中药内服外敷联合西药对症治疗慢性心力衰竭随机平行对照研究

Comprehensive Treatment of Traditional Chinese Medicine Treatment of Chronic Heart Failure Combined Basis Randomized Parallel Group Study

[目的]观察中药内服外敷联合西药对症治疗慢性心力衰竭疗效。[方法]使用随机平行对照方法,将90例住院及门诊患者按随机数字表法分为两组。均吸氧、强心、水电解质平衡等对症治疗。对照组45例中药安慰剂,0.75g/次,3次/d,口服。治疗组45例中药综合治疗:①通脉强心胶囊(核桃仁、人参15g,三七、制附片、冬麦各10g,淫羊藿、瓜蒌、大云、厚朴各5g,大枣7枚,本院自制胶囊,0.5g/粒),1.5g/次,3次/d,口服。②参附健心汤(附片、大枣、五味子、大腹皮各10g,葶苈子、红参各9g,茯苓7g,丹参5g),1剂/d,水煎200mL,2次/d,口服。春泽汤(白术15g,猪苓、茯苓、泽泻各10g,人参、麦门冬各5g,桂心、柴胡各3g),1剂/d,水煎200mL,早晚口服。③通脉活络贴(红花、冰片、血竭各15g,当归、乳香、丹参各10g,川芎、葛根各3g,1cm×1cm膏剂摊于5cm×5cm弹性透气脱敏胶布正中),取涌泉、三阴交、双侧心俞等穴位,每次取穴4~8个,15~20min/次,1贴/d,贴敷。连续治疗12周为1疗程。观测临床症状、心衰评分、不良反应。连续治疗2疗程,判定疗效。随访6~12个月,观测复发率。[结果]治疗组显效31例,有效12例,无效2例,总有效率95.56%。对照组显效12例,有效20例,无效13例,总有效率61.11%。治疗组疗效优于对照组(P【0.05)。心衰评分治疗组改善优于对照组(P【0.05)。[结论]中药内服外敷联合西药对症治疗慢性心力衰竭慢性心力衰竭效果显著,值得推广。

[Objective]Observe the effect of combined therapy combined basis for the treatment of chronic heart failure treatment. [Methods]Using randomized controlled methods, 90 cases of inpatient and outpatient were randomly divided into two groups. Were carried oxygen, cardiac, water and electrolyte balance and other basic treatment.45 cases of the control group of Chinese medicine placebo, 0.75g/, 3 /d, oral. The treatment group of 45 cases of combined therapy of TCM: Tongmai Qiangxin Capsule(Hetaoren,Renshen 15g,Sanqi, Zhifupian,Dongmai each 10g,Yinyanghuo,Gualou,Dayun,Houbu each 5g, 7 Dazao, prepared by our hospital capsule, 0.5g/ particle), 1.5g/ times, /d 3 times, oral. ② Shenfu Jianxin Decoction(Fupian,Dazao, Wuweizi,Dafupi each 10g,Tinglizi,Hongshen each 9g,Fuling 7g,Danshen 5g), 1 doses of /d, water simmer in water 200mL, 2 /d, oral. Spring Ze Decoction(Baizhu 15g,Zhuling,Fuling,Zexie each 10g, Renshen,Maimendong each 5g,Guixin,Chaihu each 3g), 1 doses of /d, water simmer in water 200mL, 2 /d, oral. The Tongmai active paste(Hoghua,Bingpian,Xuejie each 15g,Dangui,Ruxiang,Danshen each 10g, Chuanqiong,Gengen each 3g, 1cm × 1cm paste spread on the 5cm × 5cm elastic ventilating desensitization tape Center), Sanyinjiao, Yongquan, the bilateral Xinshu point, each point 4 ~ 8, 15 ~ 20min / times, 1 / d, sticking. Continuous treatment for 12 weeks as 1 course of treatment. Observation of clinical symptoms, heart failure score, adverse reaction. Continuous 2 courses of treatment, the curative effect. Patients were followed up for 6 ~ 12 months, observing the recurrence rate. 31 cases of group therapy. [Results]12 cases were effective, 2 cases ineffective, the total efficiency of 95.56%. 12 cases of control group, 20 cases effective, 13 cases ineffective, the total efficiency of 61.11%. The treatment group was better than control group(P< 0.05). Heart failure score of treatment group was better than the control group(P< 0.05). [Conclusion]Comprehensive treatment of traditional Chinese medicine treatment of chronic heart failure combined basis effect is significant, it is worth promoting.