益气温阳活血利水法联合西医治疗急性心力衰竭疗效观察

目的:探讨益气温阳活血利水中药联合西医治疗急性心力衰竭的疗效。方法:将96例入组患者随机分为治疗组及对照组各48例,对照组予常规西医治疗,治疗组在对照组基础上加益气温阳活血利水的中药汤剂浓煎口服,治疗时间为10d,观察两组患者治疗前后的NT-proBNP、LVEF、LVEDD、HR、MAP、平均尿量、总住院天数、住院总费用、平均辅助通气时间、中医证候疗效及不良反应;再随访1年内因心力衰竭再住院率及因心力衰竭的死亡率。结果:两组患者治疗后NT-pro BNP、HR、平均尿量、MAP、LVEF、LVEDD均显著改善(P<0.05),且治疗组疗效优于对照组(P<0.05);平均住院天数、平均住院总费用、平均机械辅助通气时间比较,治疗组较对照组显著降低(P<0.05);在1年随访期间里,治疗组的再住院率及死亡率较对照组显著降低(P<0.05)。结论:益气温阳活血利水类浓煎中药联合西医治疗对急性心力衰竭发作可改善心功能及生命体征、减轻耗费、改善预后。

Clinical effects of Yiqi Wenyang Huoxue Lishui method combined with western medicine on acute heart failure

Objective:To explore the clinical effect of Yiqi Wenyang Huoxue Lishui method combined with western medicine on acute heart failure.Methods:A total of 96 patients who met the standard were randomly divided into the treatment group and the control group(48 cases each).The control group was given standard western medicine treatment,the treatment group was given Yiqi Wenyang Huoxue Lishui Chinese medicine on the basis of standard western medicine treatment.The course of treatment was 10 d.N terminal pro B type natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),mean heart rate(HR),mean arterial pressure(MAP),urine volume,total hospitalization days,total hospitalization cost,mean assisted ventilation time,curative effect of TCM syndrome and adverse reactions were observed before and after treatment in the two groups respectively.After discharge,patients were followed up for 1 year to record the rehospitalization rate and mortality rate due to heart failure.Results:After treatment,the NT-proBNP,HR,MAP,urine volume,LVEF and LVEDD of patients in the two groups showed significant differences compared with those before treatment(P<0.05),while the comparison between the two groups after treatment showed that the treatment group was better than the control group(P<0.05).Compared with the control group,the total hospitalization days,total hospitalization cost,mean assisted ventilation time of the treatment group were significantly reduced(P<0.05).During the follow-up period,the rehospitalization rate and the overall mortality rate in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion:Yiqi Wenyang Huoxue Lishui method combined with western medicine has certain effects on improving cardiac function,improving vital signs,shortening hospitalization course,reducing cost and improving prognosis of patients with acute heart failure.