【摘要】：目的:比較西藥基礎(chǔ)上的中醫(yī)辨證論治方案與單純西藥方案治療慢性心力衰竭(Chronic Heart Failure,CHF)的臨床療效的差異;探討中醫(yī)辨證論治方案在治療CHF的特點(diǎn)及優(yōu)勢(shì)。方法:本研究符合納入標(biāo)準(zhǔn)的CHF患者共150例,采用SPSS軟件進(jìn)行分層區(qū)組隨機(jī)化,將患者分為治療組和對(duì)照組,每組75例。并對(duì)納入的CHF患者進(jìn)行辨證分型(氣虛血瘀證,氣陰兩虛血瘀證,陽虛血瘀證)。對(duì)照組予常規(guī)西藥治療;治療組在西醫(yī)治療基礎(chǔ)上按氣虛血瘀證、氣陰兩虛血瘀證、陽虛血瘀證3證型,分別應(yīng)用保元湯、養(yǎng)心通脈Ⅱ方、四逆湯和參附湯加減;兩組均治療6個(gè)月。觀察血漿NT-pro BNP、6分鐘步行試驗(yàn)和心功能療效、單個(gè)癥狀療效的變化。結(jié)果:治療前各證型的性別、年齡、6分鐘步行試驗(yàn)、血漿NT-pro BNP、心功能方面組間無顯著差異。經(jīng)過6個(gè)月治療后,各證型的6分鐘步行試驗(yàn)、血漿NT-pro BNP均顯著優(yōu)于治療前(P0.05)。經(jīng)6個(gè)月治療后,對(duì)于氣虛血瘀證、氣陰兩虛血瘀證,治療組血漿NT-pro BNP均優(yōu)于對(duì)照組(P0.05);對(duì)于陽虛血瘀證,兩組間的血漿NT-pro BNP差異無統(tǒng)計(jì)學(xué)意義。經(jīng)6個(gè)月治療后,對(duì)于氣虛血瘀證、氣陰兩虛血瘀證和陽虛血瘀證,與對(duì)照組比較,治療組6分鐘步行試驗(yàn)結(jié)果均優(yōu)于對(duì)照組(P0.05),差異有統(tǒng)計(jì)學(xué)意義。經(jīng)過6個(gè)月干預(yù)后,對(duì)于氣虛血瘀證心功能療效,治療組優(yōu)于對(duì)照組(P0.05);對(duì)于氣陰兩虛血瘀證、陽虛血瘀證,兩組心功能較治療前改善,且治療組顯效率、總有效率均高于對(duì)照組,但經(jīng)秩和檢驗(yàn)兩組尚未達(dá)到統(tǒng)計(jì)學(xué)差異。本研究未觀察到血尿便常規(guī)、肝、腎和電解質(zhì)明顯的異常。經(jīng)過6個(gè)月干預(yù)后,在單項(xiàng)癥狀改善方面,兩組改善主癥療效相當(dāng),本研究在改善心衰氣短、自汗、盜汗、口干等癥狀癥狀上有明顯優(yōu)勢(shì)。結(jié)論:西藥基礎(chǔ)上的中醫(yī)辨證治療CHF方案的臨床療效優(yōu)于單純西藥方案;且無毒副作用,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，

本文編號(hào)：2409486