| 摘要: |
| 目的：观察益气健脾化湿汤联合西药治疗慢性心力衰竭（CHF）合并高尿酸血症的疗效及安全性。方法：将82 例CHF伴高尿酸血症患者随机分为治疗组与对照组。对照组42 例给予CHF西医基础药物治疗，治疗组40 例在对照组基础上加用益气健脾化湿汤治疗，2组均在院治疗7d后出院，在家继续服药至30 d。观察2组治疗前后血尿酸、血肌酐、B型利钠肽（BNP）、6 min步行距离、左心室射血分数（LVEF）、30 d内再入院率及痛风发作率、不良反应情况。结果：治疗第7天临床总有效率治疗组为97.50%（39/42），对照组为97.62%（41/42），2组差异无统计学意义（P>0.05）。血尿酸水平对照组治疗30 d与治疗前比较，治疗组治疗7、30 d与治疗前比较，差异均有统计学意义（P<0.05），且治疗30 d 2组比较，差异有统计学意义（P<0.05）。2组血肌酐、BNP治疗7、30 d与本组治疗前比较及同时间节点组间比较，差异均有统计学意义（P<0.05）；2组6 min步行距离、LVEF治疗30 d与本组治疗前比较及治疗后组间比较，差异均有统计学意义（P<0.05）。治疗期间治疗组再入院1 例（2.5%），痛风发作0 例；对照组再入院 1 例（2.38%），痛风发作2 例（4.76%），2组比较，再入院率差异无统计学意义（P>0.05），痛风发作率差异有统计学意义（P<0.05）。结论：益气健脾化湿汤在改善CHF患者症状、改善心脏功能、降低血尿酸水平、减少治疗期间痛风发作方面具有明显的疗效。 |
| 关键词: 慢性心力衰竭 高尿酸血症 中西医结合疗法 益气健脾化湿汤 |
| DOI： |
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| rated traditional Chinese and Western medicine therapy in treatment of patients with chronic heart failure and hyperuricemia：An analysis of 40 cases |
| YAN Rong,PENG Jixin,XU Jiayang |
| (Jiangning Hospital of Traditional Chinese Medicine，Nanjing 211100，Jiangsu，China) |
| Abstract: |
| Objective：To investigate the clinical effect and safety of Qi-tonifying，spleen-strengthening，and dampness-removing decoction combined with Western medicine in the treatment of patients with chronic heart failure (CHF) and hyperuricemia.Methods：A total of 82 patients with CHF and hyperuricemia were randomly divided into treatment group and control group.The 42 patients in the control group were given basic Western medicine therapy，and the 40 patients in the treatment group were given Qi-tonifying，spleen-strengthening，and dampness-removing decoction in addition to the treatment in the control group.Both groups were discharged after 7 days of treatment in hospital and continued to take the drugs for 30 days at home.The two groups were compared in terms of serum uric acid，serum creatinine，B-type natriuretic peptide (BNP)，six-minute walk distance，left ventricular ejection fraction (LVEF)，readmission rate within 30 days，incidence rate of gout attack，and adverse reactions before and after treatment.Results：On day 7 of treatment，there was no significant difference in overall response rate between the treatment group and the control group［97.50% (39/42) vs 97.62% (41/42)，P>0.05］.The control group had a significant change in serum uric acid on day 30 of treatment，and the treatment group had a significant change on days 7 and 30 of treatment (P<0.05)；there was a significant difference in serum uric acid between the two groups on day 30 of treatment (P<0.05).Both groups had significant changes in serum creatinine and BNP on days 7 and 30 of treatment，and there were significant differences between the two groups at the same time point (P<0.05)；both groups had significant changes in six-minute walk distance and LVEF on day 30 of treatment，and there were significant differences between the two groups after treatment (P<0.05).Period of treatment，in the treatment group，1 patient (2.5%) was readmitted and no patient experienced gout attack，while in the control group，1 patient (2.38%) was admitted and 2 patients (4.76%) experienced gout attack；there was no significant difference in readmission rate between the two groups (P>0.05)，while there was a significant difference in the incidence rate of gout attack between the two groups (P<0.05).Conclusion：In patients with CHF，Qi-tonifying，spleen-strengthening，and dampness-removing decoction has a marked clinical effect in improving symptoms and cardiac function and reducing serum uric acid and gout attack during treatment. |
| Key words: chronic heart failure hyperuricemia integrated traditional Chinese and Western medicine therapy Qi-tonifying,spleen-strengthening,and dampness-removing decoction |
