| 摘要: |
| 目的：观察益气活血、化瘀利水方联合西药治疗冠心病心力衰竭气虚血瘀兼水停证的临床疗效。方法：将164 例冠心病心力衰竭气虚血瘀兼水停证患者随机分为治疗组和对照组，每组各82 例。治疗组给予益气活血、化瘀利水方联合西药治疗，对照组单予西药治疗。观察2组的综合疗效、中医证候总积分、左室射血分数（LVEF）、心输出量（CO）、左心室收缩末期内径（LVEDs）、左心室舒张末期内径（LVEDd）、6 min步行距离、N末端B型脑钠肽前体（NT-proBNP）、心率（HR）、心率校正QT（QTc）间期、血清组织型纤溶酶原激活物（tPA）、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平、纤溶酶原激活物抑制物-1（PAI-1）、生长分化因子-15（GDF-15）及不良反应发生率。结果：总有效率治疗组为84.15%（69/82），对照组为69.51%（57/82），2组比较，差异有统计学意义（P＜0.05）。2组中医证候总积分、LVEF、CO、LVEDs、LVEDd、6 min步行距离、NT-proBNP、HR、QTc间期以及血清tPA、NGAL、PAI-1、GDF-15水平治疗前后组内比较及治疗后组间比较，差异均有统计学意义（P＜0.05）。不良反应发生率治疗组为4.88%（4/82），低于对照组的10.98%（9/82），但差异无统计学意义（P>0.05）。结论：应用益气活血、化瘀利水方联合西药治疗气虚血瘀兼水停型冠心病心力衰竭疗效显著，可以有效改善患者临床症状和心功能，安全性较好。 |
| 关键词: 冠心病 心力衰竭 气虚血瘀兼水停证 中西医结合疗法 益气活血 化瘀利水 |
| DOI： |
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| Clinical effect of Qi-tonifying，blood-activating，stasis-resolving，and diuresis-inducing prescription combined with Western medicine in treatment of heart failure caused by coronary heart disease with syndrome of deficiency with blood stasis and water retention：An analysis of 82 cases |
| CUI Chensi,YAO Jiaqi,WANG Qian |
| (Gongyi People’s Hospital，Gongyi 451200，Henan，China) |
| Abstract: |
| Objective：To investigate the clinical effect of Qi-tonifying，blood-activating，stasis-resolving，and diuresis-inducing prescription combined with Western medicine in the treatment of heart failure caused by coronary heart disease with syndrome of deficiency with blood stasis and water retention.Methods：A total of 164 patients with heart failure caused by coronary heart disease with syndrome of deficiency with blood stasis and water retention were randomly divided into treatment group and control group，with 82 patients in each group.The patients in the treatment group were given Qi-tonifying，blood-activating，stasis-resolving，and diuresis-inducing prescription combined with Western medicine，and those in the control group were given Western medicine treatment alone.The two groups were observed in terms of overall response，traditional Chinese medicine (TCM) syndrome score，left ventricular ejection fraction (LVEF)，cardiac output (CO)，left ventricular end-systolic diameter (LVEDs)，left ventricular end-diastolic diameter (LVEDD)，six-minute walk distance，N-terminal pro-brain natriuretic peptide (NT-proBNP)，heart rate (HR)，corrected QT interval (QTc)，serum levels of tissue-type plasminogen activator (tPA)/neutrophil gelatinase-associated lipocalin (NGAL)/plasminogen activator inhibitor-1 (PAI-1)/growth differentiation factor-15 (GDF-15)，and incidence of adverse events.Results：There was a significant difference in overall response rate between the treatment group and the control group［84.15% (69/82) vs 69.51% (57/82)，P＜0.05］.After treatment，both groups had significant changes in TCM syndrome score，LVEF，CO，LVEDs，LVEDD，six-minute walk distance，NT-proBNP，HR，QTc，and the serum levels of tPA，NGAL，PAI-1，and GDF-15，and there were significant differences in these indicators between the two groups after treatment (P＜0.05).The treatment group had a lower incidence rate of adverse reactions than the control group［4.88% (4/82) vs 10.98% (9/82)，P>0.05］.Conclusion：The Qi-tonifying，blood-activating，stasis-resolving，and diuresis-inducing prescription combined with Western medicine has a marked clinical effect in the treatment of heart failure caused by coronary heart disease with syndrome of deficiency with blood stasis and water retention and can significantly improve clinical symptoms and cardiac function，with relatively good safety. |
| Key words: coronary heart disease heart failure syndrome of deficiency with blood stasis and water retention integrated traditional Chinese and Western medicine therapy Qi-tonifying and blood-activating therapy stasis-resolving and diuresis-inducing therapy |
