穴位敷贴治疗慢性心力衰竭阳气亏虚、血瘀水停证疗效观察
|
摘要
目的:观察穴位敷贴治疗慢性心力衰竭(chronic heart failure,CHF)阳气亏虚、血瘀水停证的临床疗效。方法:选取2016年1月1日至2017年12月31日山东省济宁市中医院治疗的CHF患者160例,随机分为治疗组和对照组,每组80例。两组均给予常规西医基础治疗,治疗组另给予穴位贴敷治疗。观察两组患者临床疗效、6 min步行距离、血浆NTpro BNP、明尼苏达心力衰竭生存质量量表(Minnesota living with heart failure questionnaire,MLHFQ)、生活质量SF-36量表变化情况。结果:治疗组有效率为89. 87%,对照组有效率为72. 15%,治疗组有效率高于对照组,有显著统计学意义(P=0. 006 <0. 01);治疗组治疗后血浆NT-pro BNP水平明显低于对照组,具有显著统计学意义(P=0. 000 <0. 01);治疗组治疗后6 min步行距离明显高于对照组,具有统计学意义(P=0. 000 <0. 01);治疗组治疗后MLHFQ评分明显低于对照组,具有统计学意义(P=0. 000 <0. 01);治疗组治疗后SF-36生命质量评分明显高于对照组,具有统计学意义(P=0. 000 <0. 01)。结论:穴位敷贴能改善CHF阳气亏虚、血瘀水停证患者心功能,提高患者生活质量,改善患者预后。
Objective: To observe the clinical curative effect of point Application on chronic heart failure( CHF) with yang-qi deficiency and blood stasis and water retention syndrome. Methods: A total of 60 CHF patients treated by Jining Hospital of TCM Shandong Province from January 1,2016 to December 31,2017 were randomly divided into the treatment group and the control group,with 80 cases in each group. Both groups were given routine basic treatment of Western medicine,while the treatment group was additionally given point application therapy. The clinical efficacy,6-minute walking distance,plasma NT-pro BNP,Minnesota living with Heart Failure Questionnaire( MLHFQ) and changes of SF-36 scale of quality of life were observed. Results: The effective rate of the treatment group was 89. 87%,and that of the control group was 72. 15%. The effective rate of the treatment group was higher than that of the control group,and the difference was statistically significant( P = 0. 006 < 0. 01). After the treatment,the plasma NT-pro BNP level in the treatment group was significantly lower than that in the control group,and the difference was statistically significant( P = 0. 000 < 0. 01). The walking distance in the treatment group was significantly higher than that in the control group and the difference was statistically significant( P = 0. 000 < 0. 01). After the treatment,the MLHFQ score in the treatment group was significantly lower than that in the control group and the difference was statistically significant( P = 0. 000 <0. 01). The SF-36 quality of life score in the treatment group was significantly higher than that in the control group and the difference was statistically significant( P = 0. 000 < 0. 01). Conclusion: Point application can improve the cardiac function of CHF patients with deficiency of yang-qi and stagnation of blood stasis and water retention,enhance the quality of life and prognosis of patients.
Objective: To observe the clinical curative effect of point Application on chronic heart failure( CHF) with yang-qi deficiency and blood stasis and water retention syndrome. Methods: A total of 60 CHF patients treated by Jining Hospital of TCM Shandong Province from January 1,2016 to December 31,2017 were randomly divided into the treatment group and the control group,with 80 cases in each group. Both groups were given routine basic treatment of Western medicine,while the treatment group was additionally given point application therapy. The clinical efficacy,6-minute walking distance,plasma NT-pro BNP,Minnesota living with Heart Failure Questionnaire( MLHFQ) and changes of SF-36 scale of quality of life were observed. Results: The effective rate of the treatment group was 89. 87%,and that of the control group was 72. 15%. The effective rate of the treatment group was higher than that of the control group,and the difference was statistically significant( P = 0. 006 < 0. 01). After the treatment,the plasma NT-pro BNP level in the treatment group was significantly lower than that in the control group,and the difference was statistically significant( P = 0. 000 < 0. 01). The walking distance in the treatment group was significantly higher than that in the control group and the difference was statistically significant( P = 0. 000 < 0. 01). After the treatment,the MLHFQ score in the treatment group was significantly lower than that in the control group and the difference was statistically significant( P = 0. 000 <0. 01). The SF-36 quality of life score in the treatment group was significantly higher than that in the control group and the difference was statistically significant( P = 0. 000 < 0. 01). Conclusion: Point application can improve the cardiac function of CHF patients with deficiency of yang-qi and stagnation of blood stasis and water retention,enhance the quality of life and prognosis of patients.
引文
[1]潘光明,邹旭,盛小刚,等.中医药治疗慢性心力衰竭的优势和切入点[J].辽宁中医药大学学报,2011,13(4):44-45.
[2]孙龙飞,安冬青,郭龙龙.心力衰竭的中医药治疗优势与特色[J].中国中医急症,2016,25(3):452-456.
[3]陈晓虎.中医药在心力衰竭防治中的地位和作用[J].中国中西医结合杂志,2017,37(10):1157-1158.
[4]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.慢性心力衰竭诊断治疗指南[J].中华心血管病杂志,2007,35(12):1076.
[5] The criteria Committee of New York Heart Association. 1994 revisions to classification of fuctional capacity and objective assessment of patients with disease of the heart[J]. Circulation,1994,90(1):644-645.
[6]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:130.
[7]解琳莉,赵勇,张为,等.从气、血、水关系探析心水之病机与治疗[J].中华中医药杂志,2012,27(8):2113-2115.
[8]李甜,赵英强.从《黄帝内经》谈心衰病机[J].河南中医,2013,33(7):1182.
[9]张晓伟,杨海燕,金艳蓉.慢性心力衰竭患者的中医防治[J].河南中医,2013,33(9):1474-1475.
[10]刁殿军.益气温阳法治疗慢性心力衰竭的临床疗效观察[J].天津中医药,2010,27(6):456-457.
[11]林家茂,李珩,郭伟星,等.益气温阳、活血利水方药治疗慢性心力衰竭大鼠实验效应的系统评价[J].中华中医药杂志,2014,29(6):1949-1953.
[12]郭悦.益气活血温阳法治疗慢性心力衰竭疗效及对NTproBNP、hs-CRP的影响[J].心脏杂志,2018,30(2):196-199.
[13]王建明,刘宁.穴位敷贴对不稳定型心绞痛患者高敏C反应蛋白的影响[J].世界中西医结合杂志,2017,12(2):245-248.
[14]于美丽,胡晓美,徐浩.“冬病夏治”三伏贴防治冠心病心绞痛的前瞻性队列研究[J].中西医结合心脑血管病杂志,2015,13(9):1086-1089.
[15]李静然.“三伏贴敷”治疗慢性呼吸系统疾病的疗效观察及可推广性分析[J].中国医学工程,2017,25(7):108-110.
[16]蒋洪强,张金国.黄芪及其衍生物对慢性心力衰竭大鼠模型保护作用的研究进展[J].上海中医药杂志,2015,49(10):90-93.
[17]李庆.附子汤对慢性心力衰竭大鼠心室重构及肾素血管紧张素醛固酮系统的影响[J].新中医,2015,47(1):222-224.
[18]张国顺,白义萍,王小兰,等.葶苈子抗心衰有效组分筛选及其作用机制分析[J].中国实验方剂学杂志,2017,23(4):118-125.
[19]宝璐尔,张林,周晓慧,等.强心方组分对心肌梗死后心力衰竭小鼠心功能的影响[J].同济大学学报(医学版),2017,38(6):6-11.
[20]瞿珍清,林秀琴,何显荣,等.丹参酮IIA磺酸钠对慢性心力衰竭患者冠状动脉血流动力学的影响探析[J].中医临床研究,2016,8(6):16-19.
[21]高军太.任建华老师应用红花治疗心力衰竭的经验总结[J].中医临床研究,2017,9(2):29-30.
[22]陈建梅,史爱梅,叶炳华,等.红花黄色素对冠心病心衰患者脑钠肽水平的影响[J].中国实用医药,2017,12(29):118-119.
[23]华新宇,张令令,杨庆堂.三七总皂苷治疗慢性心力衰竭的疗效观察[J].实用医学杂志,2011,27(6):1122.
[24]华新宇,王晓兰,康美清,等.三七总皂苷对慢性心力衰竭患者心功能及血浆细胞凋亡相关因子的影响[J].中国中医急症,2014,23(12):2368-2370.
[25]李忠芳,田耀平.中药商陆的研究进展[J].安徽农学通报,2013,19(5):108-112.
[2]孙龙飞,安冬青,郭龙龙.心力衰竭的中医药治疗优势与特色[J].中国中医急症,2016,25(3):452-456.
[3]陈晓虎.中医药在心力衰竭防治中的地位和作用[J].中国中西医结合杂志,2017,37(10):1157-1158.
[4]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.慢性心力衰竭诊断治疗指南[J].中华心血管病杂志,2007,35(12):1076.
[5] The criteria Committee of New York Heart Association. 1994 revisions to classification of fuctional capacity and objective assessment of patients with disease of the heart[J]. Circulation,1994,90(1):644-645.
[6]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:130.
[7]解琳莉,赵勇,张为,等.从气、血、水关系探析心水之病机与治疗[J].中华中医药杂志,2012,27(8):2113-2115.
[8]李甜,赵英强.从《黄帝内经》谈心衰病机[J].河南中医,2013,33(7):1182.
[9]张晓伟,杨海燕,金艳蓉.慢性心力衰竭患者的中医防治[J].河南中医,2013,33(9):1474-1475.
[10]刁殿军.益气温阳法治疗慢性心力衰竭的临床疗效观察[J].天津中医药,2010,27(6):456-457.
[11]林家茂,李珩,郭伟星,等.益气温阳、活血利水方药治疗慢性心力衰竭大鼠实验效应的系统评价[J].中华中医药杂志,2014,29(6):1949-1953.
[12]郭悦.益气活血温阳法治疗慢性心力衰竭疗效及对NTproBNP、hs-CRP的影响[J].心脏杂志,2018,30(2):196-199.
[13]王建明,刘宁.穴位敷贴对不稳定型心绞痛患者高敏C反应蛋白的影响[J].世界中西医结合杂志,2017,12(2):245-248.
[14]于美丽,胡晓美,徐浩.“冬病夏治”三伏贴防治冠心病心绞痛的前瞻性队列研究[J].中西医结合心脑血管病杂志,2015,13(9):1086-1089.
[15]李静然.“三伏贴敷”治疗慢性呼吸系统疾病的疗效观察及可推广性分析[J].中国医学工程,2017,25(7):108-110.
[16]蒋洪强,张金国.黄芪及其衍生物对慢性心力衰竭大鼠模型保护作用的研究进展[J].上海中医药杂志,2015,49(10):90-93.
[17]李庆.附子汤对慢性心力衰竭大鼠心室重构及肾素血管紧张素醛固酮系统的影响[J].新中医,2015,47(1):222-224.
[18]张国顺,白义萍,王小兰,等.葶苈子抗心衰有效组分筛选及其作用机制分析[J].中国实验方剂学杂志,2017,23(4):118-125.
[19]宝璐尔,张林,周晓慧,等.强心方组分对心肌梗死后心力衰竭小鼠心功能的影响[J].同济大学学报(医学版),2017,38(6):6-11.
[20]瞿珍清,林秀琴,何显荣,等.丹参酮IIA磺酸钠对慢性心力衰竭患者冠状动脉血流动力学的影响探析[J].中医临床研究,2016,8(6):16-19.
[21]高军太.任建华老师应用红花治疗心力衰竭的经验总结[J].中医临床研究,2017,9(2):29-30.
[22]陈建梅,史爱梅,叶炳华,等.红花黄色素对冠心病心衰患者脑钠肽水平的影响[J].中国实用医药,2017,12(29):118-119.
[23]华新宇,张令令,杨庆堂.三七总皂苷治疗慢性心力衰竭的疗效观察[J].实用医学杂志,2011,27(6):1122.
[24]华新宇,王晓兰,康美清,等.三七总皂苷对慢性心力衰竭患者心功能及血浆细胞凋亡相关因子的影响[J].中国中医急症,2014,23(12):2368-2370.
[25]李忠芳,田耀平.中药商陆的研究进展[J].安徽农学通报,2013,19(5):108-112.