| 摘要: |
| 目的：观察西医常规疗法联合管通汤治疗射血分数保留的心衰（HFpEF)患者的临床疗效。方法：选取气虚血瘀、痰浊内阻型HFpEF患者80 例，将其随机分为2组，对照组采用西医常规治疗，治疗组在对照组基础上加用管通汤治疗。2组均治疗3个月。观察比较2组中医证候疗效与氨基末端B型脑钠肽前体（N-proBNP)、6 min步行试验（6MWT）、心脏超声各项指标［二尖瓣舒张早期血流E和舒张晚期血流A的比值（E/A）、二尖瓣舒张早期血流E和组织多普勒舒张早期速度EI的比值（E/E’）、左房内径（LA）、E峰减速时间（DT）］及明尼苏达生活质量量表（MLHFQ）评分。结果：中医证候总有效率治疗组为92.5%（37/40），对照组为72.5%（29/40），组间比较，差异有统计学意义（P＜0.05）。2组 NT-proBNP、6MWT、心脏超声各项指标、MLHFQ评分治疗前后组内比较，差异均有统计学意义（P＜0.05）；治疗后组间比较，NT-proBNP、6MWT、MLHFQ评分差异有统计学意义（P＜0.05），心脏超声各项指标组间比较差异无统计学意义（P>0.05）。结论：在西医常规疗法基础上联合管通汤治疗可有效改善患者的中医证候、心功能、运动耐量及生活质量，值得推广。 |
| 关键词: 射血分数保留的心力衰竭 气虚血瘀 痰浊内阻 中西医结合治疗 管通汤 |
| DOI： |
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| Clinical effect of Guantong decoction in treatment of patients with heart failure with preserved ejection fraction：An analysis of 40 cases |
| YANG Lin,XIE Gang,WU Chao |
| (Shaoyang Hospital of Traditional Chinese Medicine，Shaoyang 422000，Hunan，China) |
| Abstract: |
| Objective：To investigate the clinical effect of conventional Western medicine treatment combined with Guantong decoction in the treatment of patients withheart failure with preserved ejection fraction (HFpEF).Methods：A total of 80 HFpEFpatients with Qi deficiency and blood stasis and phlegm obstruction syndrome were randomly divided into treatment group and control group.The patients in the control group were given conventional Western medicine treatment，and those in the treatment group were given Guantong decoction in addition to the treatment in the control group.The course of treatment was 3 months for both groups.The two groups were compared in terms of outcome of traditional Chinese medicine (TCM) syndrome，N-terminal pro-B-type natriuretic peptide (NT-proBNP)，six-minute walk test (6MWT)，echocardiography parameters ［ratio of early mitral blood inflow velocity to late mitral blood inflow velocity，ratio of early mitral blood inflow velocity to early diastolic mitral annular velocity on tissue Doppler imaging，left atrial diameter，and E deceleration time］，and Minnesota Living with Heart Failure Questionnaire (MLHFQ) score.Results：There was a significant difference in the overall response rate of TCM syndrome between the treatment group and the control group ［92.5%(37/40)vs 72.5%(29/40)，P<0.05］.Both groups had significant changes in NT-proBNP，6MWT，echocardiography parameters，and MLHFQ score after treatment (P＜0.05)，and there were significant differences in NT-proBNP,6MWT，and MLHFQ score between the two groups after treatment (P＜0.05)，while there were no significant differences in echocardiographic parameters between the two groups after treatment (P>0.05).Conclusion：For patients with HFpEF，conventional Western medicine treatment combined with Guantong decoction can effectively improve TCM syndrome，cardiac function，exercise tolerance，and quality of life and thus holds promise for clinical application. |
| Key words: heart failure with preserved ejection fraction Qi deficiency and blood stasis phlegm obstruction syndrome integrated traditional Chinese and Western medicine therapy Guantong decoction |
