温阳活血法治疗慢性心力衰竭的临床研究

目的观察温阳活血法对慢性心力衰竭的临床疗效。方法将100例慢性心力衰竭病人随机分为治疗组和对照组,各50例。对照组给予常规抗心力衰竭治疗(血管紧张素转换酶抑制剂或血管紧张素受体拮抗剂、β受体阻滞剂、血管扩张剂、利尿剂、强心剂等药物),治疗组在对照组治疗基础上加用温阳活血为主的温阳益气活血汤,疗程4周。观察两组治疗前后中医临床症状与体征、纽约心脏病协会(NYHA)心功能分级变化,应用彩色多普勒测定两组每搏输出量(SV)、心输出量(CO)、心脏指数(CI)、左室射血分数(LVEF)、左室短轴缩短率(FS)、左室舒张末内径(LVEDD),测定血清脑钠肽(BNP)浓度。结果治疗组总有效率94%,优于对照组的78%(P<0.05)。两组治疗后SV、CO、CI、LVEF、LVEDD、BNP较治疗前均有明显改善,但治疗组优于对照组(P<0.05)。结论温阳活血法对慢性心力衰竭具有确切的疗效,对心功能各项指标均具有明显的改善作用。

Clinical Observation on Yang-warming and Blood-activating Therapy for Chronic Heart Failure

Objective To investigate the effects of yang-warming and blood-activating therapy in the treatment of chronic heart failure(CHF).Methods One hundred patients with CHF were randomly divided into two groups:Control group(n=50)treated by conventional anti-heart failure treatment(angiotensin-converting enzyme inhibitors or angiotensin receptor blockers,β-blockers,vasodilators,diuretics,inotropic),treatment group(n=50)treated by conventional anti-heart failure treatment and Wenyang Yiqi Huoxue decoction for 4 weeks.The traditional Chinese medical symptoms,New York Heart Association(NYHA) heart function classification were observed.The systolic volume(SV),cardiac output(CO),cardiac index(CI),left ventricular ejection fraction(LVEF),fractional shortening of left ventricular short axis(FS),and left ventricular end-diastolic diameter(LVEDd)were observed.The level of plasma B-type natriuretic peptide(BNP)was detested.Results The total effective rate was 94% in treatment group,which was significantly higher than that in control group(78%,P<0.05).The levels of SV,CO,CI,LVEF,LVEDD,and BNP in treatment group were better than that in control group(P<0.05).Conclusion Yang-warming and blood-activating therapy was effective for CHF,which could improve heart function.