生脉养心汤治疗慢性心力衰竭的临床观察

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1、提要目的：观察生脉养心汤对慢性充血性心力衰竭的临床疗效。方法：根据纳入病例标准，选取60例慢性心力衰竭患者，随机分为治疗组和对照组。对照组30例，给予常规西药治疗；治疗组30例，在常规西药治疗基础上加服生脉养心汤，水煎服日一剂，4周为一疗程，进行临床观察。分别于治疗前、后行心电图及血、尿、便常规，血电解质，肝肾功能等实验室检查，观察患者心功能（NYHA分级、Lee氏心衰分级）、6分钟步行距离、心脏射血分数、每搏输出量、E/A以及症状、体征、中医临床证候在治疗前后的变化，从而评价疗效以及安全性。结果：治疗4周后，临床研究显示治疗组在六分钟步行试验、

2、Lee氏心衰积分方面优于对照组（P＜0.05）；中医单项症状疗效分析表明：治疗组在单项症状的改善情况上明显优于对照组（P＜0.05）且能明显改善中医证候（P＜0.05）；但是在NYHA分级以及心脏射血分数、每搏输出量、E/A值治疗组与对照组无显著性差异（P＞0.05）。结论：生脉养心汤对慢性充血性心力衰竭（气阴两亏证）在改善临床症状、改善中医证候、增加六分钟步行距离、提高心功能等方面有确切疗效，但在提高心脏射血分数、每搏输出量、E/A值以及NYHA分级时与常规西药治疗组无明显差异。关键词生脉养心汤；慢性心力衰竭；临床观察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