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1、提要目的:本文通过对80例CHF(充血性心力衰竭)心肾阳虚型患者的研究,认为心气虚是心衰的始动因素,阳气虚衰是心衰的病机关键,心肾阳气虚衰是心衰的重要病机及加重因素,温阳益气、化瘀行水是治疗心力衰竭的基本措施。并以此拟方桂芪温通行水方,旨在观察温阳益气、化瘀行水法治疗CHF患者的临床疗效。方法:将80例CHF患者随机分为桂芪温通行水方治疗组40例和对照组40例。系统观察并比较了两组患者治疗前后间的中医证候积分,西医Lee氏心衰积分,心功能分级,心脏彩超(包括射血分数、每搏排出量、每分钟输出量、左心室舒张末期内径、E/A)、神经内分泌指标(NO、AngⅡ、ET、NT-proBNP
2、)及治疗前后肝肾功能的变化。结果:桂芪温通行水方可以明显改善患者的临床症侯及Lee氏心衰积分、心功能分级、超声心动图等主要指标。结论:桂芪温通行水方在降低中医证候总积分、心衰积分以及心功能分级方面与对照组比较差异有统计学意义,具有减轻患者临床症状、提高患者的运动耐量、改善患者生活质量的作用。关键词桂芪温通行水方;心肾阳虚;充血性心力衰竭;临床研究ClinicalObservationofGuiqiwentongxingshuiPreparationClinicalEffectonCHFSpeciality:cardiovasculardiseaseofInternalMedic
3、ineofTCM.Author:JiangNanTutor:XuYanAbstractObjective:Throughthestudyof80casesofCHFpectoriswithheartkidneydeficiencyofyangsyndromeinthispaper,webelievethattheheartkidneydeficiencyofyangisimportantpathogenesis,soWenyangyiqiandHuayuxingshuimeridiansaretheirimportantgovernancelaws,andGuiqiwenton
4、gxingshuiwasdesignedtoobservetheclinicalefficiencyoftheWenyangyiqiandHuayuxingshuiintreatingpatientsofCHF.Method:80patientswithCHFwererandomlydividedintotwogroups,40casesinthetreatmentgroupusingGuiqiwentongxingshuiand40casesinthecontrastinggroup.Aroundthesystemobservedandcomparestwogroupofpa
5、tientstotreatbetweentheChinesemedicinecardperiodoffivedaysintegral,thedoctorpracticingwesternmedicineLeeheartfadestheintegral,theheartfunctiongraduation,theheartcolorultra(includingshootsmenstruationnumber,wrestlesdisplacement,eachminuteoutput,leftventriclediastolelaststageinsidediameter,E/A
6、everytime),aroundbodyweightandtreatmenthepatorenalfunctionchange.Results:Guiqiwentongxingshuicansignificantlyimprovethepatients’clinicalsymptoms,Leeheartfadestheintegral,theheartfunctiongraduationandechocardiogram.Conclusion:AddsthetasteGuiqiwentongxingshuitoreducetheChinesemedicinecardperio
7、doftotalintegral,theheartfadestheintegralaswellastheheartfunctiongraduationaspectandthecontrolgroupcomparisondifferencehasstatisticssignificance,hasreducesthepatientclinicalsymptom,enhancespatient'smovementtolerance,improvesthepatientqualityoflifet