摘要
目的:探讨升阳活血利水法联合西药治疗慢性心力衰竭(简称“慢性心衰”)患者的疗效及其对中医症状积分、心功能的影响。方法:选取2019年5月~2021年6月本院收治的84例慢性心力衰竭患者,随机数字表法将患者分为对照组(n=42)和观察组(n=42),对照组给予西药治疗,观察组在对照组基础上联合升阳活血利水法治疗,比较两组临床疗效、中医症状积分、心功能、心肌能量消耗值(MEE)、6分钟步行距离(6-MWD)、N端脑钠肽前体(NT-proBNP)以及不良反应发生情况。结果:观察组临床总有效率92.86%高于对照组的76.19%(P<0.05);治疗后观察组气喘、乏力、心悸、气短、畏寒肢冷中医症状积分均低于对照组(P<0.05);治疗后观察组心搏量、左室射血分数、左室收缩末期内径、左室舒张末期内径各心功能指标和MEE、6-MWD、NT-proBNP水平均优于对照组(P<0.05);治疗后血小板聚集率(PAgT)降低,组织型纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制因子1(PAI-1)升高,观察组水平优于对照组(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:升阳活血利水法联合西药治疗慢性心衰可有效改善患者临床症状,并可调节心功能及NT-proBNP水平,促进运动恢复,且安全性好。
Objective:To investigate the curative effect of applying raising Yang,activating blood and promoting diuresis method combined with western medicine in the treatment of patients with chronic heart failure(CHF),and its influence on TCM symptom scores and cardiac function.Methods:84 patients with CHF admitted to the hospital between May 2019 and June 2021 were selected.They were divided into a controlled group(n=42)and an observation group(n=42)by the random number table method.All patients were treated with western medicine.On this basis,patients in the observation group were treated by raising Yang,activating blood and promoting diuresis method.The two groups were compared in terms of TCM symptom scores,cardiac function,myocardial energy expenditure(MEE),6-minute walking distance(6-MWD),N-terminal prohormone of brain natriuretic peptide(NT-proBNP)and adverse reactions.Results:The total clinical response rate of the observation group(92.86%)was higher than that of the controlled group(76.19%)(P<0.05).After treatment,the TCM symptom scores of asthma,fatigue,palpitations,shortness of breath,intolerance of cold and cold limbs in the observation group were lower than those in the controlled group(P<0.05).After treatment,cardiac function indicators(stroke volume,left ventricular ejection fraction,left ventricular end-systolic diameter,left ventricular end-diastolic diameter),MEE,6-MWD and NT-proBNP level in the observation group were better than those in the controlled group(P<0.05).After treatment,platelet aggregation rate(PAgT)decreased,tissue-type plasminogen activator(t-PA)and plasminogen activator inhibitor-1(PAI-1)increased,and these indicators in the observation group were better than those in the controlled group group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Raising Yang,activating blood and promoting diuresis method combined with western medicine for treating CHF can effectively improve clinical symptoms,regulate cardiac function and NT-proBNP level,and promote exercise recovery of the patients,with good safety.
作者
孙善动
周成胜
甘小双
叶挺
SUN Shandong;ZHOU Chengsheng;GAN Xiaoshuang;无(Department of General Practice,Suzhou Municipal Hospital of Traditional Chinese Medicine,Suzhou Anhui 234000,China;Department of Cardiology,Suzhou Municipal Hospital of Traditional Chinese Medicine,Suzhou Anhui 234000,China)
出处
《四川中医》
2023年第2期94-97,共4页
Journal of Sichuan of Traditional Chinese Medicine
基金
安徽省教育厅,安徽高校自然科学研究项目重点项目(KJ2020A0400)
关键词
慢性心力衰竭
升阳活血利水法
中医症状积分
心功能
Chronic heart failure
Raising Yang,activating blood and promoting diuresis method
TCM symptom score
Cardiac function
作者简介
孙善动,硕士,副主任中医医师,研究方向:中医内科,E-mail:ssd416849346@163.com。
