辨证论治慢性心力衰竭临床观察

摘要

Objective: To observe therapeutic effects of syndrome differentiation and treatment in treating chronic heart failure(CHF). Methods:All 180 patients were randomly divided into three groups, 60 cases each group, all the patients received conventional therapy of western medicine. Qi-insufficiency blood-stasis group took BaoYuan Tang and modified BuYang HuanWu Tang, Yang-deficiency water-flooding group received modified ZhenWu Tang. The changes of LVEF, FS, TNF-α, Ang-Ⅱand IL-6 of three groups were compared as well as therapeutic effects. Results:Total effective rates of Qi-insufficiency blood-stasis group and Yang-deficiency water-flooding group were higher than that of the control group (P<0.05);LVEF and FS of three groups after treating were improved signifi-cantly compared with before treating (P<0.05), the differences had statistical meaning when Qi-insufficiency blood-stasis group and Yang-deficiency water-flooding group were compared with the control group (P<0.05);Ang-Ⅱ, IL-6 and TNF-αof three groups after treating were decreased (P<0.05). Conclusion:Treating CHF by syndrome differentiation and treatment is effective.%目的：观察辨证论治慢性心力衰竭的临床疗效。方法：将180例患者随机分为3组，每组60例，3组患者均给予西医常规治疗。气虚血瘀组加用保元汤合补阳还五汤加减治疗，阳虚水泛组加用真武汤加味治疗。比较3组临床疗效及左室射血分数(LVEF)、左室短轴缩短率(FS)、肿瘤坏死因子(TNF-α)、血管紧张素Ⅱ(Ang-Ⅱ)、白细胞介素-6(IL-6)等指标的变化。结果：气虚血瘀组、阳虚水泛组总有效率均高于对照组(P＜0.05)；LVEF、FS 3组治疗后均较治疗前有明显提高（P＜0.05），气虚血瘀组、阳虚水泛组与对照组相比，差异具有统计学意义（P＜0.05）；3组治疗后Ang-Ⅱ、IL-6及TNF-α显著降低（P＜0.05）。结论：辨证论治疗慢性心力衰竭临床疗效显著。