真武汤加味治疗急性失代偿性心力衰竭患者利尿剂抵抗的临床研究

目的观察真武汤加味治疗对急性心力衰竭伴利尿剂抵抗的临床疗效和安全性。方法将120例急性心衰伴利尿剂抵抗的患者随机分为治疗组和对照组各60例,两组均采用西药常规治疗,治疗组在西药常规治疗基础上加用真武汤加味治疗,治疗14 d后,观察两组患者临床疗效及治疗前后24 h尿量、心功能、电解质、肾功能及中医证候积分。结果治疗14 d后,和对照组相比,治疗组的临床总有效率为93.33%,高于对照组的80.00%;两组患者24 h尿量、心功能、低钾血症的发生、中医证候积分等均较治疗前明显改善,治疗组优于对照组(P<0.05或P<0.01);在治疗的安全性方面,两组的CREA、BUN、血Na^+较治疗前无明显改善,差异无统计学意义(P>0.05)。结论真武汤加味治疗阳虚水泛型急性心衰伴利尿剂抵抗临床疗效显著,可明显增加患者24 h尿量,改善心功能及临床症状,并且安全性高,值得进一步研究。

Clinical Study of Zhenwu Decoction on Acute Decompensated Heart Failure Patients with Diuretic Resistance

Objective:To observe the clinical efficacy and safety of Zhenwu Decoction on acute decompensated heart failure with diuretic resistance.Methods:120 patients were randomly divided into the treatment group and the control group,60 cases in each group.Both groups were treated with routine western medicine treatment.The treatment group was added Zhenwu Decoction.After 14 days of treatment,the clinical effect,24-hour urine volume,heart function,electrolyte,kidney function and TCM syndrome score of the two groups were observed.Results:After 14 days of treatment,compared with the control group,the total clinical effective rate of the treatment group was 93.33%,higher than 80.00%of the control group.24-hour urine volume,cardiac function,occurrence of hypokalemia and TCM syndrome score of the two groups were significantly improved compared with before treatment,and the curative effect of the treatment group was better than that of the control group;the difference was statistically significant(P<0.05).In terms of treatment safety,there were no significant improvements in serum CREA,BUN and serum sodium ion between the two groups compared with before treatment(P>0.05).Conclusion:The current evidence shows Zhenwu Decoction has a significant clinical effect on acute heart failure with diuretic resistance and edema due to yang deficiency,which can significantly increase 24-hour urine volume,and improve heart function and clinical symptoms,with high safety.