苓桂术甘汤对心阳虚证慢性心力衰竭患者胃动力的影响

Effect of Linggui Zhugan Decoction on gastric motility in patients with chronic heart failure of heart yang deficiency syndrome

关键词:  苓桂术甘汤  慢性心力衰竭  莫沙必利  胃排空时间

Key words:  Linggui Zhugan Decoction  chronic heart failure  mosapride  gastric emptying time

摘要:

[目的] 观察苓桂术甘汤对心阳虚证慢性心力衰竭（CHF）患者胃动力的影响，探讨苓桂术甘汤治疗CHF患者胃动力下降的疗效，为临床治疗该病提供新思路。[方法] 将符合标准的90例患者按区组随机化法分为对照组、西药组和中药组，每组各30例，3组均给予规范化抗心力衰竭治疗，同时西药组加莫沙必利，中药组加苓桂术甘汤，分别对3组患者治疗前、治疗后2周及治疗后4周的消化道症状积分、胃排空时间、脑钠肽（BNP）水平、左室射血分数（LVEF）、生活质量评分等指标进行统计分析。[结果] 治疗后2周，与对照组相比，另两组患者胃肠道症状分级评分量表（GSRS）评分、BNP水平、生活质量评分均下降，胃排空时间缩短，且GSRS评分、胃排空时间及生活质量评分差异有统计学意义（P<0.05）；与西药组相比，中药组患者BNP水平、生活质量评分下降幅度更明显，且差异有统计学意义（P<0.05）。治疗后4周，与治疗后2周比，3组患者各指标均下降，差异有统计学意义（P<0.05）；较另两组患者，中药组患者各指标下降的幅度更明显，且差异有统计学意义（P<0.05）；两组患者的LVEF值在治疗后4周较治疗前均有所上升，且中药组患者LVEF值治疗前后差异有统计学意义（P<0.05）。[结论] 苓桂术甘汤可降低心阳虚证CHF患者GSRS评分、BNP水平，提高LVEF值，缩短胃排空时间，改善生活质量，且疗效优于莫沙必利。同时，随诊治疗时间的延长，疗效也更加明显。

Abstract:

[Objective] To observe the effect of Linggui Zhugan Decoction on gastric motility in patients with chronic heart failure (CHF) due to heart yang deficiency,and to explore the therapeutic effect of Linggui Zhugan Decoction on gastric motility decline in CHF patients,so as to provide new ideas for clinical treatment.[Methods] Ninety patients who met the standard were randomly divided into control group,Western medicine group and Chinese medicine group,with 30 cases in each group. All three groups were given standardized anti-heart failure treatment,while Western medicine group was given mosapride and Chinese medicine group was given Linggui Zhugan Decoction. The digestive tract symptom score,gastric emptying time,BNP level,left ventricular ejection fraction (EF%) and quality of life score of the three groups were statistically analyzed before treatment,2 weeks after treatment and 4 weeks after treatment.[Results] Two weeks after treatment,compared with the control group,the GSRS score,BNP level,and quality of life scores of the other two groups all decreased,and the gastric emptying time was shortened. The differences in GSRS score,gastric emptying time,and quality of life score were statistically significant (P<0.05);compared with the Western medicine group,the BNP level and quality of life score of the Chinese medicine group decreased more significantly,and the difference was statistically significant (P<0.05). After 4 weeks of treatment,compared with 2 weeks after treatment,the indicators of the three groups of patients all decreased,the difference was statistically significant (P<0.05);compared with the other two groups of patients,the decrease of each index of the patients in the Chinese medicine group was more obvious,and the difference was statistically significant (P<0.05). The EF value of two groups of patients increased after 4 weeks of treatment compared with that before treatment,and the difference of EF value of the patients in the Chinese medicine group before and after treatment was statistically significant (P<0.05).[Conclusion] Linggui Zhugan Decoction can reduce the GSRS score and BNP level of CHF patients with heart yang deficiency syndrome,increase the EF value,shorten the gastric emptying time,improve the quality of life,and the efficacy is better than mosapride. At the same time,with the prolonged treatment time,the curative effect is more obvious.