温针灸联合复脉汤对慢性心力衰竭患者血管内皮功能及心功能影响研究
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摘要
目的:探讨温针灸联合复脉汤对慢性心力衰竭患者血管内皮功能及心功能影响。方法:选取我院收治的慢性心力衰竭患者84例,依据随机数字表法随机分为对照组和治疗组,各42例,对照组给予西医常规治疗;治疗组在对照组的基础上应用温针灸联合复脉汤干预治疗,两组患者均治疗4周。比较两组患者临床疗效、6 min步行距离测试、血管内皮功能检测及超声心动图疗效指标LVEF变化情况。结果:治疗后治疗组临床总有效率为95. 24%,对照组临床总有效率为76. 19%,治疗组较对照组改善明显,结果具有显著差异(P <0. 05);治疗组患者6 min步行距离测试均升高,较对照组升高更显著(P <0. 05);治疗组患者血管内皮功能均较对照组改善明显,结果具显著差异(P <0. 05);治疗组患者LVEF升高较对照组明显,差异具统计学意义(P <0. 05)。结论:温针灸联合复脉汤治疗慢性心力衰竭具有显著疗效,可起到疏通经脉、温补心阳、濡润心脉、复脉定悸的功效,且温针灸简单易行,对机体的创伤甚微,中药煎剂药效持久有力,故值得临床推广应用。
Objective: To explore the effect of needle-warming moxibustion combined with Fumai Decoction on vascular endothelial function and cardiac function in patients with chronic heart failure( CHF). Methods: 84 CHF patients were randomly divided into the control group( n = 42) and the treatment group( n = 42). The control group was treated with routine western medication; on which basis,the treatment group was also treated with needle-warming moxibustion combined with Fumai decoction for four weeks. The clinical efficacy,6-minute walking distance test,vascular endothelial examination,and LVEF changes were compared in the two groups. Results: After the treatment,the total effective rate of the treatment group was 95. 24%,which was significantly higher than 76. 19% of the control group( P < 0. 05). Scores of 6-minute walking distance were both increased in the two group,the increase was more significant in the treatment group( P < 0. 05). The vascular endothelial function in the treatment group was significantly improved than that in the control group( P < 0. 05).The increase of LVEF in the treatment group was significantly higher than that in the control group( P < 0. 05).Conclusion: Needle-warming moxibustion combined with Fumai Decoction has a significant curative effect on CHF. It can warm the meridians,invigorate Heart-yang,moisten Heart and improve palpitation. The therapy is simple and easy to operate with its less injury. TCM decoction has long-term efficacy,therefore the combination therapy is worth popularizing and applying in clinic.
Objective: To explore the effect of needle-warming moxibustion combined with Fumai Decoction on vascular endothelial function and cardiac function in patients with chronic heart failure( CHF). Methods: 84 CHF patients were randomly divided into the control group( n = 42) and the treatment group( n = 42). The control group was treated with routine western medication; on which basis,the treatment group was also treated with needle-warming moxibustion combined with Fumai decoction for four weeks. The clinical efficacy,6-minute walking distance test,vascular endothelial examination,and LVEF changes were compared in the two groups. Results: After the treatment,the total effective rate of the treatment group was 95. 24%,which was significantly higher than 76. 19% of the control group( P < 0. 05). Scores of 6-minute walking distance were both increased in the two group,the increase was more significant in the treatment group( P < 0. 05). The vascular endothelial function in the treatment group was significantly improved than that in the control group( P < 0. 05).The increase of LVEF in the treatment group was significantly higher than that in the control group( P < 0. 05).Conclusion: Needle-warming moxibustion combined with Fumai Decoction has a significant curative effect on CHF. It can warm the meridians,invigorate Heart-yang,moisten Heart and improve palpitation. The therapy is simple and easy to operate with its less injury. TCM decoction has long-term efficacy,therefore the combination therapy is worth popularizing and applying in clinic.
引文
[1]张勤帅.中药临床药师参与中西医结合治疗慢性心力衰竭用药管理模式探讨[D].北京:北京中医药大学,2017.
[2]王洋,徐烨华,熊爱琴,等.氧化苦参碱抑制异丙肾上腺素诱导大鼠慢性心力衰竭及对ADMA代谢通路的影响[J].中国中药杂志,2014,39(3):471-477.
[3]王翔,易省阳.慢性心力衰竭诊断及治疗新进展[J].中华实用诊断与治疗杂志,2015,29(1):10-12.
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[5]丁旭,林海龙,李雅洁,等.老年慢性心力衰竭患者临床特点分析[J].中国循证心血管医学杂志,2014,6(2):215-217.
[6]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.
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[8]张建,华琦.心力衰竭的诊断与治疗[M].北京:人民卫生出版社,2006:1-27.
[9] Crapo RO,Cusaburi R,Coates AL,et al. ATS statement:guidelines for the six-minute walk test[J]. Am J Respir Crit Care Med,2002,166(1):111-117.
[10]陈焕清,熊小强,段朝晖,等.麝香保心丸对冠心病血管内皮功能的影响及其作用机制[J].中成药,2009,31(11):1651-1654.
[11]田国芳,宋玉勤,张丽花,等.参芪复脉汤加减联合常规西医治疗慢性心力衰竭合并低血压状态疗效观察[J].河北中医,2017(9):1340-1343.
[12]张志刚,芮素芳.炙甘草汤与真武汤对老年慢性心衰患者血流动力学、血清MMP-9、TIMP-1及心肌酶谱影响的比较[J].中国生化药物杂志,2015,35(10):61-64.
[13]田国芳,宋玉勤,张丽花,等.参芪复脉汤加减联合常规西医治疗慢性心力衰竭合并低血压状态疗效观察[J].河北中医,2017,39(9):1340-1343.
[14]陈兆佳.温针灸治疗中度慢性心力衰竭患者脑钠肽变化的临床研究[J].中国医学工程,2016,24(10):33-35.
[15]温勇坚.温针灸治疗中度心衰患者脑钠肽变化分析[J].中国卫生工程学,2017,16(3):372-373.
[16]王奎英.炙甘草汤联合西药治疗心阳虚慢性心衰随机平行对照研究[J].实用中医内科杂志,2016,30(9):61-63.
[17]富嫱.炙甘草汤辨治缓慢性心律失常[J].实用中医内科杂志,2016,30(8):47-48.
[18]王树东,董宝强,陈文娜,等.电针“内关”穴对心肌缺血大鼠TXB2,PGF1α和心肌形态影响的实验研究[J].辽宁中医杂志,2015,42(2):413-415.
[19]温勇坚.温针灸治疗中度心衰患者脑钠肽变化分析[J].中国卫生工程学,2017,16(3):372-373.
[2]王洋,徐烨华,熊爱琴,等.氧化苦参碱抑制异丙肾上腺素诱导大鼠慢性心力衰竭及对ADMA代谢通路的影响[J].中国中药杂志,2014,39(3):471-477.
[3]王翔,易省阳.慢性心力衰竭诊断及治疗新进展[J].中华实用诊断与治疗杂志,2015,29(1):10-12.
[4]周亚滨,邬慧美,孙静,等.慢性心力衰竭中医治疗进展[J].辽宁中医药大学学报,2016,18(1):8-10.
[5]丁旭,林海龙,李雅洁,等.老年慢性心力衰竭患者临床特点分析[J].中国循证心血管医学杂志,2014,6(2):215-217.
[6]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.
[7]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:28-32,79-80.
[8]张建,华琦.心力衰竭的诊断与治疗[M].北京:人民卫生出版社,2006:1-27.
[9] Crapo RO,Cusaburi R,Coates AL,et al. ATS statement:guidelines for the six-minute walk test[J]. Am J Respir Crit Care Med,2002,166(1):111-117.
[10]陈焕清,熊小强,段朝晖,等.麝香保心丸对冠心病血管内皮功能的影响及其作用机制[J].中成药,2009,31(11):1651-1654.
[11]田国芳,宋玉勤,张丽花,等.参芪复脉汤加减联合常规西医治疗慢性心力衰竭合并低血压状态疗效观察[J].河北中医,2017(9):1340-1343.
[12]张志刚,芮素芳.炙甘草汤与真武汤对老年慢性心衰患者血流动力学、血清MMP-9、TIMP-1及心肌酶谱影响的比较[J].中国生化药物杂志,2015,35(10):61-64.
[13]田国芳,宋玉勤,张丽花,等.参芪复脉汤加减联合常规西医治疗慢性心力衰竭合并低血压状态疗效观察[J].河北中医,2017,39(9):1340-1343.
[14]陈兆佳.温针灸治疗中度慢性心力衰竭患者脑钠肽变化的临床研究[J].中国医学工程,2016,24(10):33-35.
[15]温勇坚.温针灸治疗中度心衰患者脑钠肽变化分析[J].中国卫生工程学,2017,16(3):372-373.
[16]王奎英.炙甘草汤联合西药治疗心阳虚慢性心衰随机平行对照研究[J].实用中医内科杂志,2016,30(9):61-63.
[17]富嫱.炙甘草汤辨治缓慢性心律失常[J].实用中医内科杂志,2016,30(8):47-48.
[18]王树东,董宝强,陈文娜,等.电针“内关”穴对心肌缺血大鼠TXB2,PGF1α和心肌形态影响的实验研究[J].辽宁中医杂志,2015,42(2):413-415.
[19]温勇坚.温针灸治疗中度心衰患者脑钠肽变化分析[J].中国卫生工程学,2017,16(3):372-373.