参附强心汤治疗射血分数保留慢性心衰的临床研究

发布时间：2019-04-11 06:43

【摘要】：目的观察参附强心汤对射血分数保留的慢性心衰(阴阳两虚,水瘀内停证)患者超声心动图指标的影响及临床疗效情况,并初步探讨其作用机制。方法选取2014年8月-2015年8月来我院治疗并经检查确诊为射血分数保留的慢性心功能不全(阴阳两虚,水瘀内停证)的患者57例,随机分为对照组(28例)和观察组(29例)。对照组给予常规治疗,观察组在常规治疗基础上加用参附强心汤,2组均2周为1个疗程,1个疗程后进行疗效评估。观察2组治疗前后血浆脑钠肽(BNP)、6min步行距离(6MWT)、超声心动图等指标变化。结果 2组治疗后血浆BNP、6MWT均有改善(P0.05~0.01),但观察组下降显著(P0.05);超声心动图指标中左房(LAD)大小2组均未明显改善(P0.05),二尖瓣环舒张早期最大血流速度(E峰)/二尖瓣环室间隔及左室侧壁组织舒张早期最大速度(Ea)比值、肺动脉收缩压(PSA)2组患者均有明显改善(P0.05~0.01),与对照组相比,观察组变化幅度更为显著(P0.05)。结论参附强心汤能有效改善射血分数保留的慢性心功能不全患者血浆BNP水平、6min步行距离、超声心动图等指标。
[Abstract]:Objective to observe the effect of Shenfu Qiangxin decoction (Shenfu Qiangxin decoction) on echocardiographic indexes and clinical efficacy in patients with chronic heart failure (Yin-Yang deficiency, water stasis and internal arrest) preserved by ejection fraction (EF), and to explore its mechanism. Methods from August 2014 to August 2015, 57 patients with chronic cardiac insufficiency (deficiency of yin and yang, stagnation of water stasis) were randomly divided into two groups: control group (28 cases) and observation group (29 cases). The control group was given routine treatment, and the observation group was treated with Shenfu Qiangxin decoction on the basis of routine treatment. The two groups were treated for 2 weeks as a course of treatment, and the curative effect was evaluated after one course of treatment. Plasma brain natriuretic peptide (BNP), 6min walking distance (6MWT) and echocardiography were observed before and after treatment. Results Plasma BNP,6MWT was improved after treatment in both groups (P 0.05), but decreased significantly in the observation group (P0.05). The left atrium (LAD) size was not significantly improved in both groups (P0.05), and the ratio of peak E flow velocity (E peak) to mitral annulus interventricular septum and left ventricular lateral wall tissue early diastolic velocity (Ea) was not significantly improved in both groups (P0.05). Pulmonary artery systolic blood pressure (PSA)-2) was significantly improved in both groups (P 0.05). Compared with the control group, the range of changes in the observation group was more significant than that in the control group (P0.05). Conclusion Shenfu Qiangxin decoction can effectively improve the levels of plasma BNP, 6min walking distance and echocardiography in patients with chronic heart failure with reserved ejection fraction.
【作者单位】：南京中医药大学附属中西医结合医院;南京中医药大学第一临床医学院;南京中医药大学附属医院;
【基金】：江苏省科技厅科研计划资助课题(BE2015730)
【分类号】：R541.6

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