摘要
目的 观察益心汤治疗舒张性心力衰竭（DHF）的临床疗效.方法 采用前瞻性随机对照临床研究方法,选择上海市长宁区天山中医医院2012年12月至2015年11月收治的80例气虚阳衰,水瘀内停型DHF患者,按随机数字表法分为观察组和对照组（每组40例）.对照组采用常规西药治疗;观察组在对照组基础上联合应用中药益心汤,共治疗4周.分别于治疗前和治疗4周观察患者的中医证候积分,检测N-末端B型钠尿肽前体（NT-proBNP）水平;随访6个月观察心衰的复发率,比较两组各观察指标及NT-proBNP的改善情况.结果 最终共76例患者完成临床研究,其中观察组39例,对照组37例.两组均可明显改善DHF患者的中医证候积分（分：观察组为9.23±4.77比26.28±6.17,对照组为11.79±5.12比25.51±6.02,均P＜0.05）、心功能指标NT-proBNP（μg/L：观察组为1 068.89±1 048.59比3 261.51±1 560.90,对照组为1 675.54±1 331.71比3 073.11±1 495.48,均P＜ 0.05）,治疗结束时,观察组有效率明显高于对照组[89.74％ （35/39）比72.97％（27/37）,P＜0.05].随访6个月时观察组5例复发,复发率为14.29％;对照组复发11例,其中1例为心源性猝死,复发率为40.74％,差异具有统计学意义（P=0.019）.结论 西药常规治疗同时联合使用中药益心汤治疗DHF,疗效优于单纯西药治疗,且复发率较低.
Objective To observe the clinical effects of using Yixin decoction to treat diastolic heart failure （DHF）. Methods A prospective randomized controlled clinical study was conducted, 80 patients suffering from DHF accompanied by deficiency of vital energy and yang as well as fluid stasis and stagnation admitted to Tianshan Chinese Medicine （TCM） Hospital in Changning District of Shanghai from December 2012 to November 2015 were enrolled, and they were randomly divided into observation group and control group （each group, 40 patients）. The patients in control group were given conventional western medicine, while the patients in observation group besides the conventional western medicine treatment, they were additionally given Yinxin decoction for 4 weeks. Before treatment as well as 4 weeks after treatment, the integral of physical signs of TCM syndrome were observed, and N-terminal pro-brain natriuretic peptide prohormone （NT-proBNP） was detected. After 6 months of follow-up, the recurrence rate of heart failure was observed, the indexes recorded in two ga-oups and the improvement of NT-proBNP were analyzed and compared in the two groups. Results Finally, there were only 76 patients having accomplished the clinical research, including 39 patients in observation group and 37 patients in control group. The integral of physical signs of TCM syndrome （observation group： 9.23±4.77 vs. 26.28±6.17, control group： 11.79±5.12 vs. 25.51±6.02, both P 〈 0.05）, NT-proBNP （μg/L： observation group was 1 068.89±1 048.59 vs. 3 261.51±1 560.90, control group was 1 675.54±1 331.71 vs. 3 073.11±1 495.48, all P 〈 0.05） were all obviously improved in two groups （P 〈 0.05）. At the end of treatment, the effective rate of observation group was obviously higher than that of control group [89.74% （35/39） vs. 72.97% （27/37）, P 〈 0.05]. In the 6 months of follow-up, there were 5 cases having recurrence in observation group, the rate being 14.29%, and at the same time recurrence occurred in 11 cases in control group, consisting one case of sudden cardiac death,the rate being 40.74%, the difference being statistically significant （P =0.019）. Conclusions The curative effect of using Yixin decoction combined with conventional western medicine to treat DHF is better than using conventional western medicine alone and the recurrence rate in the combined group is relatively lower.
出处
《中国中西医结合急救杂志》
CAS
北大核心
2016年第6期589-592,共4页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
上海市长宁区卫生和计划生育委员会科研项目（20124ZY04001）
关键词
益心汤
气虚阳衰
水瘀内停型
慢性舒张性心力衰竭
N-末端B型钠尿肽前体
Yixin decoction
Deficiency of vital energy and yang
Fluid stasis and stagnation
Chronic diastolic heart failure
N-terminal pro-brain natriuretic peptide prohormone
作者简介
通讯作者：范兴良，Email：1212fxl@163．com
