参芪强心汤联合八段锦治疗老年慢性心力衰竭气滞血瘀证临床研究
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R541.6

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Clinical Study on Shenqi Qiangxin Tang Combined with Baduanjin for Senile Chronic Heart Failure with Qi Stagnation and Blood Stasis Syndrome
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    摘要:

    目的:观察参芪强心汤联合八段锦治疗老年气滞血瘀型慢性心力衰竭(CHF) 的临床疗效。方法:选取86 例老年气滞血瘀型CHF 患者,按随机数字表法分为对照组及观察组各43 例,2 组均给予规范现代医学基础治疗,对照组在此基础上辅以八段锦康复训练,观察组在对照组基础上给予参芪强心汤口服。比较2 组临床疗效,比较2 组治疗前后中医证候积分、6 min 步行距离(6MWD)、左室射血分数(LVEF)、血清心肌钙蛋白T(cTnT)、N 末端B 型利钠肽原(NT-proBNP) 水平、红细胞聚集指数、血小板聚集率、明尼苏达心力衰竭生存质量量表(MLHF-Q) 评分的变化,观察随访3 个月2 组不良反应发生情况。结果:治疗后,观察组临床疗效总有效率为90.70%,对照组为74.42%,2 组比较,差异有统计学意义(P<0.05)。治疗后,2 组中医证候积分均较治疗前下降,6MWD 指标值均较治疗前增加,差异均有统计学意义(P<0.05);观察组中医证候积分低于对照组,6MWD 指标值高于对照组,差异均有统计学意义(P<0.05)。治疗后,2 组LVEF指标值均较治疗前升高,NT-proBNP、cTnT 水平均较治疗前下降,差异均有统计学意义(P<0.05);观察组LVEF 指标值高于对照组,NT-proBNP、cTnT 水平均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2 组红细胞聚集指数、血小板聚集率均较治疗前下降,观察组红细胞聚集指数、血小板聚集率均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2 组MLHF-Q 量表中躯体状况、情绪状况、其他状况评分均较治疗前下降,观察组MLHF-Q 量表各项评分均低于对照组,差异均有统计学意义(P<0.05)。随访期间,观察组不良反应发生率为16.28%,对照组为11.63%,2 组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:在现代医学基础上辅以参芪强心汤联合八段锦治疗CHF 的疗效确切,可有效改善患者临床症状及心功能指标,提高生活质量。

    Abstract:

    Abstract:Objective:To observe the clinical effect of Shenqi Qiangxin tang combined with Baduanjin for senile chronic heart failure(CHF) with qi stagnation and blood stasis syndrome. Methods: A total of 86 cases of senile CHF patients with qi stagnation and blood stasis syndrome were selected and divided into the control group and the observation group according to the random number table method,with 43 cases in each group. Both groups were basically treated with standard modern medical treatment; the control group was additionally treated with rehabilitation training of Baduanjin,and the observation group was given oral administration of Shenqi Qiangxin tang based on the treatment of the control group. The clinical effects in the two groups were compared. Before and after treatment,the changes in Chinese medicine syndrome scores,6-min walk distance(6MWD),left ventricular ejection fraction(LVEF),levels of cardiac troponin T (cTnT) in serum, N- terminal fragment of the pro- B- type natriuretic peptide(NT- proBNP), red cell aggregation, platelet aggregation rate, and Minnesota Living with Heart Failure Questionnaire(MLHFQ) scores in the two groups were compared. Both groups were given three- month follow- up, and the incidences of adverse reactions in the two groups were observed. Results: After treatment, the total effective rate of clinical effect was 90.70% in the observation group and 74.42% in the control group,the difference being significant(P<0.05). After treatment, Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment, and 6MWD was increased when compared with that before treatment,differences being significant(P<0.05);Chinese medicine syndrome score in the observation group was lower than that in the control group, and the value of 6MWD was higher, differences being significant(P<0.05). After treatment, the LVEF values in the two groups were increased when compared with those before treatment, and the levels of NT- proBNP and cTnT were decreased when compared with those before treatment, differences being significant(P<0.05). After treatment, the LVEF value in the observation group was higher than that in the control group, and the levels of NT- proBNP and cTnT were lower, differences being significant(P<0.05). After treatment, red cell aggregation and platelet aggregation rates in the two groups were decreased when compared with those before treatment,and the red cell aggregation and platelet aggregation rate in the observation group were lower than those in the control group, differences being significant(P<0.05). After treatment, the scores of physical condition, emotional state and other situations in MLHF- Q in the two groups were decreased when compared with those before treatment,and the scores in the MLHF-Q in the observation group were lower than those in the control group,differences being significant(P<0.05). During the followup period, the incidence of adverse reactions was 16.28% in the observation group and 11.63% in the control group, there being no significant difference(P>0.05). Conclusion: Based on modern medicine, the additional application of Shenqi Qiangxin tang combined with Baduanjin for CHF has a definite curative effect,and can effectively improve clinical symptoms,heart function indexes and quality of life.

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祝春燕,李晓东,傅美香,冯栅栅.参芪强心汤联合八段锦治疗老年慢性心力衰竭气滞血瘀证临床研究[J].新中医,2022,54(17):84-88

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  • 在线发布日期: 2022-09-06
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