益气通络解毒汤联合美托洛尔对慢性心力衰竭患者预后及生活质量的影响

目的：观察益气通络解毒汤联合美托洛尔对慢性心力衰竭（ CHF）患者预后及生活质量的影响。方法将76例CHF患者随机分为2组。治疗组38例采用益气通络解毒汤联合美托洛尔治疗，对照组38例采用规范化西药治疗。2组均6个月为1个疗程，1个疗程后统计疗效，采用明尼苏达生活质量问卷（ MLHFQ）评价2组的生活质量水平；CHF改善情况按心力衰竭评分表评价；统计再次住院率、病死率；观察治疗前后2组舒张末期左室内径（LVDd）、左室射血分数（LVEF）及6 min步行距离（6MWT）变化。结果2组MLHFQ评分均呈减少趋势，治疗2～6个月后治疗组MLHFQ评分低于对照组（P﹤0．05）。治疗组治疗6个月后心力衰竭程度改善优于对照组（P﹤0．05）。2组均获走访，随访时间6～12个月，平均（9．7±2．3）个月，随访期间治疗组再次住院率、死亡率低于对照组（ P＜0．05）。2组治疗后LVDd、LVEF、6MWT与本组治疗前比较差异均有统计学意义（P＜0．05），且治疗组治疗后LVDd、LVEF、6MWT与对照组治疗后比较差异均有统计学意义（ P＜0．05）。结论益气通络解毒汤联合美托洛尔治疗CHF疗效确切，可改善患者心功能及远期预后，改善患者的生活质量。

Effect of Yiqitongluojiedu decoction combined with Metoprolol on the prognosis and quality of life of patients with chronic heart failure

Objective To discuss the effect of Yiqitongluojiedu decoction combined with Metoprolol on the prognosis and quality of life of patients with chronic heart failure （ CHF） .Methods 76 CHF patients were randomly divided into two groups .38 cases in control group were treated by standardization of western medicine .38 cases in treatment group were treated by Yiqitongluojiedu decoction combined with Metoprolol .The course was six months in two groups.The levels of quality of life in two groups were evaluated by Minnesota Living with Heart Failure Ques-tionnaire （ MLHFQ ） .The improvement of heart failure was evaluated by heart failure assessment score sheet .The changes of LVDd,LVEF,6MWT before and after treatment and re-hospitalization rates and mortality were observed .Results MLHFQ score showed decreasing trend in two groups.MLHFQ score After 2~6 month of treatment MLHFQ score in treatment group was lower than that in control group （P〈0.05）.Improving the degree of heart failure in treatment group was superior to that in control group after six months of treatment （P〈0.05）.Follow-up period was 6 to 12 months in two groups.Re-hospitalization rates and mortality in treatment group was lower than that in control group during follow -up （P〈0.05）.There were sig-nificant differences between before and after treatment on LVDd ,LVEF and 6MWT in two groups （P〈0.05）.There were significant differences between two groups on LVDd ,LVEF and 6MWT after treatment （P〈0.05）.Conclusion Yiqitongluojiedu decoction combined with Metoprolol has definite effect on CHF ,and can improve cardiac function and long-term prognosis of patients ,improve the quality of life of patients .