参芪益心汤联合心肺运动康复治疗慢性心力衰竭临床研究
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摘要
目的探讨参芪益心汤联合心肺运动康复治疗慢性心力衰竭(CHF)的临床疗效。方法选取医院2014年1月至2017年12月收治的CHF患者77例,根据随机数字表法分为观察组(38例)和对照组(39例)。根据两组患者的实际病情给予血管紧张素转换酶抑制剂和β-受体阻滞剂,以及洋地黄制剂类药物常规治疗CHF,对照组加用参芪益心汤,观察组在对照组治疗基础上联合心肺运动康复,两组均治疗2周。结果观察组总有效率为92. 11%,明显高于对照组的71. 79%(P <0. 05);治疗后,两组患者的左室舒张末内径(LVEDd)、左室收缩末内径(LVESd)均明显低于治疗前,且观察组低于对照组,但差异不显著(P> 0. 05);两组患者左室收缩末容量(LVESV)、左室舒张末容量(LVEDV)及左室射血分数(LVEF)均明显高于治疗前,且观察组明显高于对照组(P <0. 05);两组患者的最大通气量(MVV)明显高于治疗前,且观察组明显高于对照组(P <0. 05);观察组并发症发生率与对照组相当(5. 26%比5. 13%,P> 0. 05)。结论参芪益心汤联合心肺运动康复治疗CHF疗效更好,能较好地改善心肺功能,安全性高。
Objective To investigate the clinical effect of Shenqi Yixin Decoction combined with cardiopulmonary exercise rehabilitation in the treatment of chronic heart failure( CHF). Methods Totally 77 patients with CHF admitted to our hospital from January 2014 to December 2017 were selected and divided into the observation group( 38 cases) and the control group( 39 cases) according to the random number table method. The patients in the two groups were given angiotensin-converting enzyme inhibitors( ACEI) preparations,β-blockers and digitalis preparations for routine treatment of CHF according to the actual condition of patients,on this basis,the patients in the control group were given Shenqi Yixin Decoction,while the patients in the observation group were treated with cardiopulmonary exercise rehabilitation on the basis of the control group. The patients in the two groups were treated for 2 weeks. Results The total effective rate of the observation group was 92. 11%,which was significantly higher than 71. 79% of the control group( P < 0. 05). After treatment,the left ventricular end-diastolic diameter( LVEDd) and left ventricular end-systolic diameter( LVESd) in the two groups were significantly lower than those before treatment,and those in the observation group were lower those in the control group,but the difference was not significant( P > 0. 05). The left ventricular end-systolic volume( LVESV),left ventricular end-diastolic volume( LVEDV) and left ventricular ejection fraction( LVEF) in the two groups were significantly higher than those before treatment,and those in the observation group were significantly higher than those in the control group( P < 0. 05). The maximal ventialtory volume( MVV) in the two groups was significantly higher than that before treatment,and that in the observation group was significantly higher than that in the control group( P < 0. 05). The incidence rate of complications in the observation group was similar to that in the control group( 5. 26% vs. 5. 13%,P > 0. 05). Conclusion Shenqi Yixin Decoction combined with cardiopulmonary exercise rehabilitation in the treatment of patients with CHF has better curative effect and high safety,it can better improve their cardiopulmonary function.
Objective To investigate the clinical effect of Shenqi Yixin Decoction combined with cardiopulmonary exercise rehabilitation in the treatment of chronic heart failure( CHF). Methods Totally 77 patients with CHF admitted to our hospital from January 2014 to December 2017 were selected and divided into the observation group( 38 cases) and the control group( 39 cases) according to the random number table method. The patients in the two groups were given angiotensin-converting enzyme inhibitors( ACEI) preparations,β-blockers and digitalis preparations for routine treatment of CHF according to the actual condition of patients,on this basis,the patients in the control group were given Shenqi Yixin Decoction,while the patients in the observation group were treated with cardiopulmonary exercise rehabilitation on the basis of the control group. The patients in the two groups were treated for 2 weeks. Results The total effective rate of the observation group was 92. 11%,which was significantly higher than 71. 79% of the control group( P < 0. 05). After treatment,the left ventricular end-diastolic diameter( LVEDd) and left ventricular end-systolic diameter( LVESd) in the two groups were significantly lower than those before treatment,and those in the observation group were lower those in the control group,but the difference was not significant( P > 0. 05). The left ventricular end-systolic volume( LVESV),left ventricular end-diastolic volume( LVEDV) and left ventricular ejection fraction( LVEF) in the two groups were significantly higher than those before treatment,and those in the observation group were significantly higher than those in the control group( P < 0. 05). The maximal ventialtory volume( MVV) in the two groups was significantly higher than that before treatment,and that in the observation group was significantly higher than that in the control group( P < 0. 05). The incidence rate of complications in the observation group was similar to that in the control group( 5. 26% vs. 5. 13%,P > 0. 05). Conclusion Shenqi Yixin Decoction combined with cardiopulmonary exercise rehabilitation in the treatment of patients with CHF has better curative effect and high safety,it can better improve their cardiopulmonary function.
引文
[1]车琳,王乐民.慢性心力衰竭患者心肺储备功能评估在心脏康复中的意义[J].岭南心血管病杂志,2013,19(4):387-390.
[2] TRANKLE C,CANADA JM,BUCKLEY L,et al. Impaired myocardial relaxation with exercise determines peak aerobic exercise capacity in heart failure with preserved ejection fraction[J]. ESC Heart Fail,2017,4(3):351-355.
[3]高华,张振英,刘艳玲,等.运动康复对慢性心力衰竭患者的临床研究[J].中国临床医生杂志,2016,44(3):54-57.
[4] LE VD,JENSEN GV,KJLLER-HANSEN L. Prognostic Usefulness of Cardiopulmonary Exercise Testing for Managing Patients With Severe Aortic Stenosis[J]. Am J Cardiol,2017,120(5):844-849.
[5]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.中国心力衰竭诊断和治疗指南2014[J].中华心血管病杂志,2014,42(2):98-122.
[6]梁茂新,洪治平.对新版《中药新药临床研究指导原则》的若干意见[J].世界科学技术-中医药现代化,2004,6(5):40-43.
[7]刘莉,刘丽丽,隋艳波,等.参芪益心汤对CHF大鼠心肌代谢重构的影响[J].中医药信息,2014,31(4):102-104.
[8] PANAGOPOULOU N,KARATZANOS E,DIMOPOULOS S,et al.The effect of exercise training on characteristics of exercise oscillatory ventilation in chronic heart failure-Reply to the Letter to the Editor[J]. Eur J Prev Cardiol,2017,24(12):1285-1286.
[9]李四维.心肺运动试验在心脏康复评估中的应用[J].中国循环杂志,2017,32(4):331-333.
[10]刘艳红.参芪益心汤加减治疗慢性心力衰竭的临床疗效[J].世界最新医学信息文摘,2016,16(40):100-101.
[11]康铁朵,刘文娴,康云鹏,等.心脏康复运动在老年慢性心力衰竭患者治疗中的应用[J].中国医药,2017,12(2):171-174.
[12]路青,李首春,展春艳.参芪益心汤加减治疗慢性心力衰竭临床观察[J].内蒙古中医药,2016,35(13):43.
[13]李叶梅,李共梅,郭均涛,等.心脏康复模式对慢性心力衰竭患者心肺储备功能、生活质量及NT-proBNP水平的影响[J].检验医学与临床,2016,13(11):1462-1465.
[14]张振英,孙兴国,席家宁,等.心肺运动试验制定运动强度对慢性心力衰竭患者心脏运动康复治疗效果影响的临床研究[J].中国全科医学,2016,19(35):4303-4309.
[2] TRANKLE C,CANADA JM,BUCKLEY L,et al. Impaired myocardial relaxation with exercise determines peak aerobic exercise capacity in heart failure with preserved ejection fraction[J]. ESC Heart Fail,2017,4(3):351-355.
[3]高华,张振英,刘艳玲,等.运动康复对慢性心力衰竭患者的临床研究[J].中国临床医生杂志,2016,44(3):54-57.
[4] LE VD,JENSEN GV,KJLLER-HANSEN L. Prognostic Usefulness of Cardiopulmonary Exercise Testing for Managing Patients With Severe Aortic Stenosis[J]. Am J Cardiol,2017,120(5):844-849.
[5]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.中国心力衰竭诊断和治疗指南2014[J].中华心血管病杂志,2014,42(2):98-122.
[6]梁茂新,洪治平.对新版《中药新药临床研究指导原则》的若干意见[J].世界科学技术-中医药现代化,2004,6(5):40-43.
[7]刘莉,刘丽丽,隋艳波,等.参芪益心汤对CHF大鼠心肌代谢重构的影响[J].中医药信息,2014,31(4):102-104.
[8] PANAGOPOULOU N,KARATZANOS E,DIMOPOULOS S,et al.The effect of exercise training on characteristics of exercise oscillatory ventilation in chronic heart failure-Reply to the Letter to the Editor[J]. Eur J Prev Cardiol,2017,24(12):1285-1286.
[9]李四维.心肺运动试验在心脏康复评估中的应用[J].中国循环杂志,2017,32(4):331-333.
[10]刘艳红.参芪益心汤加减治疗慢性心力衰竭的临床疗效[J].世界最新医学信息文摘,2016,16(40):100-101.
[11]康铁朵,刘文娴,康云鹏,等.心脏康复运动在老年慢性心力衰竭患者治疗中的应用[J].中国医药,2017,12(2):171-174.
[12]路青,李首春,展春艳.参芪益心汤加减治疗慢性心力衰竭临床观察[J].内蒙古中医药,2016,35(13):43.
[13]李叶梅,李共梅,郭均涛,等.心脏康复模式对慢性心力衰竭患者心肺储备功能、生活质量及NT-proBNP水平的影响[J].检验医学与临床,2016,13(11):1462-1465.
[14]张振英,孙兴国,席家宁,等.心肺运动试验制定运动强度对慢性心力衰竭患者心脏运动康复治疗效果影响的临床研究[J].中国全科医学,2016,19(35):4303-4309.