生脈養(yǎng)心湯治療慢性心力衰竭的臨床觀(guān)察

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1、提要目的：觀(guān)察生脈養(yǎng)心湯對(duì)慢性充血性心力衰竭的臨床療效。方法：根據(jù)納入病例標(biāo)準(zhǔn)，選取60例慢性心力衰竭患者，隨機(jī)分為治療組和對(duì)照組。對(duì)照組30例，給予常規(guī)西藥治療；治療組30例，在常規(guī)西藥治療基礎(chǔ)上加服生脈養(yǎng)心湯，水煎服日一劑，4周為一療程，進(jìn)行臨床觀(guān)察。分別于治療前、后行心電圖及血、尿、便常規(guī)，血電解質(zhì)，肝腎功能等實(shí)驗(yàn)室檢查，觀(guān)察患者心功能（NYHA分級(jí)、Lee氏心衰分級(jí)）、6分鐘步行距離、心臟射血分?jǐn)?shù)、每搏輸出量、E/A以及癥狀、體征、中醫(yī)臨床證候在治療前后的變化，從而評(píng)價(jià)療效以及安全性。結(jié)果：治療4周后，臨床研究顯示治療組在六分鐘步行試驗(yàn)、

2、Lee氏心衰積分方面優(yōu)于對(duì)照組（P＜0.05）；中醫(yī)單項(xiàng)癥狀療效分析表明：治療組在單項(xiàng)癥狀的改善情況上明顯優(yōu)于對(duì)照組（P＜0.05）且能明顯改善中醫(yī)證候（P＜0.05）；但是在NYHA分級(jí)以及心臟射血分?jǐn)?shù)、每搏輸出量、E/A值治療組與對(duì)照組無(wú)顯著性差異（P＞0.05）。結(jié)論：生脈養(yǎng)心湯對(duì)慢性充血性心力衰竭（氣陰兩虧證）在改善臨床癥狀、改善中醫(yī)證候、增加六分鐘步行距離、提高心功能等方面有確切療效，但在提高心臟射血分?jǐn)?shù)、每搏輸出量、E/A值以及NYHA分級(jí)時(shí)與常規(guī)西藥治療組無(wú)明顯差異。關(guān)鍵詞生脈養(yǎng)心湯；慢性心力衰竭；臨床觀(guān)察ClinicalEvalu

3、ationofShengmaiYangxinTanginTreatingchronicheartfailureSpeciality:InternalMedicineofTraditionalChineseMedicineAuthor:XuChunyuTutor:Prof.LuXiaohuiAbstractObjective:ToobservetheclinicalefficacyofShengmaiYangxinTanginTreatingchroniccongestiveheartfailure.Method:accordingtothesta

4、ndardsintothecase，60patientswithchronicheartfailurewererandomlydividedintotreatmentandcontrolgroups.Thecontrolgroupof30casesweretreatedwithconventionalwesternmedicineandthetreatmentgroupwith30casesweredosedwithinShengmaiYangxinTangonthebasisoftheconventionalwesternmedicine，an

5、ddeterminedclinicalefficacyevaluationafterfourweeks.UnderwentthelaboratoryexaminationofECGandbloodroutine，urinalysis，routinestool，serumelectrolytes，liverandkidneyfunctionbeforeandafterthetreatment，respectively.Andobservedthechangesofcardiacfunctioninpatients(NYHAfunctionalcla

6、ss，Lee'sheartfailureclassification)，6minuteswalkingdistance，heartcolorDopplerejectionfraction，strokevolume，E/A，aswellassignsandsymptoms，TCMclinicalsyndromebeforeandaftertreatment.Inordertoevaluatetheefficacyandsafety.Results:After4weeksoftreatment，theclinicalstudyshowedthattr

7、eatmentgroupinthe6-minutewalktest，integralaspectofLee'sheartfailurethanthecontrolgroup(P<0.05);efficacyofChinesemedicineforindividualsymptoms:thetreatmentgroupintheimprovementofindividualsymptomsthanthecontrolgroup(P<0.05)andcanpentadsignificantlyimprovedTCMsyndrome(P<0.05);i

8、nNYHAclassevaluationofcardiacfunction，andechocardiogramphyejectionfr