摘要
目的:炙甘草汤合血府逐瘀汤加减联合西药治疗慢性心力衰竭(气阴两虚兼血瘀证)的临床疗效进行研究,并对患者的生活质量进行评价。方法:将我院收治的95例慢性心力衰竭(气阴两虚兼血瘀证)患者按随机数字表法分为对照组(n=47)和观察组(n=48),对照组患者给予常规西药标准治疗,观察组患者在对照组西药治疗的基础上加用炙甘草汤合血府逐瘀汤加减治疗,比较两组患者治疗前后的中医症状分级量化积分,心脏彩超的心功能(LVDD、LVEF、SV、FS等)指标检查情况,血浆中脑肽钠(BNP)浓度和6分钟步行试验结果,超敏肌钙蛋白(hs-cTn)、半乳糖凝集素-3(galectin-3)、可溶性基质溶素-2(sST2)、超敏C反应蛋白(hs-CRP)指标检测结果,并比较两者患者的心功能疗效和中医证候疗效、不良反应发生情况及生活质量评价情况。结果:观察组患者治疗后中医症状(除头晕心烦外)分级量化积分均显著低于对照组;观察组患者治疗后LVDD、LVEF、SV、FS等心功能指标均显著高于对照组;观察组治疗后的血浆BNP显著低于对照组治疗后,且6分钟步行试验结果显著高于对照组治疗后;观察组治疗后的hs-cTn、galectin-3、sST2、hs-CRP检测结果均显著低于对照组治疗后;观察组的心功能疗效和中医证候疗效的总有效率均显著优于对照组(87.50%vs 68.08%)和(89.58%vs 72.34%)。两组患者在治疗期间均无明显不良反应发生;观察组治疗后的生活质量mlHFQ评分显著低于对照组治疗后,且SF-36评分显著高于对照组治疗后。结论:炙甘草汤合血府逐瘀汤加减联合西药治疗慢性心力衰竭(气阴两虚兼血瘀证)能够明显改善中医症状、心功能指标(LVDD、LVEF、SV、FS)及各评价指标(BNP、hs-cTn、galectin-3、sST2、hs-CRP),提高心功能疗效和中医证候疗效,提升患者的生活质量。
Objective: To study the clinical efficacy of fried glycyrrhizae decoction plus xuefu zhuyu decoction combined with western medicine in the treatment of chronic heart failure,and to evaluate the quality of life in patients. Methods: 95 cases of chronic heart failure( Qiyinliangxu and Xuexu Syndrom) were randomly divided into the control group( n = 47) and the observation group( n = 48). The patients in the control group were treated with conventional western medicine,and those in the observation group were treated with fried glycyrrhizae decoction and xuefu zhuyu decoction combined with the same western medicine used in the control group. After the treatment,we compared TCM symptom classification scores,the cardiac function( LVDD,LVEF,SV,FS) of heart color Doppler ultrasound,plasma BNP concentration and 6 minute walking test results,the results of hs-cTn,galectin-3,sST2 and hs-CRP,and compared the curative effect of the heart function and the curative effect of traditional Chinese medicine,adverse reactions and quality of life. Results: Except dizzy and vexation symptoms,TCM symptom quantified scores in the observation group were significantly lower than those in the control group after the treatment. The cardiac function( LVDD,LVEF,SV,FS) in the observation group after the treatment were significantly lower than that in the control group. The plasma BNP level in the observation group was significantly lower than that in the control group,and the result of the 6 minute walking test was significantly higher than that in the control group. The results of hs-cTn,galectin-3,sST2 and hs-CRP in the observation group after the treatment were significantly lower than those in the control group. The effect on the heart function and total efficiency of TCM syndrome in the observation group were significantly better than those in the control group( 87. 50% vs 68. 08%) and( 89. 58% vs 72. 34%). There was no obvious adverse reaction during the treatment of two groups. The quality of life( mlH FQ) score in the observation group after the treatment was significantly lower than that in the control group,while SF-36 score was significantly higher than that in the control group. Conclusion:Fried glycyrrhizae decoction plus xuefu zhuyu decoction combined with western medicine in the treatment of chronic heart failure can improve the classification of TCM symptoms quantitative scores,cardiac function indexes( LVDD,LVEF,SV,FS) and the evaluation indexes( BNP,hs-cTn,galectin-3,sST2,hs-CRP). It can improve the curative effect on the heart function and TCM syndrome and improve the quality of life of patients.
作者
何培根
刘菁
冯协和
闵新文
陈俊
He Peigen;Liu Jing;Feng Xiehe;Min Xinwen;Chen Jun(Department of Cardiovascular Medicine, Dongfeng Hospital Affiliated to Hubei University of Medicine,Hubei Key Laboratory of Wudang Local Chinese Medicine Research, Shiyan 442000)
出处
《中药药理与临床》
CAS
CSCD
北大核心
2019年第1期168-172,共5页
Pharmacology and Clinics of Chinese Materia Medica
基金
国家自然科学基金资助项目(81400288)
湖北省自然科学基金资助项目(2012FFA052)
关键词
炙甘草汤
血府逐瘀汤
慢性心力衰竭
临床疗效
生活质量
fried glycyrrhizae decoction
xuefu zhuyu decoction
chronic heart failure
clinical efficacy
quality of life
