护心灸联合常规疗法治疗阳气亏虚型慢性心力衰竭合并便秘临床研究
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R256.29

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广东省中医药局科研项目(20222012)


Clinical Study on Heart-Protecting Moxibustion Combined with Conventional Therapy for Chronic Heart Failure Complicated by Constipation of Yang Qi Deficiency Type
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    摘要:

    目的:观察护心灸联合常规疗法治疗阳气亏虚型慢性心力衰竭合并便秘的临床疗效。方法:选取 2022年3月—2024年3月广东省第二中医院收治的90例阳气亏虚型慢性心力衰竭合并便秘患者。采用随机数字 表法分为对照组和观察组各45例。对照组给予抗心力衰竭、便秘的常规治疗,观察组在对照组基础上给予护 心灸治疗,2组均治疗14天。治疗前后检测心功能指标[左心室射血分数(LVEF)、每搏输出量(SV)、心搏 量指数(SVI)、心脏指数(CI)、B型利钠肽(BNP)],评估中医证候评分、便秘症状评分、便秘患者生活质 量量表(PAC-QOL) 评分,比较2组的临床疗效、不良反应发生率。结果:治疗后,观察组总有效率高于对照 组(P<0.05)。2组LVEF、SV、SVI、CI值均较治疗前升高,BNP水平均较治疗前降低,差异均有统计学意 义(P<0.05)。观察组LVEF、SV、SVI、CI 值均高于对照组,BNP 水平低于对照组,差异均有统计学意 义(P<0.05)。2组心悸气喘、畏寒肢冷、面肢浮肿、咳吐泡沫痰、烦躁汗出、唇甲青紫、腹胀、小便短少评 分均较治疗前降低(P<0.05),观察组以上8项中医证候评分均低于对照组(P<0.05)。2组排便频率、排便 时间、粪便性状、排便难易程度、下坠感、腹痛评分均较治疗前降低(P<0.05),观察组以上6项评分均低于 对照组(P<0.05)。2组PAC-QOL躯体不适、心理社会不适、担忧与顾虑、满意度评分及总分均较治疗前下 降(P<0.05),观察组以上5项评分均低于对照组(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。 结论:采用护心灸联合常规疗法治疗阳气亏虚型CHF合并便秘患者可提高临床疗效,有效改善患者的心功能, 减轻心力衰竭及便秘带来的各种症状,提高生活质量,且安全性较好。

    Abstract:

    Abstract:Objective:To observe the clinical efficacy of heart-protecting moxibustion combined with conventional therapy in treating chronic heart failure complicated by constipation of yang qi deficiency type. Methods: A total of 90 patients with chronic heart failure complicated by constipation of yang qi deficiency type admitted to Guangdong Second Traditional Chinese Medicine Hospital from March 2022 to March 2024 were selected. They were randomly divided into the control group and the observation group using the random number table method,with 45 cases in each group. The control group received conventional treatment for heart failure and constipation,while the observation group received additional heart-protecting moxibustion based on the control group's treatment. Both groups were treated for 14 days. Cardiac function indicators [left ventricular ejection fraction (LVEF), stroke volume (SV), stroke volume index (SVI), cardiac index (CI), B-type natriuretic peptide (BNP)] were measured before and after treatment. Traditional Chinese medicine syndrome scores,constipation symptom scores,and Patient Assessment of Constipation Quality of Life (PAC-QOL) scores were evaluated. Clinical efficacy and the incidence of adverse reactions were compared between the two groups. Results:After treatment,the total effective rate in the observation group was higher than that in the control group (P<0.05). The LVEF,SV,SVI,and CI values increased in both groups compared to before treatment, while BNP levels decreased, with differences being significant (P<0.05). The observation group showed higher LVEF,SV,SVI,and CI values and lower BNP levels than the control group,with differences being significant (P<0.05). Scores for palpitations and shortness of breath,aversion to cold and cold limbs,facial and limb edema, frothy sputum, irritability and sweating, cyanotic lips and nails, abdominal distension, and scanty urine decreased in both groups compared to before treatment (P<0.05). The observation group had lower scores for these eight traditional Chinese medicine syndrome items than the control group,with differences being significant (P<0.05). Scores for defecation frequency,defecation time,stool consistency,difficulty of defecation,sensation of incomplete evacuation, and abdominal pain decreased in both groups compared to before treatment (P<0.05). The observation group had lower scores for these six constipation symptoms than the control group (P<0.05). The sub-item of PAC-QOL scores (physical discomfort, psychosocial discomfort, worry and concern, satisfaction) and total scores decreased in both groups compared to before treatment (P<0.05). The observation group showed lower scores in all PAC-QOL sub-item and total scores than the control group (P<0.05). The incidence of adverse reactions in the observation group was lower than that in the control group (P<0.05). Conclusion: Heart-protecting moxibustion combined with conventional therapy for chronic heart failure complicated by constipation of yang qi deficiency type can improve clinical efficacy,effectively enhance cardiac function,alleviate various symptoms associated with heart failure and constipation,improve quality of life,and demonstrate favorable safety.

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刘培洪,袁丁.护心灸联合常规疗法治疗阳气亏虚型慢性心力衰竭合并便秘临床研究[J].新中医,2026,58(7):45-51

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  • 在线发布日期: 2026-04-20
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