本文關(guān)鍵詞：調(diào)和營(yíng)衛(wèi)法對(duì)慢性心力衰竭心臟自主神經(jīng)功能失衡的臨床研究　出處：《時(shí)珍國(guó)醫(yī)國(guó)藥》2017年06期 　論文類型：期刊論文

  更多相關(guān)文章： 慢性心力衰竭 心臟自主神經(jīng) 調(diào)和營(yíng)衛(wèi) 桂枝湯

【摘要】：目的觀察調(diào)和營(yíng)衛(wèi)法對(duì)慢性心力衰竭心臟自主神經(jīng)功能失衡的臨床療效。方法參照《中藥新藥臨床研究指導(dǎo)原則》(試行)納入慢性心力衰竭中醫(yī)辨證屬痰飲阻肺證型、陽(yáng)虛水泛證型、氣虛血瘀證型者共182例,隨機(jī)數(shù)字表法分為試驗(yàn)組92例和對(duì)照組90例。對(duì)照組給予西醫(yī)基礎(chǔ)治療加傳統(tǒng)中醫(yī)辨證治療,試驗(yàn)組在對(duì)照組治療基礎(chǔ)上配以桂枝湯加減,兩組均服藥8周。觀察調(diào)和營(yíng)衛(wèi)法對(duì)慢性心力衰竭患者心功能、N末端B型腦鈉肽前體(NT-pro BNP)、左心室射血分?jǐn)?shù)(LVEF)、每搏輸出量(SV)、心率變異性(HRV)、中醫(yī)癥狀積分、地高辛及利尿劑停減率的影響。結(jié)果治療8周后,試驗(yàn)組心功能療效總有效率為82.6%,對(duì)照組的總有效率56.6%,試驗(yàn)組優(yōu)于對(duì)照組(P0.05);兩組治療前后比較,NT-pro BNP指標(biāo)均下降,LVEF、SV、HRV指標(biāo)均提高,兩組比較試驗(yàn)組療效優(yōu)于對(duì)照組(P0.05或0.01);兩組中醫(yī)癥狀積分均有明顯改善,試驗(yàn)組優(yōu)于對(duì)照組(P0.05或0.01);試驗(yàn)組治療后地高辛及利尿劑停減率優(yōu)于對(duì)照組(P0.05)。結(jié)論調(diào)和營(yíng)衛(wèi)法能調(diào)節(jié)慢性心力衰竭患者心臟自主神經(jīng)功能失衡,改善心功能及臨床癥狀,優(yōu)于傳統(tǒng)中醫(yī)治療方藥,在治療心衰病各證型中具有普遍的適用性。
[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.
【作者單位】： 山東中醫(yī)藥大學(xué);濟(jì)寧市中醫(yī)研究所;山東中醫(yī)藥高等�？茖W(xué)校;山東中醫(yī)藥大學(xué)附屬醫(yī)院;
【基金】：國(guó)家自然科學(xué)基金(No.81673970)
【分類號(hào)】：R259
【正文快照】： 慢性心力衰竭是多種心血管疾病發(fā)展的終末期階段,盡管臨床指南中強(qiáng)調(diào)β受體阻斷劑、ACEI或ARB、醛固酮受體拮抗劑“金三角”方案在慢性心力衰竭治療中的重要地位,但心衰患者的發(fā)病率及死亡率仍然較大[1]。研究證實(shí),心力衰竭病變的嚴(yán)重程度與心率變異性(HRV)具有高度相關(guān)性[2],

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