补元养心汤对扩张型心肌病心肾功能不全的临床疗效研究

摘要

Objective:to explore the curative effect of Buyuan Yangxin Tang on the heart and kidney insufficiency of dilated car-diomyopathy.Methods:200 patients with dilated cardiomyopathy-induced heart failure combined with kidney insufficiency from our de-partment were randomly divided into experimental group ( EG) and control group ( CG) .CG were given western conventional therapy under the guidance of heart failure while EG were added with our self-made Buyuan Yangxin Tang , for four weeks as a course.Com-pare the curative effect scores before and after treatment, and other indexes like LVDd, LVEF, cardio-thoracic ration, BNP, CRP, se-rum creatinine, urea nitrogen and uric acid, to observe the therapeutic effect of Buyuan Yangxin tang .Results:(1) before and af-ter therapy, the total effective rate of EG was 96%, CG 71.4%, the former superior to the latter ( P <0.05 ); ( 2 ) compared to pretherapy, both indexes of the heart improved greatly, LVEF increased to some degree ( P CG <0.05;P EG <0.01); LVDd and BNP decreased ( P CG <0.05;P EG <0.01);cardio-thoracic ration decreased ( P CG <0.05;P EG <0.01);CRP improved signifi-cantly ( P CG <0.05;P EG <0.01);compared to CG, the heart functional index improved more significantly ( P <0.05); (3) compared to pretherapy, kidney indexes of both group were improved, serum creatinine, urea nitrogen and blood uric acid decreased ( P CG <0.05;P EG <0.01); EG improved more significantly than CG in all indexes ( P <0.05) .Conclusion: western therapy together with Buyuan Yangxin Tang can improve not only clinical symptoms and heart function, but also kidney index, which makes up for the damage to the kidney during treatment of heart failure with western medicine.%目的：探讨补元养心汤对扩张型心肌病心肾功能不全的治疗效果。方法：选取我科扩张型心肌病心力衰竭合并肾功能不全患者200例，随机分为实验组和对照组，对照组按心力衰竭指南给予西药常规治疗，实验组在西药常规治疗的基础上加用我院自拟方“补元养心汤”。4周为1疗程，均治疗1个疗程。对比治疗前后两组患者的临床疗效评分及左室舒张末期内径（ LVDd）、左室射血分数（ LVEF）、心胸比率、脑钠素（ BNP）、 CRP、血肌酐、尿素氮、尿酸等指标，观察补元养心汤的治疗效果。结果：（1）治疗前后，实验组总有效率为96．0％，对照组总有效率为71．4％，实验组优于对照组（ P ＜0．05）；（2）与治疗前比较，两组心脏指标明显改善， LVEF不同程度提高（ P 对照组＜0．05， P 实验组＜0．01）， LVDd和BNP有所下降（ P 对照组＜0．05， P 实验组＜0．01）；心胸比缩小（ P 对照组＜0．05， P 实验组＜0．01）； CRP有明显的改善（ P 对照组＜0．05， P 实验组＜0．01）；与对照组比较，实验组各项心功能指标改善更显著（ P ＜0．05）；（3）与治疗前比较，两组肾脏指标均改善，血肌酐、尿素氮、血尿酸均较治疗前下降（ P 对照组＜0．05， P 实验组＜0．01），组间比较，实验组各项肾功能指标改善更明显（ P ＜0．05）。结论：在西医治疗的基础上加用补元养心汤可在改善患者临床症状和心功能的同时，改善肾脏指标，弥补了西药治疗心衰中对肾脏的损害。