| 摘要: |
| 目的：观察真武汤合五苓散加减对阳虚水泛型急性失代偿性心衰（ADHF）患者心功能和B型脑钠肽（BNP）的影响。方法：将96 例ADHF患者随机分为治疗组和对照组，每组各48 例。对照组予以西医常规治疗，治疗组在对照组的基础上加用真武汤合五苓散加减治疗。观察2组患者治疗前后的中医证候积分、肺部啰音消失时间、住院时间、美国纽约心脏病学会（NYHA）心功能分级情况、BNP水平及不良反应发生情况。结果：治疗组中有2 例患者无法坚持服用中药而剔除，1 例患者院内猝死脱落。对照组中有2 例患者由于出现心源性休克而剔除，1 例患者自动出院而脱落，1 例患者自行服用中成药而剔除。治疗后，治疗组中医证候积分低于对照组，患者住院时间和肺部啰音消失时间短于对照组，心功能Ⅰ级和Ⅱ级患者多于对照组，BNP水平亦低于对照组，差异均有统计学意义（P＜0.05或P＜0.01）。且2组电解质紊乱、肝肾功能异常、胃肠道反应等各类不良反应发生率比较，差异均无统计学意义（P>0.05）。结论：真武汤合五苓散加减治疗ADHF阳虚水泛证患者，能够改善其中医证候积分，改善心功能，缩短住院时间及肺部啰音消失时间，降低BNP水平，且未增加不良反应。 |
| 关键词: 急性失代偿性心衰 阳虚水泛型 真武汤 五苓散 |
| DOI： |
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| Effect of Zhenwu decoction combined with modified Wuling powder on cardiac function and brain natriuretic peptide in patients with acute decompensated heart failure with water overflowing due to Yang deficiency |
| TANG Pinsheng,YANG Haiyu,YU Tao |
| (Hunan University of Chinese Medicine，Changsha 410208，Hunan，China;Jiangmen Wuyi Hospital of Traditional Chinese Medicine，Jiangmen 529000，Guangdong，China) |
| Abstract: |
| Objective：To investigate the effect of Zhenwu decoction combined with modified Wuling powder on cardiac function and brain natriuretic peptide (BNP) in patients with acute decompensated heart failure (ADHF) with water overflowing due to Yang deficiency.Methods：A total of 96 patients with ADHF were randomly divided into treatment group and control group，with 48 patients in each group.The patients in the control group were given conventional Western medicine therapy，and those in the treatment group were given Zhenwu decoction combined with modified Wuling powder in addition to the treatment in the control group.The two groups were compared in terms of traditional Chinese medicine (TCM) syndrome score before and after treatment，time to disappearance of pulmonary rales，length of hospital stay，New York Heart Association (NYHA) class for cardiac function，BNP level，and incidence rate of adverse reactions.Results：In the treatment group，2 patients were removed since they could not adhere to TCM therapy and 1 patient was lost due to sudden death；in the control group，2 patients were removed due to cardiogenic shock，1 patient was lost after discharge without treatment，and 1 patient was removed due to the administration of Chinese patent drug.Compared with the control group after treatment，the treatment group had a significantly lower TCM syndrome score，significantly shorter length of hospital stay and time to disappearance of pulmonary rales，a significantly higher proportion of patients with class I/II cardiac function，and a significantly lower BNP level (P<0.05 or P<0.01).There were no significant differences between the two groups in the incidence rates of adverse reactions including electrolyte disturbance，dysfunction of the liver and the kidney，and gastrointestinal reactions (P>0.05).Conclusion：In the treatment of patients with ADHF with water overflowing due to Yang deficiency，Zhenwu decoction combined with modified Wuling powder can significantly improve TCM syndrome score and cardiac function，shorten the length of hospital stay and the time to disappearance of pulmonary rules，and reduce BNP level，without increasing adverse reactions. |
| Key words: acute decompensated heart failure water overflowing due to Yang deficiency Zhenwu decoction Wuling powder |
