辨证分型联合西药治疗慢性心力衰竭随机平行对照研究

Observation of Decoction Combined with Western Medicine on 30 Cases Chronic Heart Failure

[目的]观察辨证分型联合西药治疗慢性心力衰竭疗效。[方法]使用随机平行对照方法,将60例住院患者按随机数字表法分为两组。对照组30例地高辛片0.25mg/次,1次/d;双氢克尿噻片25mg/次,2次/d。安体舒通片20mg/次,2次/d;卡托普利片25mg/次,3次/d。治疗组30例辨证论治,心肺气虚,养心补肺汤(人参、五味子各10g,黄芪30g,灸甘草5g,白术12g,党参、当归、浮小麦各15g);气滞血瘀加红花10g,郁金50g;痰浊加葶苈子5g。气阴两亏,补气汤(生地、枣仁各12g,黄连20g,天冬、柏子仁、远志、当归、灸甘草各10g,人参、栀子各15g);心肾阴虚、头晕耳鸣加熟地15g,枸杞10g,山药20g;阴虚阳亢,加珍珠母5g、生石决明20g。心肾阳虚:温阳益气汤(红参、制附子、川芎各10g,黄芪60g,车前子包煎20g,赤芍、茯苓、丹参、山楂各30g,泽泻、白术、通草各15g);阳损及阴,水不涵木出现眩晕、耳鸣耳聋、手足蠕动(鹿角胶6g,加莵丝子、龟板胶各10g)。1剂/d,水煎150mL,2次/d。西药治疗同对照组。连续治疗15d为1疗程。观测临床症状、不良反应。连续治疗1疗程,判定疗效。[结果]治疗组显著15例,有效12例,无效3例,恶化0,总有效率90.00%。对照组显著7例,有效12例,无效8例,恶化2,总有效率66.67%。治疗组疗效优于对照组(P<0.05)。[结论]辨证分型联合西药治疗慢性心力衰竭效果显著,值得推广。

[Objective]To observe the traditional Chinese medicine liquid form combined western medicine curative effect in patients with chronic heart failure.[Methods]30 cases of hospitalized patients with chronic heart failure with traditional Chinese medicine soup combined with western medicine routine treatment.Heart and lung qi deficiency syndrome,yangxin tonifying lung decoction(Renshen、Wuweizi10g,Huangshi30g,Zhigancao5g,Baishu12g,Dangshen、Danggui、Fuxiaomai15g;Atractylodes,floating wheat.Qi and blood stasis(Honghua10g,Yujin50g);Phlegm turbidity(Tinglizi5g).Qi and Yin deficient,tonifying qi decoction(Shengdi,Zaoren12g,Huanglian20g,Tiandong,Boziren,Yuanzhi,Danggui,Zhigancao10g Renshen,Zhizi15g).Heart kidney Yin deficiency,dizziness,tinnitus,(Shudi15g,Gouqi 10g,Shangyao20gZhenzhumu5g,Shengshijueming 20g);Heart kidney Yang deficiency syndrome(WenYangYiQisoup,Hongshen,Zhifuzi,Chuanqiong10g,Huangshi60g,Cheqianzi(packet Fried)20g,Chishao,Fuling,Danshen,Shanzha30g,Zexie,Baishu,Tongcao15g)Yang and Yin,water does not contain wood creep appeared dizziness,tinnitus,deafness,hands and feet,(Lujiaojiao 6g,Tusizi,Guibanjiao 10 g).150 ml/times,2 times/d,15 d continuous treatment for 1 course of treatment.Observation of clinical symptoms and determine efficacy and adverse reactions.[Results]12 cases,15 cases in treatment group was significantly effective,ineffective in 3,deteriorating 0,the total effective rate was 90.00%.Effectiveness was significantly in 7 cases,12 cases effectiveness and 8 cases,deterioration in 2,the total effective rate was 66.67%.The treatment group curative effect is better than that of control group(P<0.05).[Conclusion]the traditional Chinese medicine with western medicine therapy of chronic heart failure,is worth promoting.