参附注射液治疗阳气虚型慢性心力衰竭

目的:观察参附注射液治疗阳气虚型慢性心力衰竭(chronic heart failure,CHF)患者的临床疗效.方法:CHF患者72例,随机分为治疗组(36例)和对照组(36例).两组均给予常规治疗,治疗组加用参附注射液静脉输注,对照组加用生脉注射液静脉输注,共2周.治疗前后记录中医证候积分、生活质量积分、6 min步行距离、测定左室射血分数(left ventricular ejection fraction,LVEF)及血浆N末端B型利钠肽原(amino-terminal pro-brain natriuretic peptide,NT-proBNP)水平.结果:治疗后两组患者的中医证候积分、生活质量积分、血浆NT-proBNP水平均明显下降,LVEF升高,6 min步行距离增加(P＜0.05)；治疗组在中医证候积分、生活质量积分、6 min步行距离方面改善优于对照组(P＜0.05),在改善喘息、疲倦乏力、气短、畏寒肢冷和舌象方面也明显优于对照组(P＜0.05),LVEF和NT-proBNP与对照组比较差异无统计学意义.结论:参附注射液对阳气虚型CHF疗效显著,中药注射液仍应在辨证论治理论指导下应用.

Treatment of Chronic Heart Failure with Shenfu Injection

Objective: From the clinical trial to observe the therapeutic effects of Shenfu injection(SFI) on patients of chronic heart failure(CHF). Method: Seventy-two CHF patients were randomly assigned to treatment group(36 cases) and control group(36 cases). All were treated by the regular CHF treatment, but SFI was given to the patients in treatment group and Shengmai injection(SMI) to the patients in control group additionally. The course of treatment was two weeks. Before and after the treatments, the integral of Traditional Chinese Medicine(TCM) syndrome and quanlity of life(QOL), 6-minute walking distance, left ventricular ejection fraction(LVEF) and amino-terminal pro-brain natriuretic peptide(NT-proBNP) were observed. Result: Compared with before treatment, obvious improvement of clinical symptom and experiment index was obtained in two groups(P<0.05). After treatment, the integral of TCM syndrome and QOL were reduced and 6-minute walking distance was increased further in treatment group(P<0.05). The treatment group was superior to the control group in the amendment of the clinical symptom of gasp, fatigue, shortness of breath, cold extremities,and tongue picture(P<0.05). There was no statistical difference in the increased LVEF and descended serum levels of NT-proBNP between the two groups. Conclusion: SFI showing definite effects on CHF with yang deficiency syndrome. Clinical using TCM injection still should follow the guidance of TCM syndrome differentiation theory.