标题：益气温阳利水方治疗老年阳气亏虚型慢性充血性心衰疗效观察

      作者：鄂立平，姚计文，李海燕    (北京市和平里医院心内科，北京 100013)

      卷次： 2018年29卷19期

      【摘要】 目的 探讨中医益气温阳利水方治疗阳气亏虚型老年慢性充血性心力衰竭患者的临床价值。方法 选取 2016年 1月至 2017年 10月北京市和平里医院心内科收治的阳气亏虚型老年慢性充血性心力衰竭患者 120例，采用随机数表法分为中西医组和对照组各60例，两组患者均给予西医基础治疗，中西医组同时还给予益气温阳利水方辅助治疗，疗程8周，比较两组患者的临床治疗效果。结果 治疗前，中西医组和对照组患者的各项中医症候积分比较差异均均无统计学意义(P>0.05)；治疗后，中西医组患者的心悸、胸闷、气短、乏力、水肿、畏冷怯风、小便清、舌淡、颈静脉怒张症候积分均明显低于对照组，差异均有统计学意义(P<0.05)；治疗前，中西医组和对照组的左室射血分数(LVEF%)、左室舒张末期内径(LVEDd)、左心室收缩末期内径(LVESD)、心输出量(CO)、血清脑钠肽(BNP)比较差异均无统计学意义(P>0.05)；治疗后，中西医组患者的LVEDd、LVESD、BNP均明显低于对照组，LVEF%、CO均明显高于对照组，差异均有统计学意义(P<0.05)；治疗后，两组患者的LVEF%、CO较本组治疗前明显升高，而LVEDd、LVESD、各项中医症候积分和BNP水平较本组治疗前均明显降低，差异均有统计学意义(P<0.05)。结论 中医益气温阳利水方结合西医常规治疗能进一步改善阳气亏虚型老年慢性充血性心力衰竭患者的心功能及中医症候症状，具有较好的临床治疗效果。
      【关键词】 中医；益气温阳利水方；阳气亏虚型；老年；慢性充血性心力衰竭；疗效
      【中图分类号】 R541.6+1 【文献标识码】 A 【文章编号】 1003—6350（2018）19—2714—04

Curative effect of supplementing qi warming yang and promoting water metabolism in treating chroniccongestive heart failure of senile patients with Yang deficiency type.
E Li-ping, YAO Ji-wen, LI Hai-yan. Departmentof Cardiology, Beijing He Ping Li Hospital, Beijing 100013, CHINA
【Abstract】 Objective To explore the clinical value of Traditional Chinese medicine (TCM) supplementing qiwarming yang and promoting water metabolism in treating chronic congestive heart failure of senile patients with Yangdeficiency type. Methods A total of 120 patients with chronic congestive heart failure of Yang deficiency type admit-ted in the Department of Cardiology, Beijing He Ping Li Hospital, from January 2016 to October 2017 were selected. Ac-croding to the random number table, they were divided into the Chinese and Western medicine group and the controlgroup, with 60 patients in each group. The two groups were given basic medical treatment of western medicine. The Chi-nese and Western medicine group was given supplementing qi warming yang and promoting water metabolism on the ba-sis of basic medical treatment of western medicine. The course of treatment was 8 weeks. The clinical treatment effectsbetween the two groups of patients were compared. Results Before treatment, there was no significant difference in thescores of TCM syndrome between the Chinese and Western Medicine group and the control group (P>0.05). After treat-ment, the scores of palpitations, chest tightness, shortness of breath, fatigue, edema, chills and hurricane, urinary clear-ness, pale tongue and jugular vein anger in the Chinese and Western Medicine group were significantly lower than thosein the control group, and the differences were statistically significant (P<0.05). Before treatment, there were no signifi-cant differences in left ventricular ejection fraction (LVEF%), left ventricular end-diastolic diameter (LVEDd), left ven-tricular end-systolic diameter (LVESD), cardiac output (CO) and serum brain natriuretic peptide (BNP) between the Chi-nese and Western Medicine group and the control group (P>0.05). After treatment, the levels of LVEDd, LVESD, andBNP in the Chinese and Western Medicine group were significantly lower than those in the control group, but LVEF%and CO were significantly higher than those in the control group, and the differences were statistically significant (P<0.05). After treatment, LVEF% and CO in the two groups were significantly higher than those before treatment (P<0.05),while the LVEDd, LVESD, TCM syndrome scores and BNP levels between the two groups were significantly lower thanthose before treatment (P<0.05). Conclusion Traditional Chinese medicine supplementing qi warming yang and pro-moting water metabolism combined with Western medicine routine treatment can further improve the heart function andTCM symptom symptoms of elderly patients with chronic congestive heart failure of Yang deficiency type, which has agood clinical therapeutic effect.
      【Key words】 Traditional Chinese medicine (TCM); Supplementing qi warming yang and promoting water metab-olism; Yang deficiency type; Elderly; Chronic congestive heart failure; Curative effect·论 著·doi:10.3969/j.issn.1003-6350.2018.19.014基金项目：北京市中医药科技项目(编号：JJ2017-04)