中医三型辨证论治慢性心力衰竭的临床疗效观察

发布时间：2019-01-16 04:52

【摘要】：目的:比较西药基础上的中医辨证论治方案与单纯西药方案治疗慢性心力衰竭(Chronic Heart Failure,CHF)的临床疗效的差异;探讨中医辨证论治方案在治疗CHF的特点及优势。方法:本研究符合纳入标准的CHF患者共150例,采用SPSS软件进行分层区组随机化,将患者分为治疗组和对照组,每组75例。并对纳入的CHF患者进行辨证分型(气虚血瘀证,气阴两虚血瘀证,阳虚血瘀证)。对照组予常规西药治疗;治疗组在西医治疗基础上按气虚血瘀证、气阴两虚血瘀证、阳虚血瘀证3证型,分别应用保元汤、养心通脉Ⅱ方、四逆汤和参附汤加减;两组均治疗6个月。观察血浆NT-pro BNP、6分钟步行试验和心功能疗效、单个症状疗效的变化。结果:治疗前各证型的性别、年龄、6分钟步行试验、血浆NT-pro BNP、心功能方面组间无显著差异。经过6个月治疗后,各证型的6分钟步行试验、血浆NT-pro BNP均显著优于治疗前(P0.05)。经6个月治疗后,对于气虚血瘀证、气阴两虚血瘀证,治疗组血浆NT-pro BNP均优于对照组(P0.05);对于阳虚血瘀证,两组间的血浆NT-pro BNP差异无统计学意义。经6个月治疗后,对于气虚血瘀证、气阴两虚血瘀证和阳虚血瘀证,与对照组比较,治疗组6分钟步行试验结果均优于对照组(P0.05),差异有统计学意义。经过6个月干预后,对于气虚血瘀证心功能疗效,治疗组优于对照组(P0.05);对于气阴两虚血瘀证、阳虚血瘀证,两组心功能较治疗前改善,且治疗组显效率、总有效率均高于对照组,但经秩和检验两组尚未达到统计学差异。本研究未观察到血尿便常规、肝、肾和电解质明显的异常。经过6个月干预后,在单项症状改善方面,两组改善主症疗效相当,本研究在改善心衰气短、自汗、盗汗、口干等症状症状上有明显优势。结论:西药基础上的中医辨证治疗CHF方案的临床疗效优于单纯西药方案;且无毒副作用,安全性好。
[Abstract]:Objective: to compare the clinical curative effect of traditional Chinese medicine (TCM) and traditional Chinese medicine (TCM) in the treatment of chronic heart failure (Chronic Heart Failure,CHF) on the basis of western medicine, and to explore the characteristics and advantages of TCM syndrome differentiation in the treatment of chronic heart failure (CHF). Methods: 150 patients with CHF were randomly divided into treatment group and control group with SPSS software. The patients with CHF were classified according to syndrome differentiation (Qi deficiency and blood stasis syndrome, qi and yin deficiency blood stasis syndrome, yang deficiency blood stasis syndrome). The control group was treated with routine western medicine, the treatment group was treated with three syndrome types: Qi deficiency and blood stasis syndrome, Qi Yin deficiency and blood stasis syndrome, Yang deficiency and blood stasis syndrome, respectively using Baoyuan decoction, Yangxintongmai 鈪，

本文编号：2409486