升陷汤加味联合西医综合治疗慢性心力衰竭气虚血瘀证患者的临床疗效观察

Clinical observation on the combined treatment of qi asthenia causing blood stasis syndrome patients in chronic heart failure with Modified Shengxian Decoction and Western medicine

关键词:  心力衰竭  气陷  升陷汤加味  气虚血瘀  临床疗效观察  中西医结合

Key words:  heart failure  gas collapse  Modified Shengxian Decoction  qi asthenia causing blood stasis  clinical efficacy observation  integrated traditional Chinese and Western medicine

摘要:

[目的] 观察升陷汤加味联合西医综合治疗慢性心力衰竭（CHF）气虚血瘀证患者的临床疗效。[方法] 将60例CHF气虚血瘀证患者随机分为对照组和治疗组，每组30例；对照组患者接受常规西医治疗，治疗组患者在对照组基础上加服升陷汤加味，疗程为4周。观察患者治疗前后Lee氏心衰评分、中医证候疗效评分、左室射血分数（LVEF）、血清N末端B型利钠肽原（NT-proBNP）水平，并观察统计两组的临床疗效。[结果] 治疗组心功能疗效有效率为93.34%（28/30），对照组为66.67%（20/30），治疗组中医证候疗效有效率为96.67%（29/30），对照组为70.00%（21/30），两组患者心功能疗效、中医证候疗效评分比较，差异均有统计学意义（P<0.05）。治疗后两组患者Lee氏心衰评分、中医证候疗效评分、血清NT-proBNP水平均较前降低，LVEF较前增加，差异均有统计学意义（P<0.05）。治疗组患者治疗后Lee氏心衰评分、中医证候疗效评分、血清NT-proBNP水平均低于对照组，LVEF高于对照组，差异均有统计学意义（P<0.05）。两组患者无明显不良事件发生。[结论] 升陷汤加味联合西医综合治疗可更好地提高CHF气虚血瘀证患者临床疗效，改善临床症状，降低血清NT-proBNP水平，提高LVEF，改善心功能。

Abstract:

[Objective] To observe the clinical effect of Modified Shengxian Decoction combined with Western medicine on chronic heart failure (CHF) patients with qi asthenia causing blood stasis syndrome.[Methods] The 60 CHF patients with qi asthenia causing blood stasis syndrome were randomly divided into control group and treatment group,30 cases in each group. Patients in the control group received conventional Western medicine treatment,patients in the treatment group on the basis of the control group added Modified Shengxian Decoction,the course of 4 weeks. Lee's heart failure score,traditional Chinese medicine (TCM) syndrome score,left ventricular ejection fraction(LVEF) and serum N-terminal B-type natriuretic peptide (NT-proBNP) levels were observed before and after treatment,and the clinical efficacy of the two groups were observed and statistically analyzed.[Results] The effective rate of cardiac function was 93.34% (28/30) in the treatment group and 66.67%(20/30) in the control group. The effective rate of TCM syndrome in the treatment group was 96.67%(29/30) in the treatment group and 70.00%(21/30) in the control group.The differences were statistically significant(P<0.05). After treatment,Lee's heart failure score,TCM syndrome score and serum NT-proBNP level in the two groups were lower than before,and LVEF was increased,the differences were statistically significant(P<0.05). Lee's heart failure score,TCM syndrome score and serum NT-proBNP level in the treatment group were lower than those in the control group,while LVEF was higher than those in the control group,the differences were statistically significant(P<0.05). No obvious adverse events occurred in 2 groups.[Conclusion] Modified Shengxian Decoction combined with Western medicine comprehensive treatment can better improve the clinical efficacy of CHF patients with qi asthenia causing blood stasis syndrome,improve clinical symptoms,reduce serum NT-proBNP level, improve LVEF,improve cardiac function.