益气泻肺冲剂治疗慢性心力衰竭的临床观察(1)
摘要 目的：观察比较益气泻肺冲剂与西药治疗慢性心力衰竭(CHF)的临床疗效。方法：选取2011年1月至2013年12月期间在北京市昌平区中医医院心血管病科确诊为慢性心力衰竭(CHF)的患者70例，随机分为对照组和观察组，每组35例。对照组按西医常规治疗方案进行治疗；观察组则在对照组基础上，根据辨证加用中药益气泻肺冲剂加减进行治疗。观察治疗前后心力衰竭患者的临床症状、体征、心肺运动试验(CPET)后指标、左室射血分数(LVEF)、左室舒张末径值(LVED)及血浆NT-proBNP水平。结果：治疗后，观察组症状积分及体征积分均低于对照组，其差异有统计学意义(P<0.05)；2组患者治疗后LVEF上升、LVED下降、血浆NT-proBNP水平下降，观察组LVEF上升、NT-proBNP指标下降较对照组明显(P<0.05)；观察组CPET试验结果(峰值氧耗量、无氧阈)提高，较对照组明显(P<0.05)。结论：益气泻肺冲剂能够有效改善慢性心力衰竭(CHF)患者的证候、临床症状，改善患者心功能。
关键词 益气泻肺冲剂；慢性心力衰竭；临床观察
Abstract Objective：To observe the clinical efficacy of Yiqi Xiefei granule in the treatment of chronic heart failure (CHF). Methods：Seventy patients with chronic heart failure (CHF) were randomly divided into control group (n=35) and treatment group (n=35). The control group was treated with routine western medicine. The treatment group was treated with traditional Chinese medicine Yiqi Xiefei granule on the basis of routine western treatment. Left ventricular ejection fraction (LVEF)， left ventricular end diastolic diameter (LVED) and NT-proBNP were measured before and after treatment. Clinical symptoms， signs， cardiopulmonary exercise test (CPET) results were recorded. Results：After treatment， symptom scores and signs scores of the treatment group were significantly lower than those of the control group (P<0.05). After treatment， LVEF increased， LVED decreased， NT-proBNP decreased， LVEF increased， NT-proBNP in both groups (P<0.05). After treatment， CPET (peak oxygen consumption， anaerobic threshold) in the treatment group were significantly higher than those in the control group (P<0.05). Conclusion：Yiqi Xiefei granule can effectively improve the symptoms of patients with chronic heart failure (CHF) as well as cardiac function.
Key Words Yiqi Xiefei granule； Congestive Heart Failure； Clinical Observation
中图分类号：R256.2文献标识码：Adoi：10.3969/j.issn.1673-7202.2017.06.021
心力衰竭(Heart Failure)，是指心脏因为各种心脏结构或功能性疾病原因，导致心室充盈及(或)射血功能受损而引起的一组临床综合征[1]。临床实践证明，心力衰竭疾病的临床严重程度是影响心力衰竭患者的预后的决定性因素，如何改善心力衰竭疾病的预后，已成为心脏专科领域的研究热点。笔者运用自拟中药方剂益气泻肺冲剂，治疗CHF患者35例，观察患者心功能及血浆NT-proBNP等指标变化，收到良好的疗效，现将结果报道如下。
1 资料与方法
1.1 一般資料 选取2011年1月至2013年12月期间在北京市昌平区中医医院心血管病科确诊为慢性心力衰竭(CHF)的患者70例，按照随机数字表法将患者随机分为观察组和对照组，每组35例。观察组患者中男19例，女16例；年龄47～78岁，平均年龄(58±18)岁；心力衰竭病史(53±28)个月，心功能Ⅱ级(HYNA心功能分级)患者5例、Ⅲ级23例、Ⅳ级7例。对照组患者中男16例，女19例；年龄52～79岁，平均年龄(65.4±9.6)岁；心力衰竭病史(45±29)个月，心功能Ⅱ级患者6例、Ⅲ级25例、Ⅳ级4例。2组患者在性别、年龄、病程等方面比较，差异均无统计学意义(P>0.05)，具有可比性。
1.2 诊断标准
1.2.1 西医诊断标准 心力衰竭的诊断标准，参照《实用内科学》[1]诊断标准。, 百拇医药(郭学军)
关键词 益气泻肺冲剂；慢性心力衰竭；临床观察
Abstract Objective：To observe the clinical efficacy of Yiqi Xiefei granule in the treatment of chronic heart failure (CHF). Methods：Seventy patients with chronic heart failure (CHF) were randomly divided into control group (n=35) and treatment group (n=35). The control group was treated with routine western medicine. The treatment group was treated with traditional Chinese medicine Yiqi Xiefei granule on the basis of routine western treatment. Left ventricular ejection fraction (LVEF)， left ventricular end diastolic diameter (LVED) and NT-proBNP were measured before and after treatment. Clinical symptoms， signs， cardiopulmonary exercise test (CPET) results were recorded. Results：After treatment， symptom scores and signs scores of the treatment group were significantly lower than those of the control group (P<0.05). After treatment， LVEF increased， LVED decreased， NT-proBNP decreased， LVEF increased， NT-proBNP in both groups (P<0.05). After treatment， CPET (peak oxygen consumption， anaerobic threshold) in the treatment group were significantly higher than those in the control group (P<0.05). Conclusion：Yiqi Xiefei granule can effectively improve the symptoms of patients with chronic heart failure (CHF) as well as cardiac function.
Key Words Yiqi Xiefei granule； Congestive Heart Failure； Clinical Observation
中图分类号：R256.2文献标识码：Adoi：10.3969/j.issn.1673-7202.2017.06.021
心力衰竭(Heart Failure)，是指心脏因为各种心脏结构或功能性疾病原因，导致心室充盈及(或)射血功能受损而引起的一组临床综合征[1]。临床实践证明，心力衰竭疾病的临床严重程度是影响心力衰竭患者的预后的决定性因素，如何改善心力衰竭疾病的预后，已成为心脏专科领域的研究热点。笔者运用自拟中药方剂益气泻肺冲剂，治疗CHF患者35例，观察患者心功能及血浆NT-proBNP等指标变化，收到良好的疗效，现将结果报道如下。
1 资料与方法
1.1 一般資料 选取2011年1月至2013年12月期间在北京市昌平区中医医院心血管病科确诊为慢性心力衰竭(CHF)的患者70例，按照随机数字表法将患者随机分为观察组和对照组，每组35例。观察组患者中男19例，女16例；年龄47～78岁，平均年龄(58±18)岁；心力衰竭病史(53±28)个月，心功能Ⅱ级(HYNA心功能分级)患者5例、Ⅲ级23例、Ⅳ级7例。对照组患者中男16例，女19例；年龄52～79岁，平均年龄(65.4±9.6)岁；心力衰竭病史(45±29)个月，心功能Ⅱ级患者6例、Ⅲ级25例、Ⅳ级4例。2组患者在性别、年龄、病程等方面比较，差异均无统计学意义(P>0.05)，具有可比性。
1.2 诊断标准
1.2.1 西医诊断标准 心力衰竭的诊断标准，参照《实用内科学》[1]诊断标准。, 百拇医药(郭学军)
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