四逆汤合参附汤治疗慢性心力衰竭阳虚血瘀证
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摘要
目的探讨四逆汤合参附汤治疗广西地区慢性心力衰竭(CHF)阳虚血瘀证患者的临床疗效和生活质量,为中医药指导CHF提供资料。方法纳入7家医院CHF阳虚血瘀证患者病例,随机分为治疗组26例、对照组27例,治疗组在对照组治疗基础上加服四逆汤合参附汤加减。疗程为6个月。比较2组患者的心功能指标(6MWT、LVEF、NT-proBNP)、中医四诊要素积分临床疗效、中医四诊要素积分、明尼苏达心力衰竭生活质量调查表(MLHFQ)。结果治疗组心功能分级、中医四诊要素积分临床疗效有效率较对照组高,中医四诊要素积分、6MWT、LVEF、NT-proBNP、MLHFQ各领域积分改善均优于对照组(P<0.05)。结论四逆汤合参附汤可改善广西地区CHF阳虚血瘀证患者的心功能和提高生活质量。
Objective To investigate the effect of Sini decoction and Shenfu decoction on the clinical effect and quality of life of patients with yang deficiency and blood stasis syndrome of chronic heart failure in Guangxi, and to provide information for guiding CHF. Methods The patients with CHF of yang deficiency and blood stasis syndrome in seven hospitals were randomly divided into treatment group(n = 26) and control group(n = 27). The treatment group was treated with Sini decoction and Shenfu decoction based on the treatment of control group. The course of treatment was 6 months. The cardiac function indexes of the two groups were compared, such as 6 MWT, LVEF, NT-proBNPP and the clinical efficacy of TCM four-diagnosis factor integral, TCM four-diagnosis factor score, and Minnesota heart failure quality of life questionnaire(MLHFQ). Results The effective rate of the treatment group was higher than that of the control group. The score of TCM four diagnostic factors, 6 MWT, LVEF, NT-pro BNP and the MLHFQ domain integral is better than that of the control group(P < 0.05). Conclusion Sini decoction and Shenfu decoction can improve the cardiac function and quality of life of CHF patients with yang deficiency and blood stasis syndrome.
Objective To investigate the effect of Sini decoction and Shenfu decoction on the clinical effect and quality of life of patients with yang deficiency and blood stasis syndrome of chronic heart failure in Guangxi, and to provide information for guiding CHF. Methods The patients with CHF of yang deficiency and blood stasis syndrome in seven hospitals were randomly divided into treatment group(n = 26) and control group(n = 27). The treatment group was treated with Sini decoction and Shenfu decoction based on the treatment of control group. The course of treatment was 6 months. The cardiac function indexes of the two groups were compared, such as 6 MWT, LVEF, NT-proBNPP and the clinical efficacy of TCM four-diagnosis factor integral, TCM four-diagnosis factor score, and Minnesota heart failure quality of life questionnaire(MLHFQ). Results The effective rate of the treatment group was higher than that of the control group. The score of TCM four diagnostic factors, 6 MWT, LVEF, NT-pro BNP and the MLHFQ domain integral is better than that of the control group(P < 0.05). Conclusion Sini decoction and Shenfu decoction can improve the cardiac function and quality of life of CHF patients with yang deficiency and blood stasis syndrome.
引文
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[9]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.
[10]ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories.Erratum:ATS statement:guidelines for the Six-Minute walk test[J].American Journal of Respiratory and Critical Care Medicine,2016,193(10):1185.
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[12]朱明军,李利锋,王永霞,等.慢性心力衰竭中医证型与生存质量关系的初步研究[A].中国中西医结合学会心血管病专业委员会.第十次中国中西医结合学会心血管病学术大会暨第五次江西省中西医结合学会心血管病学术大会论文汇编[C]//中国中西医结合学会心血管病专业委员会:中国中西医结合学会,南昌:2010.
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[14]LAU A J,TOH D F,CHUA T K,et al.Antiplatelet and anticoagulant effects of Panax notoginseng:comparison of raw and steamed Panax notoginseng with Panax ginseng and Panax quinquefolium[J].Journal of Ethnopharmacology,2009,125(3):380-386.
[15]石宏志,高南南,李勇枝,等.泽兰有效部分对血小板聚集和血栓形成的影响[J].中草药,2003,34(10):923-926.
[16]石宏志.泽兰对血液流变学影响的研究与进展[J].中国临床康复,2004,8(34):7776-7777.
[17]聂波,李佳彦,王硕仁,等.泽兰对人冠状动脉平滑肌细胞增殖的影响[J].中西医结合心脑血管病杂志,2010,8(9):1078-1080.
[18]欧阳熙林,韦新杰,杨城.扶芳藤的化学成分药理及其质量控制方法[J].时珍国医国药,2014,25(4):935-937.
[19]李成林,熊世磊,卢健琪,等.扶芳藤对缺氧/复氧损伤后人心内膜微血管内皮细胞内皮素-1和一氧化氮水平的影响[J].中华中医药杂志,2016,31(7):2835-2837.
[20]李成林,常拓,卢健棋,等.壮药扶芳藤对缺氧/复氧后人心内膜微血管内皮细胞VEGFR-2、VEGF的影响[J].辽宁中医药大学学报,2016,18(8):21-23.
[21]周倩,孙立立.蜜炙对甘草化学成分影响研究[J].中国药学杂志,2013,48(10):768-772.
[22]王龙,王化良.炙甘草抗心律失常临床应用研究[J].吉林中医药,2012,32(10):1074-1076.
[23]李美平,何承敏,胡继鹰,等.甘草汤对大鼠心肌缺血再灌注损伤的影响[J].湖北中医药大学学报,2011,13(1):9-11.
[2]中国中西医结合学会心血管疾病专业委员会,中国医师协会中西医结合医师分会心血管病学专家委员会.慢性心力衰竭中西医结合诊疗专家共识[J].中西医结合心脑血管病杂志,2016,14(3):225-232.
[3]邓小敏,邱全,柳彬,等.729例广西成年人中医体质类型特点分析[J].广西中医学院学报,2010,13(4):111-112.
[4]彭志林,卢健棋,温志浩,等.运用德尔菲法对广西区域慢性心力衰竭四诊要素常见程度专家调查[J].新中医,2016,48(12):9-11.
[5]朱博杰,杨清华,卢健棋,等.广西慢性心力衰竭中医临床证候及要素的回顾性研究[J].中西医结合心脑血管病杂志,2016,14(24):2867-2870.
[6]卢健棋,李苏依,温志浩,等.广西地区慢性心力衰竭中医证候要素分布规律文献分析[J].中西医结合心脑血管病杂志,2016,14(3):286-288.
[7]卢健棋,李苏依,温志浩,等.广西地区中医治疗慢性心力衰竭临床研究文献评价[J].长春中医药大学学报,2015,31(6):1191-1194,1198.
[8]胡亮.运用Delphi法对广西部分区域慢性心力衰竭中医治疗方案的调查研究[D].南宁:广西中医药大学,2016.
[9]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.
[10]ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories.Erratum:ATS statement:guidelines for the Six-Minute walk test[J].American Journal of Respiratory and Critical Care Medicine,2016,193(10):1185.
[11]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,2002:77-85.
[12]朱明军,李利锋,王永霞,等.慢性心力衰竭中医证型与生存质量关系的初步研究[A].中国中西医结合学会心血管病专业委员会.第十次中国中西医结合学会心血管病学术大会暨第五次江西省中西医结合学会心血管病学术大会论文汇编[C]//中国中西医结合学会心血管病专业委员会:中国中西医结合学会,南昌:2010.
[13]吕兰薰,孙喜才.常用中药药理[M].西安:陕西科学技术出版社,1997:190-196.
[14]LAU A J,TOH D F,CHUA T K,et al.Antiplatelet and anticoagulant effects of Panax notoginseng:comparison of raw and steamed Panax notoginseng with Panax ginseng and Panax quinquefolium[J].Journal of Ethnopharmacology,2009,125(3):380-386.
[15]石宏志,高南南,李勇枝,等.泽兰有效部分对血小板聚集和血栓形成的影响[J].中草药,2003,34(10):923-926.
[16]石宏志.泽兰对血液流变学影响的研究与进展[J].中国临床康复,2004,8(34):7776-7777.
[17]聂波,李佳彦,王硕仁,等.泽兰对人冠状动脉平滑肌细胞增殖的影响[J].中西医结合心脑血管病杂志,2010,8(9):1078-1080.
[18]欧阳熙林,韦新杰,杨城.扶芳藤的化学成分药理及其质量控制方法[J].时珍国医国药,2014,25(4):935-937.
[19]李成林,熊世磊,卢健琪,等.扶芳藤对缺氧/复氧损伤后人心内膜微血管内皮细胞内皮素-1和一氧化氮水平的影响[J].中华中医药杂志,2016,31(7):2835-2837.
[20]李成林,常拓,卢健棋,等.壮药扶芳藤对缺氧/复氧后人心内膜微血管内皮细胞VEGFR-2、VEGF的影响[J].辽宁中医药大学学报,2016,18(8):21-23.
[21]周倩,孙立立.蜜炙对甘草化学成分影响研究[J].中国药学杂志,2013,48(10):768-772.
[22]王龙,王化良.炙甘草抗心律失常临床应用研究[J].吉林中医药,2012,32(10):1074-1076.
[23]李美平,何承敏,胡继鹰,等.甘草汤对大鼠心肌缺血再灌注损伤的影响[J].湖北中医药大学学报,2011,13(1):9-11.
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