| 摘要: |
| 目的：观察木防己汤加味辅助治疗阳虚水泛型慢性肺源性心脏病（chronic pulmonary heart disease，CPHD）的临床疗效。方法：将60例阳虚水泛型 CPHD患者随机分为治疗组和对照组，每组各30例。对照组予以西医常规治疗，治疗组在对照组基础上加用木防己汤加味治疗，比较2组中医证候积分、动脉血氧分压（partial pressure of arterial oxygen， PaO2）、动脉血二氧化碳分压（partial pressure of arterial carbon dioxide， PaCO2）、第1秒用力呼气容积（forced expiratory volume in the first second， FEV1）、第1秒用力呼气容积占用力肺活量的百分比（forced expiratory volume in the first second/ forced vital capacity， FEV1/FVC）、N末端脑钠肽前体（N-terminal pro - brain natriuretic peptide， NT - proBNP）及纽约心脏学会（New York Heart Association， NYHA）心功能分级，并评价临床疗效。结果：总有效率治疗组为93.33%（28/30），对照组为80.00%（24/30），2组比较，差异无统计学意义（P>0.05）；治疗后2组中医证候积分、NT-proBNP均下降，PaO2、FEV1水平均升高，且治疗组优于对照组（P<0.05）；治疗后2组PaCO2均降低、FEV1/FVC均升高（P<0.05），但治疗组仅PaO2改善程度优于对照组（P<0.05）；治疗组心功能分级情况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）；2组患者均无药物相关性不适。结论：木防己汤加味辅助治疗阳虚水泛型CPHD具有一定的疗效优势，且安全性较好，对心功能指标改善明显，其治疗机制可能与改善心脏功能、减轻心脏负荷、增强心肌收缩力等有关。 |
| 关键词: 慢性肺源性心脏病 阳虚水泛型 木防己汤 中西医结合疗法 临床观察 |
| DOI： |
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| Clinical effect of Jiawei Mufangji decoction as an adjuvant therapy for chronic pulmonary heart disease with water overflowing due to Yang deficiency: An analysis of 30 cases |
| LIU Ying,HOU Daorui |
| (Xiangtan Hospital of Traditional Chinese Medicine, Xiangtan 411100, Hunan, China) |
| Abstract: |
| Objective: To investigate the clinical effect of Jiawei Mufangji decoction as an adjuvant therapy for chronic pulmonary heart disease （CPHD） with water overflowing due to Yang deficiency. Methods: A total of 60 CPHD patients with water overflowing due to Yang deficiency were randomly divided into treatment group and control group, with 30 patients in each group. The patients in the control group received conventional Western medicine treatment, and those in the treatment group received Jiawei Mufangji decoction in addition to the treatment in the control group. The two groups were compared in terms of traditional Chinese medicine （TCM） syndrome score, arterial partial pressure of oxygen （PaO2）, arterial partial pressure of carbon dioxide （PaCO2）, forced expiratory volume in 1 second （FEV1）, forced expiratory volume in the first second/ forced vital capacity （FEV1/FVC）, N-terminal pro-brain natriuretic peptide （NT-proBNP）, and New York Heart Association （NYHA） cardiac functional grading, and clinical outcome was assessed. Results: There was no significant difference in overall response rate between the treatment group and the control group ［93.33% （28/30） vs 80.00% （24/30）, P > 0.05］. After treatment, both groups had significant reductions in TCM syndrome score and NT-proBNP and significant increases in PaO2 and FEV1 （P < 0.05）, and the treatment group had significantly better results than the control group （P < 0.05）. After treatment, both groups had a significant reduction in PaCO2 and a significant increase in FEV1/FVC （P < 0.05）, but the treatment group had a significantly better improvement in PaO2 only than the control group （P < 0.05）. The treatment group had a significant change in cardiac functional grading after treatment, and there was a significant difference in cardiac functional grading between the two groups after treatment （P < 0.05）. No drug-related discomfort was observed in either group. Conclusion: As an adjuvant therapy, Jiawei Mufangji decoction has certain advantages and a favorable safety profile in the treatment of CPHD with water overflowing due to Yang deficiency and can significantly improve cardiac function parameters, possibly by improving cardiac function, alleviating cardiac load, and enhancing myocardial contractility. |
| Key words: chronic pulmonary heart disease water overflowing due to Yang deficiency integrated traditional Chinese and Western medicine therapy Mufangji decoction |
