评价益气养阴、活血利水法及血液超滤治疗对老年慢性心力衰竭急性失代偿患者的疗效

发布时间：2018-04-18 01:03

本文选题：益气养阴 + 活血利水法　；参考：《北京中医药大学》2017年硕士论文

【摘要】：目的:观察益气养阴、活血利水法及血液超滤治疗对老年慢性心衰急性失代偿患者的疗效方法:回顾分析49例慢性心衰急性失代偿期老年住院患者,分别配合益气养阴、活血利水法中药(26例,称为中药组)和血液超滤治疗(23例,称为超滤组),在常规西药治疗的基础上,中药治疗组在基础方"生黄芪10-30g、党参10-30g、石斛15-30g、毛冬青 10-20g、茯苓 10-30g、桂枝 10-20g、猪苓 10-20g、泽兰 10-20g、白术 10-20g、灸甘草5-6g"之上随证加减,超滤治疗组超滤方案为脱水速度200-350ml/h,超滤脱水量500ml-2000ml。观察2组治疗前及治疗后10天左右的心功能分级、NT-proBNP、eGFR的变化,并通过SPSS 22.0统计软件分析两组组内及组间的差异。结果:1.组内比较,中药组及超滤组治疗后NT-proBNP均较治疗前明显下降(P0.01);中药组及超滤组治疗后NT-proBNP分别下降33.2±33.8%、41.1±25.5%;超滤组治疗后NT-proBNP下降百分数的95%置信区间为29.8%～52.5%,中药组为19.6～46.9%,组间比较,超滤组与中药组NT-proBNP下降百分数未达到统计学差异(P0.05),但超滤组NT-proBNP下降百分数置信区间较中药组更高且集中。2.组内比较,两组治疗前后eGFR无显著差异(P0.05),组间比较亦无显著差异(P0.05)。3.两组治疗前后心功能改善总有效率分别为84.6%、91.3%,组间比较无显著差异(P0.05)。结论:在常规西药治疗的基础上,配合益气养阴、活血利水法中药或血液超滤治疗,均可能明显改善患者心功能、降低NT-proBNP;同时,两种治疗方法均未引起eGFR下降。
[Abstract]:Objective: to observe the curative effect of supplementing qi and nourishing yin, activating blood circulation and promoting water and blood ultrafiltration in treating senile patients with acute decompensation of chronic heart failure. Methods: 49 cases of senile inpatients with acute decompensation of chronic heart failure were analyzed retrospectively.On the basis of routine western medicine treatment, 26 cases were treated by activating blood circulation and promoting water, and 23 cases were treated by ultrafiltration.The traditional Chinese medicine treatment group was added and subtracted from the basic prescription "ShengHuangqi 10-30g, Codonopsis pilosula 10-30g, Dendrobium candidum 15-30g, Maotongqian 10-20g, Poria cocos 10-30g, Cinnamomum umbellata 10-20g, Zhelan 10-20g, Atractylodes macrocephalae 10-20g, moxibustion licorice 5-6g". The ultrafiltration treatment group was treated with dehydration rate 200-350 ml / h and ultrafiltration dehydration volume 500ml-2000ml.The changes of NT-proBNPN eGFR were observed before and 10 days after treatment in the two groups, and the differences between the two groups were analyzed by SPSS 22.0 software.The result is 1: 1.After treatment, NT-proBNP in the Chinese medicine group and ultrafiltration group was significantly lower than that in the pre-treatment group, NT-proBNP in the Chinese medicine group and ultrafiltration group decreased 33.2 卤33.8 卤41.1 卤25.50.The 95% confidence interval of the decrease in the percentage of NT-proBNP in the ultrafiltration group after treatment was 29.80.52.5, and that in the traditional Chinese medicine group was 19.66.9.The decrease percentage of NT-proBNP in ultrafiltration group and traditional Chinese medicine group was not significant difference (P 0.05), but the confidence interval of decreasing percentage of NT-proBNP in ultrafiltration group was higher than that in traditional Chinese medicine group.There was no significant difference in eGFR between the two groups before and after treatment (P 0.05), and there was no significant difference between the two groups (P 0.05).The total effective rate of heart function improvement in the two groups before and after treatment was 84.6 and 91.3, respectively. There was no significant difference between the two groups (P 0.05).Conclusion: on the basis of routine western medicine therapy combined with supplementing qi and nourishing yin activating blood circulation and promoting water therapy or blood ultrafiltration treatment can obviously improve the heart function of patients and reduce NT-proBNP.The two treatment methods have not caused the decrease of eGFR at the same time.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.6

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