益气复脉注射液与生脉散治疗气阴两虚型慢性心力衰竭临床疗效对比

Comparison of the Clinical Therapeutic Effects on Chronic Heart Failure of Qi and Yin Deficiency Pattern/Syndrome between Yiqi Fumai Injection and Shengmai San

目的观察将生脉散替代益气复脉注射液治疗慢性心力衰竭患者的临床疗效。方法将60例慢性心力衰竭患者随机分为治疗组和对照组,每组30例。对照组患者给予常规治疗,药物给予血管紧张素转化酶抑制剂(ACEI)类、β受体阻滞剂、醛固酮受体拮抗剂以及益气复脉注射液。治疗组患者的一般治疗和西药治疗均与对照组相同,只是将益气复脉注射液替换为生脉散汤剂。两组均连续治疗2周为1个疗程,治疗后观察两组中医证候积分、临床疗效、血浆B型脑钠肽(BNP)及心功能的变化情况。结果两组患者治疗后中医证候积分、BNP及心功能改善情况均明显优于治疗前(P<0.05),且治疗组治疗后总有效率、中医证候积分改善情况与对照组比较差异有统计学意义(P<0.05)。对照组治疗后BNP及心功能改善情况均优于治疗组(P<0.05)。结论生脉散汤剂对于中医症候和疗效优于益气复脉注射液,益气复脉注射液对于BNP值和心功能改善优于生脉散汤剂。生脉散汤剂可以有效改善患者症状,因原方剂量小,还可煎汤代茶饮用,达到简、效、便、廉的效果。

Objective To observe the clinical therapeutic effect on chronic heart failure( CHF) treated with shengmai san instead of yiqifumai injection. Methods Sixty patients of CHF were randomized into a treatment group and a control group,30 cases in each one. In the control group,the conventional treatment was given with ACEI drugs,beta blockers,aldosterone receptor antagonist and yiqifumai injection. The usual care and western medicine therapy in the treatment group were same as the control group,andshengmai san decoction substituted foryiqifumai injection. The treatment for 2 weeks was taken as 1 session in the two groups. After treatment,TCM syndrome score,clinical therapeutic effect,BNP and heart function were observed in the two groups. Results After treatment,the improvements of TCM syndrome score,BNP and heart function after treatment were apparently better than those before treatment in the two groups( P < 0. 05). In the treatment,after treatment,the improvements of the total effective rate and TCM syndrome score were different significantly as compared with the control group( P < 0. 05). But the improvements of BNP and heart function in the control group were superior to the treatment group after treatment( P < 0. 05). Conclusion Shengmai san decoction achieves the better therapeutic effects than yiqifumai injection. Yiqifumai injection improves better BNP value and heart function as compared with shengmai san decoction. Shengmai san decoction effectively relieves patients’ symptoms. The tea form of shengmai san of small dose is applicable more easily and economically.