真武汤联合常规西药治疗心肾阳虚型慢性心功能不全临床研究

目的:观察真武汤联合常规西药治疗慢性心功能不全(CHF)的临床疗效及其对左室射血分数(LVEF)、B型钠尿肽(BNP)表达的影响。方法:将心肾阳虚型CHF患者130例随机分为2组,对照组65例行西医常规治疗,观察组65例在对照组的基础上加服真武汤治疗;2组均连续治疗4周,观察患者临床疗效、心功能、血液流变学指标、中医证候积分及血清BNP、内皮素-1(ET1)含量改善情况。结果:总有效率观察组为95.38%,对照组为80.00%,2组比较,差异有统计学意义(P<0.05)。治疗后,观察组全血黏度高切、低切值均低于治疗前及对照组,差异有统计学意义(P<0.05);对照组两项指标治疗前后变化不大(P>0.05)。治疗后,2组中医证候积分、血清BNP、ET1含量均较治疗前明显降低(P<0.05);且观察组上述各项指标均低于对照组(P<0.05)。治疗后,2组患者LVESD、LVEDD值较治疗前降低(P<0.05),E/A、LVEF值较治疗前升高(P<0.05);且观察组各项指标改善较对照组更显著(P<0.05)。结论:真武汤联合常规西药治疗CHF疗效显著,可明显降低中医证候积分、血清BNP含量,改善患者心功能及血液流变学状态。

Clinical Study on Zhenwu Tang Combined with Routine Western Medicine for Chronic Heart Failure of Heart-kidney Yang Deficiency Type

Objective:To observe the clinical effect of Zhenwu tang combined with routine western medicine for chronic heart failure(CHF)and its effect on expressions of left ventricular ejection fraction(LVEF)and B-type natriuretic peptide(BNP).Methods:A total of 130 cases of CHF patients of heart-kidney yang deficiency type were randomly divided into two groups,65 cases in each group.The control group was treated with routine western medicine,and the observation group was additionally treated with Zhenwu tang based on the treatment of the control group.Both groups were treated for four weeks.The clinical effect,the heart function,the hemorheology indexes,Chinese medicine syndrome scores and the improvement of the content of BNP and endothelin-1(ET1)in serum were observed.Results:The total effective rate was 95.38%in the observation group and 80.00%in the control group,the difference being significant(P<0.05).After treatment,the whole blood high viscosity and low viscosity in the observation group were lower than those before treatment and those in the control group,the difference being significant(P<0.05);there was no significant difference being found in the comparison of the above two indexes before and after treatment(P>0.05).After treatment,Chinese medicine syndrome score and the content of BNP and ET1 in serum in the observation group were significantly lower than those before treatment and those in the control group,differences being significant(P<0.05);in the control group,only Chinese medicine syndrome score and the content of ET1 were significantly decreased when compared with those before treatment(P<0.05).After treatment,the values of LVESD and LVEDD in the two groups were decreased when compared with those before treatment(P<0.05),and the values of E/A and LVEF were increased when compared with those before treatment(P<0.05);the improvement of the above indexes in the observation group was more significant than that in the control group(P<0.05).Conclusion:The therapy of Zhenwu tang combined with routine western medicine has significant curative effect in treating CHF,which can obviously reduce Chinese medicine syndrome scores and the content of BNP in serum,and improve the heart function and hemorheology.