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目的:观察温胆汤合瓜蒌薤白半夏汤辅助治疗冠状动脉粥样硬化性心脏病(CHD)心力衰竭的临床疗效。方法:选取100例CHD心力衰竭患者,随机分为观察组与对照组各50例。对照组给予常规西药治疗,观察组在对照组用药基础上辅以温胆汤合瓜蒌薤白半夏汤治疗。比较2组临床疗效,观察治疗前后心功能指标、血清氨基末端脑钠肽前体(NT-proBNP)含量、6 min步行试验(6 MWT)距离及中医证候积分的变化,比较2组不良反应发生情况。结果:观察组治疗总有效率88.89%,高于对照组的70.83%(P<0.05)。治疗后,2组左心室射血分数(LVEF)、每搏输出量(SV)均较治疗前升高(P<0.05,P<0.01),2组左心室舒张末径(LVDED)和观察组的左心室收缩末径(LVSED)均较治疗前缩小(P<0.05,P<0.01);观察组LVEF、SV均高于对照组(P<0.05),LVSED、LVDED均小于对照组(P<0.05)。治疗后,2组血清NT-proBNP含量及中医证候积分均较治疗前降低(P<0.05,P<0.01),6 MWT距离均较治疗前延长(P<0.05,P<0.01);观察组血清NT-proBNP含量及中医证候积分均低于对照组(P<0.05),6 MWT长于对照组(P<0.05)。治疗前后,2组血、尿常规及肝功能等检查均未见异常。结论:温胆汤合瓜蒌薤白半夏汤辅助治疗CHD心力衰竭,可有效改善患者的心功能指标和血清NT-proBNP水平,缓解心力衰竭症状,提高患者的自主步行能力,效果优于常规西药治疗,且安全性高。
Objective: To observe the curative effect of Wendan Decoction combined with Gulun Baibanxia Decoction in the treatment of heart failure with coronary heart disease (CHD). Methods: 100 CHD patients with heart failure were randomly divided into observation group and control group, 50 cases each. The control group was given conventional Western medicine, and the observation group was treated with Wenbian Decoction combined with Baibanxia Decoction on the basis of the control group. The clinical curative effect was compared between the two groups. The changes of cardiac function, serum NT-proBNP, 6-MWT distance and TCM syndrome score were observed before and after treatment. The adverse reactions of two groups were compared What happened? Results: The total effective rate of the observation group was 88.89%, which was higher than that of the control group (70.83%, P <0.05). After treatment, left ventricular ejection fraction (LVEF) and stroke volume (SV) in two groups were significantly higher than those before treatment (P <0.05, P <0.01), and left ventricular diastolic diameter (LVDED) (P <0.05, P <0.01). LVEF and SV in the observation group were significantly higher than those in the control group (P <0.05), LVSED and LVDED in the observation group were significantly lower than those in the control group (P < 0.05). After treatment, the serum NT-proBNP levels and TCM syndrome scores in both groups were significantly lower than those before treatment (P <0.05, P <0.01), and 6 MWT distances were longer than those before treatment (P <0.05, P <0.01) Serum NT-proBNP content and TCM syndrome score were lower than the control group (P <0.05), 6 MWT longer than the control group (P <0.05). Before and after treatment, two groups of blood, urine and liver function tests showed no abnormalities. Conclusion: Wendan Decoction combined with Gulun Baibanxia Decoction in the treatment of CHD heart failure can effectively improve the patient’s cardiac function index and serum NT-proBNP level, alleviate the symptoms of heart failure and improve patients’ ability to walk independently, which is superior to the conventional western medicine Treatment, and high safety.