摘要
目的观察三伏贴对阳气亏虚、血瘀水停证慢性心力衰竭(CHF)患者的临床疗效及心血管事件发生情况的影响。方法纳入160例阳气亏虚、血瘀水停证CHF患者,对照组80例予常规西医基础治疗;治疗组80例再加三伏.天穴位贴敷治疗,从三伏第一天至出伏贴敷,隔日贴敷1次,每次贴敷4~6h,共20次。观察两组患者治疗前后血浆N末端B型利钠肽原(NT-proBNP)水平及明尼苏达心力衰竭生存质量量表(MLHFQ)、生活质量(SF-36)量表评分,评价治疗后临床疗效;6个月后随访患者心血管事件发生情况,并分析患者心血管事件发生情况与性别、年龄、心功能分级、三伏贴治疗、合并症等因素的相关性。结果治疗组临床疗效总有效率为89.87%,对照组为72.15%,差异具有统计学意义(P<0.01);与对照组比较,治疗后治疗组血浆NT-proBNP水平、MLHFQ评分明显降低,SF-36量表评分明显升高(P<0.01)。CHF患者的主要心血管事件发生率对照组分别为再入院31.6%、急性心力衰竭21.5%、心源性死亡2.5%,治疗组分别为15.2%、7.6%、1.3%,治疗组再入院、急性心力衰竭发生率低.于对照组(P<0.05)。心血管事件相关因素分析显示,三伏贴治疗是CHF患者再入院和急性心力衰竭事件的相关因素(B=-0.955,B=-1.202),未发现心源性死亡的相关因素。结论三伏贴能改善CHF患者的心功能、提高患者生活质量,同时能够减少CHF患者的再入院及急性心力衰竭的发生,改善患者预后。
Objective To observe the effects of acupoint application in dog days on clinical efficacy and cardiovascular events in treating chronic heart failure(CHF)with yang qi deficiency,blood stasis and water retention syndrome.Methods A total of 160 cases of CHF with yang qi deficiency,blood stasis and water retention syndrome were included.Eighty cases in the control group were given conventional western medicine basic treatment,and the other 80 cases in the treatment group were added acupoint application in dog days on acupoints.Acupoint application in dog days were given from the first day to the last day of dag days,once every other day,4-6 h per time,20 times totally.The plasma N-terminal B-type natriuretic peptide(NT-proBNP)level,Minnesota Heart Failure Quality of Life Scale(MLHFQ)and quality of life(SF-36)scale scores before and after treatment were observed in both groups.The clinical efficacy after treatment was evaluated.After 6 months,the incidence of cardiovascular events in patients was recorded,and the correlations of the incidence of cardiovascular events with gender,age,cardiac func・tion classification,acupoint application,and comorbidities were analyzed.Results The total effective rate of clinical efficacy in the treatment group was 89.87%,and 72.15%in the control group with significant difference(P<0.01);Compared with the control group,serum NT-proBNP and MLHFQ in the treatment group were significantly decreased after treatment,and SF-36 scores were significantly increased(P<0.01).The incidence of major cardiovascular events in patients with CHF was 31.6%re-hospitalization,21.5%acute heart failure,and 2.5%cardiogenic death for the control group,and 15.2%re-hospitalization,7.6%acute heart failure,and 1.3%cardiaogenic death for the treatment group.The incidence of Te・hospitalization and acute heart failure in the treatment group was lower than that of the control group(P<0.05).Analysis of factors related to cardiovascular events showed that acu・point application in dog days was a related factor for CHF patientsA re-hospitalization and acute heart failure events(B=-0.955,B=-1.202).No related factor for cardiac death was found.Conclusion Acupoint application in dog days can improve the cardiac function and quality of life of CHF patients.Besides,acupoint application in dog days therapy can decrease re-hospitalization and incidence of acute heart failure of CHF patients,improve the patient prognosis.
作者
刘宁
宋宪波
谭莉娜
王建明
朱志扬
曲争艳
LIU Ning;SONG Xianbo;TAN Lina;WANG Jianming;ZHU Zhiyang;QU Zhengyan(Traditional Chinese Medicine Hospital of Jining City,Shandong Province,272000)
出处
《中医杂志》
CSCD
北大核心
2020年第1期53-57,共5页
Journal of Traditional Chinese Medicine
关键词
慢性心力衰竭
阳气亏虚
血瘀水停
三伏贴
冬病夏治
生活质量
心血管事件
chronic heart failure
yang qi deficiency
blood stasis and water retention
acupoint application in dog days
winter disease treated in summer
quality of life
cardiovascular events
作者简介
通讯作者:曲争艳,xiaozheng35@163.com,(0537)6551860。
