【作者】 邹旭；

【导师】 文旺秀；

【作者基本信息】 广州中医药大学 ， 中医内科学， 2005， 硕士

【摘要】 目的: 观察暖心胶囊对慢性收缩性心力衰竭临床疗效的影响。 方法: 选择慢性充血性心力衰竭患者100例随机分为治疗组与对照组,对照组50例予西医基础治疗,治疗组50例在西医基础治疗上同时服用暖心胶囊,3粒/次,3次/天,疗程6个月。观察两组治疗前后的主要指标疗效、中医症状积分改善情况及6分钟步行距离,评价再次住院率,检测治疗前后心功能参数及血浆脑钠肽(BNP)的含量等。 结果: 1.治疗组与对照组均能改善心衰患者主要指标疗效,两组比较,治疗组明显高于对照组(P<0.05); 2.两组均能改善气促、四肢浮肿、心悸、疲倦乏力、自汗、胸闷、头晕、尿少、畏寒肢冷、腹胀等症状积分,但治疗组较优(P<0.05);治疗组在改善患者纳呆、气短、口唇紫暗、面色苍白、舌淡胖、舌质暗、脉弱无力、脉结或代等症状积分方面,治疗前后及与对照组比较均有显著性差异(P<0.05),对照组治疗前后无统计学差异(P>0.05); 3.治疗组再次住院率低于对照组,两组有显著性差异(P<0.05); 4.两组均能改善左心收缩功能、舒张功能相关指标,暖心胶囊组较对照组改善左心收缩、舒张功能更为明显,两组差异有显著性(P<0.05); 5.两组均能使心衰患者6分钟步行距离提高,暖心胶囊组较对照组提高更优,有显著性差异(P<0.05); 6.两组均能使心衰患者BNP水平降低,暖心胶囊组较对照组降低更著,两组具有显著性差异(P<0.05)。 结论: 暖心胶囊是临床疗效好的药物。暖心胶囊对于心力衰竭患者有确切疗效,能够改善心衰患者症状、降低心衰患者再次住院率、提高患者的6分钟步行距离和可能对降低病死率有益等较好疗效,且未发生毒、副作用。此外暖心胶囊对左心收缩、舒张功能的改善较优;降低BNP作用更著,从另一个角度提示暖心胶囊对心衰程度缓解可能对长期预后有益。其可能作用机理是作用于心衰的多个环节、多个靶点,确切机理尚需进一步研究。进一步积累该药循证医学依据,将为延缓心衰进程、降低心衰病死率的研究提供新视角。更多还原

【Abstract】 Objective:This study was performed to observe the curative effect of the traditional Chinese herb medicine Nuanxin Capsule on the disease of chronic congestive heart failure. Methods:①100 patients with CHF were divided randomly into two groups: the controlled group (treated with appropriate western medicine for CHF)and the treatment group (treated with Nuanxin Capsule as well as the same kinds of western medicine as given to the controlled group), there were 50 patients in each group.The dosage for Nuanxin Capsule was 3 capsules, 3 times daily. The treatment time was six months;②Observing the symptoms, signs and total effective ratios before and after the treatment, making a statistical disposal and comparing the curative effect;③Examining six-minute walking test, ultrasonic cardiogranu BNP in the blood et al before and after the treatment and analyzing the rehospitalization rate. Results:①The symptoms and signs of the patients on the two groups after the treatment were better than those before treatment. Compared between the two groups, the total effective rate of the treatment group was significantly better than the controlled group(P <0. 05).②As compared with the controlled group, the rate of rehospitalization in the treatment group after treatment was significantly low (P<0.05).③The parameters of the left ventricular systolic and diastolic function更多还原