益气温阳活血利水法对慢性心力衰竭患者的临床疗效及机制研究
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摘要
[目的]观察并探讨益气温阳活血利水对慢性心力衰竭患者临床疗效及相关机制。
[方法]依据西医及中医诊断标准,选择中医诊断为心衰病,心阳亏虚,心血瘀阻证的150例慢性心力衰竭患者作为观察对象,将受试者按2：1随机分为治疗组(100例)及对照组(50例)。治疗组给予西医基础治疗上加用心阳片及益气益气温阳活血利水汤药方剂,对照组给予单纯西医基础治疗,治疗2周后,观察患者治疗前后《明尼苏达生活质量表》积分,心功能NYHA分级,中医症候积分,红细胞分布宽度(RDW)、肾素(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)、B型钠尿肽(BNP)等指标变化。利用SPSS11.5对结果进行统计分析。
[结果]治疗组与对照组进行配对t检验比较,结果提示两组间红细胞分布宽度、B型利钠肽、肾素、血管紧张素Ⅱ治疗前后差异具有统计学意义,(P<0.05),但两组醛固酮治疗前后差异无统计学意义(P>0.05),两组比较心率治疗前后差异具有统计学意义(P<0.05),但呼吸、血压治疗前后两组之间差异无统计学意义(P>0.05)。两组比较,治疗前后两组之间的中医症状积分、明尼苏达积分差异具有统计学意义(P<0.05),同时治疗组心功能提示总有效比率较对照组高(67%、52%)。
治疗组和对照组不良事件的发生率分别为15%、17.5%,经Fisher精确概率检验,组间差异无统计学意义(P>0.05),两组均未出现严重不良事件。
[结论]专科中医治疗方案(心阳片+专科益气温阳活血利水方)配合西医基础治疗,可显著降低红细胞分布宽度、B型利钠肽、肾素、血管紧张素Ⅱ以及中医症状积分、明尼苏达积分以及改善心功能,并且比单独以西医基础治疗效果更明显,不良反应未见明显增加,可认为是临床安全有效的药物。
Objective:Research the effects and mechanisms of YiQiWenYangHuoXueFa on patients with chronic heart failure
Methods This research reference the diagnostic criteria based on Western medicine and Chinese medicine. Research selected 150 patients with chronic heart failure as the observation object, whose syndrome type are xinyangkuixu, xinxueyuzhu. The subjects were randomly divided into 2:1 in the treatment Group (100 cases), and the control group (50 cases). The treatment group was given Xinyangpian and traditional Chinese medicine decoction of YiQiWenYangHuoXueFa basis of Western medicine treatment. The control group was just given western medicine treatment. After two week's treatment, the research observed the change of general project (heart rate, blood pressure, breathing etc.), the points Minnesota living with heart failure questionnaire, NYHA classification, TCM syndrome score, RDW, PRA, AngⅡ, ALD, BNP, etc. Using SPSS11.5 to statistics and analysis the results.
Result Ues paired t test to compare The treatment group and control group. The results suggest that red blood cell distribution width between the two groups, B-type natriuretic peptide, renin, angiotensinⅡstatistically significant difference between before and after treatment, (P<0.05), Aldosterone in both groups before and after treatment was no significant difference (P> 0.05), heart rate before and after treatment between the two groups was statistically significant (P<0.05), but respiration, blood pressure before and after treatment was no significant difference between the two groups(P>0.05). Between the two groups before and after treatment of Chinese medicine symptom scores between the two groups, the Minnesota Points significantly different (P<0.05), while prompt and effective treatment rate of heart function than the control group (67%、52%)
Comclusion Chinese medicine treatment (Xinyangpian+ traditional Chinese medicine decoction of YiQiWenYangHuoXueFa) with the Western basic treatment, can significantly reduce red blood cell distribution width, B-type natriuretic peptide, renin, angiotensinⅡand the TCM symptom scores., points and Minnesota Improve heart function, and basic treatment than Western medicine alone is more effective, no significant increase in adverse reactions, can be considered to be clinically safe and effective drug.
[方法]依据西医及中医诊断标准,选择中医诊断为心衰病,心阳亏虚,心血瘀阻证的150例慢性心力衰竭患者作为观察对象,将受试者按2：1随机分为治疗组(100例)及对照组(50例)。治疗组给予西医基础治疗上加用心阳片及益气益气温阳活血利水汤药方剂,对照组给予单纯西医基础治疗,治疗2周后,观察患者治疗前后《明尼苏达生活质量表》积分,心功能NYHA分级,中医症候积分,红细胞分布宽度(RDW)、肾素(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)、B型钠尿肽(BNP)等指标变化。利用SPSS11.5对结果进行统计分析。
[结果]治疗组与对照组进行配对t检验比较,结果提示两组间红细胞分布宽度、B型利钠肽、肾素、血管紧张素Ⅱ治疗前后差异具有统计学意义,(P<0.05),但两组醛固酮治疗前后差异无统计学意义(P>0.05),两组比较心率治疗前后差异具有统计学意义(P<0.05),但呼吸、血压治疗前后两组之间差异无统计学意义(P>0.05)。两组比较,治疗前后两组之间的中医症状积分、明尼苏达积分差异具有统计学意义(P<0.05),同时治疗组心功能提示总有效比率较对照组高(67%、52%)。
治疗组和对照组不良事件的发生率分别为15%、17.5%,经Fisher精确概率检验,组间差异无统计学意义(P>0.05),两组均未出现严重不良事件。
[结论]专科中医治疗方案(心阳片+专科益气温阳活血利水方)配合西医基础治疗,可显著降低红细胞分布宽度、B型利钠肽、肾素、血管紧张素Ⅱ以及中医症状积分、明尼苏达积分以及改善心功能,并且比单独以西医基础治疗效果更明显,不良反应未见明显增加,可认为是临床安全有效的药物。
Objective:Research the effects and mechanisms of YiQiWenYangHuoXueFa on patients with chronic heart failure
Methods This research reference the diagnostic criteria based on Western medicine and Chinese medicine. Research selected 150 patients with chronic heart failure as the observation object, whose syndrome type are xinyangkuixu, xinxueyuzhu. The subjects were randomly divided into 2:1 in the treatment Group (100 cases), and the control group (50 cases). The treatment group was given Xinyangpian and traditional Chinese medicine decoction of YiQiWenYangHuoXueFa basis of Western medicine treatment. The control group was just given western medicine treatment. After two week's treatment, the research observed the change of general project (heart rate, blood pressure, breathing etc.), the points Minnesota living with heart failure questionnaire, NYHA classification, TCM syndrome score, RDW, PRA, AngⅡ, ALD, BNP, etc. Using SPSS11.5 to statistics and analysis the results.
Result Ues paired t test to compare The treatment group and control group. The results suggest that red blood cell distribution width between the two groups, B-type natriuretic peptide, renin, angiotensinⅡstatistically significant difference between before and after treatment, (P<0.05), Aldosterone in both groups before and after treatment was no significant difference (P> 0.05), heart rate before and after treatment between the two groups was statistically significant (P<0.05), but respiration, blood pressure before and after treatment was no significant difference between the two groups(P>0.05). Between the two groups before and after treatment of Chinese medicine symptom scores between the two groups, the Minnesota Points significantly different (P<0.05), while prompt and effective treatment rate of heart function than the control group (67%、52%)
Comclusion Chinese medicine treatment (Xinyangpian+ traditional Chinese medicine decoction of YiQiWenYangHuoXueFa) with the Western basic treatment, can significantly reduce red blood cell distribution width, B-type natriuretic peptide, renin, angiotensinⅡand the TCM symptom scores., points and Minnesota Improve heart function, and basic treatment than Western medicine alone is more effective, no significant increase in adverse reactions, can be considered to be clinically safe and effective drug.
引文
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