0.05),and the levels of LVEF,FS and E/A in the study group were higher than those in the control group(P < 0.05). The 6-minute walking distance in both groups were increased compared with those before treatment(P < 0.05),while the 6-minute walking distance in the study group was longer than that in the control group(P < 0.05). The total effective rate was 47.73% in the control group and 70.45% in the study group,the difference being significant(P < 0.05). During the treatment,no obvious adverse reaction occurred in both groups. Conclusions:The therapy of Bushen Tongyang prescription combined with routine therapy for CHF of coronary heart disease of heart-kidney yang deficiency type can effectively relieve clinical symptoms,improve heart function and exercise endurance with high safety.