温阳活血法治疗慢性心力衰竭临床特征分析.docVIP

温阳活血法治疗慢性心力衰竭临床特征分析 　作者简介：田俊（1958”），男，毕业于湖北中医药大学，主任医师，医学硕士，现工作于上海市浦东新区中医医院（邮编：200136）；邬渊敏、吴敏雨、谈宏强、黄盛娜、丁雪华、曹燕，工作于上海市浦东新区中医医院。 摘要：目的 观察温阳活血法对慢性心力衰竭的临床疗效。方法 将100例慢性心力衰竭病人随机分为治疗组和对照组，各50例。对照组给予常规抗心力衰竭治疗（血管紧张素转换酶抑制剂或血管紧张素受体拮抗剂、beta;受体阻滞剂、血管扩张剂、利尿剂、强心剂等药物），治疗组在对照组治疗基础上加用温阳活血为主的温阳益气活血汤，疗程4周。观察两组治疗前后中医临床症状与体征、纽约心脏病协会（NYHA）心功能分级变化，应用彩色多普勒测定两组每搏输出量（SV）、心输出量（CO）、心脏指数（CI）、左室射血分数（LVEF）、左室短轴缩短率（FS）、左室舒张末内径（LVEDD），测定血清脑钠肽（BNP）浓度。结果 治疗组总有效率94%，优于对照组的78%（Plt;0.05）。两组治疗后SV、CO、CI、LVEF、LVEDD、BNP较治疗前均有明显改善，但治疗组优于对照组（Plt;0.05）。结论 温阳活血法对慢性心力衰竭具有确切的疗效，对心功能各项指标均具有明显的改善作用。 　关键词：慢性心力衰竭；温阳活血法；左室射血分数；左室舒张末内径；血清脑钠肽 　中图分类号：R541.6 R289.5 文献标识码：B 文章编号2012　Clinical Observation on Yangwarming and Bloodactivating Therapy for Chronic Heart Failure 毕业论文 　Tian Jun，Wu Yuanmin，Wu Minyu，et alShanghai Pudong New Area Hospital of Traditional Chinese Medical (Shanghai 200136) 　Abstract：Objective To investigate the effects of yangwarming and bloodactivating therapy in the treatment of chronic heart failure(CHF).Methods One hundred patients with CHF were randomly divided into two groups：Control group（n＝50）treated by conventional antiheart failure treatment（angiotensinconverting enzyme inhibitors or angiotensin receptor blockers，beta;blockers，vasodilators，diuretics，inotropic），treatment group（n＝50）treated by conventional antiheart failure treatment and Wenyang Yiqi Huoxue decoction for 4 weeks.The traditional Chinese medical symptoms，New York Heart Association (NYHA) heart function classification were observed.The systolic volume (SV)，cardiac output (CO)，cardiac index（CI)，left ventricular ejection fraction (LVEF) ，fractional shortening of left ventricular short axis(FS)，and left ventricular enddiastolic diameter (LVEDd)were observed.The level of plasma Btype natriuretic peptide (BNP)was detested.Results The total effective rate was 94% in treatment group，which was significantly higher than that in control group（78%，P＜0.05）.The levels of SV，CO，CI，LVEF，LVEDD，and BNP in treatment group were