芪归八味汤治疗缺血性心肌病心力衰竭

Qigui Bawei Decoction in the Treatment of Ischemic Cardiomyopathy with Heart Failure

目的探讨芪归八味汤治疗缺血性心肌病合并心力衰竭不同证型的临床疗效。方法 76例缺血心肌病心力衰竭按照随机数字表法分为对照组37例和治疗组39例,对照组予常规治疗,治疗组在常规治疗基础上加用芪归八味汤。治疗4周后,比较两组临床症状、NYHA心功能及NT-pro BNP的变化;进一步分析患者中医证候,其中气虚血瘀组19例、痰浊闭阻组21例、气阴两虚组24例、心肾两虚组23例,比较不同证候患者芪归八味汤治疗前后症状改善情况。结果治疗组有效率(92.31%)显著高于对照组(75.68%)(P <0.05);心功能方面,治疗组的左室射血分数(LVEF)明显高于对照组,左室收缩末内径(LVESD)明显低于对照组(P <0.05);治疗组的NT-pro BNT水平显著低于对照组(P <0.05);气阴两虚组的有效率明显高于其他证型组(P <0.05)。结论芪归八味汤有助于改善缺血性心肌病合并心力衰竭患者的临床症状、心功能,提高其生活质量。

Objective To investigate the effect of Qigui Bawei decoction on the clinical efficacy of patients with ischemic cardiomyopathy complicated with different types of heart failure.Methods 76 cases of ischemic cardiomyopathy patients were divided into control group(n=37)and treatment group(n=39)according to the random number table.The control group received routine treatment.The treatment group was given Qigui Bawei decoction on the basis of routine treatment.After four weeks of treatment,the clinical symptoms,NYHA cardiac function and NT-proBNP were compared.The TCM syndromes were further analyzed,including 19 cases of qi deficiency and blood stasis,21 cases of blockade of phlegm-turbidity,and qi and yin deficiency.In the case of 23 cases of heart and kidney deficiency,the symptoms of patients with different syndromes were compared before and after treatment.Results The effective rate of the treatment group(92.31%)was significantly higher than that of the control group(P<0.05).In terms of cardiac function,the left ventricular ejection fraction(LVEF)of the treatment group was significantly higher than that of the control group,and the left ventricular end-systolic diameter(LVESD)(P<0.05).The level of NT-proBNT in the treatment group was significantly lower than that in the control group(P<0.05).The effective rate of Qi-Yin deficiency group was significantly higher than that in other syndrome groups(P<0.05).Conclusion Qigui Bawei decoction can improve the clinical symptoms and heart function of patients with ischemic cardiomyopathy complicated with heart failure and improve their quality of life.