参芪复脉汤联合西药治疗慢性心衰疗效及对患者心功能的影响

目的:探讨参芪复脉汤联合西药治疗慢性心衰的疗效及心功能的影响。方法:选择慢性心衰患者72例,随机分为对照组和观察组各36例。对照组给予琥珀酸美托洛尔加替米沙坦、氢氯噻嗪等西药治疗;观察组在对照组基础上给予中药参芪复脉汤治疗。比较两组临床疗效,观察治疗前后左心室射血分数(LVEF)、左室舒张末容积(LVEDV)、B型利尿钠肽(BNP)、N末端B型利尿钠肽原(NT-proBNP)变化及生活质量情况。结果:治疗5、7、14d后,两组中医证候积分均明显下降,观察组比对照组更明显(P<0.05)。两组治疗前LVEF、LVEDV、BNP及NT-proBNP水平比较差异无统计学意义(P>0.05);治疗后两组LVEF水平均显著升高,LVEDV、BNP及NTproBNP均显著降低(P<0.05);观察组治疗后LVEF水平显著高于对照组,LVEDV、BNP及NTproBNP显著低于对照组(P<0.05)。观察组治愈率及总有效率均高于对照组治愈率及总有效率(P<0.05)。治疗后观察组生活质量评分显著高于对照组(P<0.05)。两组患者治疗期间均无明显不良反应。结论:参芪复脉汤结合西药可显著改善慢性心衰患者LVEF、BNP及NT-proBNP等心功能指标,临床疗效显著,患者预后良好。

Effect of Shenqi Fumai decoction combined with western medicine on chronic heart failure and its influence on cardiac function

Objective:To explore the effect of Shenqi Fumai decoction combined with western medicine on chronic heart failure and its influence on cardiac function.Methods:72 patients with chronic heart failure were randomly divided into control group(36 cases)and observation group(36 cases).The control group was treated with metoprolol succinate+telmisartan+hydrochlorothiazide and other western medicine;the observation group was treated with Shenqi Fumai decoction on the basis of the control group.The clinical effects of the two groups were compared.The changes of left ventricular ejection fraction(LVEF),left ventricular end diastolic volume(LVEDV),B-type natriuretic peptide(BNP),N-terminal B-type natriuretic peptide(NT-proBNP)and quality of life were observed before and after treatment.Results:After 5,7,and 14 days of treatment,the scores of TCM syndromes in both groups were significantly decreased,and the observation group was more obvious than the control group(P﹤0.05).There was no significant difference in LVEF,LVEDV,BNP and NT-proBNP levels between the two groups before treatment(P﹥0.05);after treatment,the levels of LVEF in both groups were significantly increased,while the levels of LVEDV,BNP and NT-proBNP were significantly decreased(P﹤0.05).After treatment,the levels of LVEF in the observation group were significantly higher than those in the control group,and LVEDV,BNP and NT-proBNP were significantly lower than those in the control group(P﹤0.05).The cure rate and total effective rate of the observation group were higher than those of the control group and the total effective rate(P<0.05).After treatment,the quality of life score of the observation group was significantly higher than that of the control group(P﹤0.05).No significant adverse reactions were observed in the two groups during treatment.Conclusion:Shenqi Fumai decoction combined with western medicine can significantly improve LVEF,BNP and NT-proBNP in patients with chronic heart failure and other cardiac function indicators,the clinical effect is significant,the prognosis of patients is good.