| 引用本文: |
卢洁,刘琛怡,李济廷,卢健棋,温志浩,庞延,黄舒培,王林海.养心通脉Ⅱ号方治疗慢性心力衰竭气阴两虚血瘀证的疗效观察[J].湖南中医药大学学报,2019,39(3):399-403[点击复制] |
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| 养心通脉Ⅱ号方治疗慢性心力衰竭气阴两虚血瘀证的疗效观察 |
| 卢洁,刘琛怡,李济廷,卢健棋,温志浩,庞延,黄舒培,王林海 |
| (广西中医药大学, 广西 南宁 530001;广西中医药大学第一附属医院, 广西 南宁 530023) |
| 摘要: |
| 目的 评估养心通脉Ⅱ号方治疗广西地区慢性心力衰竭（chronic heart failure，CHF）的临床疗效，探索中医药治疗CHF的新途径。方法 采用多中心临床随机对照试验，将58例广西桂东、桂西、桂南、桂北共7家医院CHF气阴两虚血瘀证患者随机分为两组，对照组28例予西药常规治疗，治疗组30例予西药常规治疗加养心通脉Ⅱ号方，疗程6个月。对比两组患者治疗前后氨基末端脑钠肽前体（N-terminal pro-B-type natriuretic peptide，NT-proBNP）、6分钟步行试验（6-minute walk test，6MWT）、左室射血分数（left ventricular ejection fractions，LVEF）、中医证候积分、中医证候积分临床疗效、心功能疗效及明尼苏达心力衰竭生活质量调查表（minnesota living with heart failure questionnaire，MLHFQ）。结果 治疗后治疗组NT-proBNP、6MWT、LVEF、中医证候积分均明显优于对照组，差异有统计学意义（P<0.05）；在中医证候积分临床疗效方面，治疗组总有效率83.34%，对照组60.72%，差异有统计学意义（P<0.05）；在心功能疗效方面，治疗组总有效率86.66%，对照组67.85%，差异有统计学意义（P<0.05）；治疗后两组MLHFQ评分均增加（P<0.05），治疗组较对照组更能改善生活质量，差异有统计学意义（P<0.05）。结论 养心通脉Ⅱ号方能有效改善气阴两虚血瘀型CHF患者的心功能，缓解中医证候，值得临床推荐。 |
| 关键词: 慢性心力衰竭 气阴两虚血瘀证 养心通脉Ⅱ号方 氨基末端脑钠肽前体 6分钟步行试验 中医证候积分 |
| DOI：10.3969/j.issn.1674-070X.2019.03.025 |
| 投稿时间：2018-07-16 |
| 基金项目:广西壮族自治区科技攻关计划（14124003-5） |
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| Efficacy of Yangxin Tongmai PrescriptionⅡ in the Treatment of Chronic Heart Failure with Syndrome of Deficiency of Both Qi and Yin and Blood Stasis |
| LU Jie,LIU Chenyi,LI Jiting,LU Jianqi,WEN Zhihao,PANG Yan,HUANG Shupei,WANG Linhai |
| (Guangxi University of Chinese Medicine, Nanning, Guangxi 530001, China;The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi 530023, China) |
| Abstract: |
| Objective To evaluate the clinical efficacy of Yangxin Tongmai PrescriptionⅡ in the treatment of chronic heart failure (CHF) in Guangxi Province, China, and to explore a new approach to treat CHF with traditional Chinese medicine (TCM). Methods A multicenter, randomized, controlled clinical trial was performed in 7 hospitals from the east, west, south, and north areas of Guangxi Province. A total of 58 CHF patients with syndrome of deficiency of both Qi and Yin and blood stasis were randomly divided into control group (n=28) and treatment group (n=30). The control group was treated with conventional Western medicine for 6 months, while the treatment group was treated with Yangxin Tongmai PrescriptionⅡ in addition to conventional Western medicine for 6 months. The level of N-terminal pro-B-type natriuretic peptide (NT-proBNP), six-minute walk test (6MWT) result, left ventricular ejection fraction (LVEF), TCM syndrome score, clinical outcomes of TCM syndrome score and cardiac function, and Minnesota Living with Heart Failure Questionnaire (MLHFQ) score were compared between the two groups before and after treatment. Results After treatment, the treatment group had significantly improved level of NT-proBNP, 6MWT result, LVEF, and TCM syndrome score compared with the control group (P<0.05); in terms of the clinical outcome of TCM syndrome score, the treatment group had a significantly higher overall response rate than the control group (83.34% vs 60.72%, P<0.05); in terms of the clinical outcome of cardiac function, the treatment group also had a significantly higher overall response rate than the control group (86.66% vs 67.85%, P<0.05); the MLHFQ score significantly increased in both groups (P<0.05); the treatment group had a significantly more improvement in quality of life than the control group (P<0.05). Conclusion Yangxin Tongmai Prescription-2 can effectively improve the cardiac function and alleviate TCM syndrome in CHF patients with syndrome of deficiency of both Qi and Yin and blood stasis, which holds promise for clinical application. |
| Key words: chronic heart failure deficiency of both Qi and Yin and blood stasis Yangxin Tongmai PrescriptionⅡ N-terminal pro-B-type natriuretic peptide six-minute walk test traditional Chinese medicine syndrome score |
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