温阳益气利水法治疗慢性心衰的临床分析-clinical analysis of treating chronic heart failure by warming yang and benefiting qi and promoting diuresis.docxVIP

PAGE PAGE 3 中文摘要 目的：观察温阳益气利水法治疗慢性心衰的临床疗效。 方法：将符合心肾阳虚、阳虚水泛症 95 例慢性心衰患者随机分为 3 组。康复组 32 例，给温阳益气利水中药复方、针灸及标准抗心衰基础治疗；对照组 33 例， 接受标准抗心衰基础治疗；中西药组 30 例，给温阳益气利水中药复方及标准抗 心衰基础治疗。观察治疗前后心功能疗效、临床症状（心悸、畏寒肢冷、疲乏无 力、面肢浮肿、气短而喘、呼吸困难、肺部罗音、水肿、颈静脉怒张）疗效、心 彩超指标（左室射血分数、心脏指数、左室重量指数）及明尼苏达心衰生活质量 评分（LiHFe）的变化。 结果：治疗后康复组、中西药组在改善临床症状体征心悸、畏寒肢冷、疲乏无力、 呼吸困难疗效积分及提高左室射血分数方面与对照组相比有显著差异（P﹤ 0.05）；康复组治疗后临床症状体征畏寒肢冷、疲乏无力疗效积分与中西药组比 较差异性有统计学意义（P﹤0.05）；治疗后康复组生活质量评分（LiHFe）与对 照组相比虽明显降低，但差异性无统计学意义（P＞0.05）。 结论：对于心衰属心肾阳虚、阳虚水泛症患者，在西药常规治疗基础上加用温阳 益气利水中药及针灸康复治疗与单用西医抗心衰常规治疗比较，在改善临床症状 体征及提高左室射血分数方面更具有明显优势，在改善生活质量方面也能取得较 好疗效。 关键词：温阳益气利水法；慢性心衰；左室重量指数、左室射血分数；明尼苏达 心衰生活质量评分（LiHFe） Abstract Objective: To observe the effect of the Therapy of Strengthening Qi ,Warming Yang ,Promoting Diuresis methods in the rehabilitation treatment for chronic heart failure（CHF）. Methods: 95 patients suffering from CHF to be in line with deficiency of heart-YANG and kidney-YANG and hydroretention with asthenic yang were randomly divided into three groups，33 patients in Control group were treated by regular treatment of western medicine，32patients in rehabilitation treatment group were treated by regular treatment with wenyangyiqilishui decoction and moxibustion.30 patients in Chinese and western medicine treatment group were treated by regular treatment with wenyangyiqilishui decoction. 30 days as one course. To observe the changement of heart function and clinical symptom（palpitation 、chilly and limbs cold 、feel weary 、 swollen in face and limbs 、short breath and wheeze 、dyspnea 、rales in bellows 、 edema 、distention of jugular vein ）curative effect and index of（left ventricle ejection fraction、 cardiac index、left ventricle ponderal index）and life quality with CHF patients. Results： The clinical symptom （palpitation 、chilly and limbs cold 、feel weary、 dyspnea） and left ventricle ejection fraction again were different in rehabilitation treatment group 、Chinese and western medicine treatment group and Control group and had statistic significant