补阳还五汤联合西药治疗气虚血瘀风_省略_性心脏病并发脑栓塞42例临床观察

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1、DOI：10.13729/j.issn.1671-7813.2015.07.52网络出版时间：2015-07-1415:41:36网络出版地址：http://www.cnki.net/kcms/detail/21.1187.R.20150714.1541.052.html2015年实用中医内科杂志第29卷第7期JOURNALOFPRACTICALTRADITIONALCHINESEINTERNALMEDICINE·115·衷中参西补阳还五汤联合西药治疗气虚血瘀风湿性心脏病并发脑栓塞42例临床观察编号S20140746收稿20

2、14-07-04孙玉凤修回2015-01-16编辑戴豪泽(吉林省农安县中医院心内科科，吉林农安130200)摘要[目的]观察补阳还五汤联合西药治疗气虚血瘀风湿性心脏病并发脑栓塞疗效。[方法]使用前瞻性设计方法，对42例住院及门诊患者利尿、改善心功能、抗凝等对症治疗。补阳还五汤(黄芪30g，当归尾、赤芍、地龙、川穹、桃仁各15g，红花10g；失语显著加菖蒲，郁金；气阴两虚显著加五味子；胸闷、心悸显著加单手、瓜蒌、生龙牡、桂枝；3周内出院，可带药)。连续治疗3周为1疗程。观测临床症状、证候积分、心衰积分、脑功能缺损评分、左室短轴

3、缩短分数(FS)、左室短轴缩短分数(FS)、舒张早晚期充盈速度最大值比值(E/A)、不良反应。连续治疗1疗程，判定疗效。[结果]临床治愈19例，显效13例，有效6例，无效3例，加重1例。证候积分、心衰积分、脑功能缺损评分、LVEF、FS、E/A水平改善明显(P＜0.05)。[结论]补阳还五汤联合西药治疗气虚血瘀风湿性心脏病并发脑栓塞，疗效满意，无副作用，值得推广。关键词风湿性心脏病；脑栓塞；气虚血瘀；补阳还五汤；证候积分；心衰积分；脑功能缺损评分；左室短轴缩短分数(FS)；左室短轴缩短分数(FS)；舒张早晚期充盈速度最大值比

4、值(E/A)；临床观察doi：10.13729/j.issn.1671-7813.2015.07.5242PatientsClinicalObservationofRheumaticHeartDiseasewithQiDeficiencyandBloodStasisTypeandCerebralEmbolismTreatedbyBuyanghuanwutangandWesternMedicinesSUNYufeng(Nong'anCountyChineseMedicalHospitalinJilinProvince,Nong

5、'an130200,Jilin,China)Abstract[Objective]ToanalyzerheumaticheartdiseasewithqideficiencyandbloodstasistypeandcerebralembolismResultstreatedbybuyanghuanwutangandwesternmedicines.[Methods]42patientsweretreatedwithprospectivedesignMethodincludingtheirdiuresis,heartfunc

6、tionandanticoagulantsymptomaticetc.Buyanghuanwutang(Astragalus30g,Chineseangelicaroot,redpeonyroot,earthworm,Szechuanlovagerhizome,peachkernelforeach15g,safflower10g;changpuandturmericwereaddedforsignificantaphasiapatients,schisandrawasaddedforqiandyindeficiency,da

7、nshou,snakegourdfruit,rawLongmu,cassiatwigwereaddedforsignificantpalpitationpatients;ifpatientslefthospitalin3weeks,therelativemedicinesshouldbegiven).1treatmentcourseper3weekscontinuously.Theywereinspectedclinicalcondition,syndromeintegral,heartfailureintegral,cer

8、ebralfunctiondefectscore,leftventricularfractionshortening(FS),earlyandlatediastolicfillingvelocitymaximumratio(E/A),adversereaction.accordingto1