调和营卫法对慢性心力衰竭心脏自主神经功能失衡的临床研究

发布时间：2018-01-07 01:15

本文关键词：调和营卫法对慢性心力衰竭心脏自主神经功能失衡的临床研究　出处：《时珍国医国药》2017年06期 　论文类型：期刊论文

【摘要】：目的观察调和营卫法对慢性心力衰竭心脏自主神经功能失衡的临床疗效。方法参照《中药新药临床研究指导原则》(试行)纳入慢性心力衰竭中医辨证属痰饮阻肺证型、阳虚水泛证型、气虚血瘀证型者共182例,随机数字表法分为试验组92例和对照组90例。对照组给予西医基础治疗加传统中医辨证治疗,试验组在对照组治疗基础上配以桂枝汤加减,两组均服药8周。观察调和营卫法对慢性心力衰竭患者心功能、N末端B型脑钠肽前体(NT-pro BNP)、左心室射血分数(LVEF)、每搏输出量(SV)、心率变异性(HRV)、中医症状积分、地高辛及利尿剂停减率的影响。结果治疗8周后,试验组心功能疗效总有效率为82.6%,对照组的总有效率56.6%,试验组优于对照组(P0.05);两组治疗前后比较,NT-pro BNP指标均下降,LVEF、SV、HRV指标均提高,两组比较试验组疗效优于对照组(P0.05或0.01);两组中医症状积分均有明显改善,试验组优于对照组(P0.05或0.01);试验组治疗后地高辛及利尿剂停减率优于对照组(P0.05)。结论调和营卫法能调节慢性心力衰竭患者心脏自主神经功能失衡,改善心功能及临床症状,优于传统中医治疗方药,在治疗心衰病各证型中具有普遍的适用性。
[Abstract]:Objective to observe the clinical effect of the method of reconciling Ying Wei on cardiac autonomic nervous dysfunction in patients with chronic heart failure (CHF). Methods according to the guiding principles of Clinical Research of New drugs of traditional Chinese Medicine (trial). The TCM syndrome differentiation of chronic heart failure belongs to phlegm and drink blocking lung syndrome. There were 182 cases of yang deficiency and water universal syndrome and qi deficiency and blood stasis syndrome, which were randomly divided into experimental group (n = 92) and control group (n = 90). The control group was treated with western medicine basic treatment plus traditional Chinese medicine syndrome differentiation. The experimental group was treated with Guizhi decoction on the basis of the control group and the two groups were treated for 8 weeks. N-terminal B-type brain natriuretic peptide precursor NT-pro BNPP, left ventricular ejection fraction (LVEF), SVV per stroke output, HRV, HRV, TCM symptom score. Results after 8 weeks of treatment, the total effective rate of cardiac function in the trial group was 82.6 and that in the control group was 56.6%. The test group was superior to the control group (P 0.05). Before and after treatment, the indexes of NT-pro BNP were decreased and the indexes of LVEFV / SVV were increased. The curative effect of the two groups was better than that of the control group (P0.05 or 0.01). The scores of TCM symptoms in the two groups were significantly improved, and the experimental group was better than the control group (P0.05 or 0.01). After treatment, the digoxin and diuretic withdrawal rate in the trial group was better than that in the control group (P0.050.Conclusion Harmonic Ying-Wei method can regulate cardiac autonomic nervous dysfunction and improve cardiac function and clinical symptoms in patients with chronic heart failure. Superior to traditional Chinese medicine, it has universal applicability in the treatment of heart failure.
【作者单位】：山东中医药大学;济宁市中医研究所;山东中医药高等专科学校;山东中医药大学附属医院;
【基金】：国家自然科学基金(No.81673970)
【分类号】：R259
【正文快照】： 慢性心力衰竭是多种心血管疾病发展的终末期阶段,尽管临床指南中强调β受体阻断剂、ACEI或ARB、醛固酮受体拮抗剂“金三角”方案在慢性心力衰竭治疗中的重要地位,但心衰患者的发病率及死亡率仍然较大[1]。研究证实,心力衰竭病变的严重程度与心率变异性(HRV)具有高度相关性[2],

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