中西医结合治疗慢性心力衰竭临床观察

目的：观察中西医结合治疗慢性心力衰竭（CHF）患者的临床疗效。方法：选择82例NYHA心功能Ⅱ～Ⅳ级CHF患者,随机分为两组。常规治疗组（简称对照组）40例用洋地黄、利尿剂、血管紧张素转换酶抑制剂及硝酸盐类药物进行常规治疗,中西医结合组（简称治疗组）42例在常规治疗基础上加用中药辨证治疗。治疗前和治疗24 w后,应用超声心动图评价左室功能,6 min步行距离评价运动耐量,测量血浆脑钠肽（BNP）评价神经内分泌激活。结果：治疗组治疗后生活质量、NYHA心功能、心输出量（CO）、心脏指数（CI）、左室射血分数（EF）、BNP明显改善,6 min步行距离明显增加;对照组变化不明显。结论：中西医结合治疗CHF,可明显改善CHF患者左室功能,抑制神经内分泌激活,改善运动耐量。

Clinical Observation of Chronic Heart Failure treated with Integrated Chinese and Western Medicine

Objective：To observe the clinical therapeutic effect of integrated Chinese and western medicine on chronic heart failure （CHF）. Methods：82 cases of CHF with NYHA heart function II-IV were selected and randomized into two groups. Routine treatment group（control group）（40 cases）was administrated digitalis, diuretics, angiotension Converting enzyme inhibitor（ACEI）and nitrates. Integrated Chinese and western medicine group （treatment group）（42 cases）was supplemented with Chinese herbs based on the differentiation of syndromes beside routine treatment. Results： Before and 24w after treatment, echocardiography was applied to assess the left ventricular function, 6min walking test was to assess exercise tolerance and plasma BNP level was to assess neuroendocrine activation. It was discovered that life quality, NYHA heart function, cardiac output, cardiac index,left ventricular ejection fraction and BNP had been improved remarkably after treatment. The distance in 6min walk test was increased obviously. But,in control group,the ehanges were not remarkable. Conclusion：Integrated Chinese and western medicine improves the left ventricular function,inhibits neuroendocrine activation and enhances exercise tolerance in chronic heart failure.