主 办:北 京 中 医 药 大 学
ISSN 1006-2157 CN 11-3574/R

北京中医药大学学报 ›› 2018, Vol. 41 ›› Issue (8): 696-701.doi: 10.3969/j.issn.1006-2157.2018.08.013

• 临床研究 • 上一篇    下一篇

益气泻肺利水方治疗慢性心力衰竭合并室性期前收缩的临床观察*

张为1, 肖珉1#, 张立晶1, 赵勇1, 李玉峰2, 郭实1, 常佩芬1, 黄宏3   

  1. 1 北京中医药大学东直门医院 北京 100700;
    2 北京中医药大学心血管研究所;
    3 北京中医药大学
  • 收稿日期:2017-12-04 出版日期:2018-08-30 发布日期:2018-08-30
  • 通讯作者: 肖珉,女,博士,副教授,副主任医师,研究方向:中西医结合防治心血管病,E-mail:13910906849@163.com
  • 作者简介:张为,男,博士,副主任医师
  • 基金资助:
    北京市自然科学基金重点课题项目(No.7161008)

Effects of qi-boosting lung-dredging water-draining formula on chronic heart failure combined with premature ventricular contraction: clinical observation*

Zhang Wei1, Xiao Min1#, Zhang Lijing1, Zhao Yong1, Li Yufeng2, Guo Shi1, Chang Peifen1, Huang Hong3   

  1. 1 Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing 100700, China;
    2 Institute of Cardiovascular Research, Beijing University of Chinese Medicine, Beijing 100700, China;
    3 Beijing University of Chinese Medicine, Beijing 100029, China
  • Received:2017-12-04 Online:2018-08-30 Published:2018-08-30
  • Supported by:
    Key Project of Beijing Natural Science Foundation(No.7161008)

摘要: 目的 评价益气泻肺利水方治疗慢性心力衰竭合并室性期前收缩(早搏)的疗效和安全性。方法 采用随机双盲安慰剂对照的方法,将60例慢性心力衰竭合并室性期前收缩属阳虚水泛证患者随机分为试验组和对照组(每组30例)。试验组给予慢性心力衰竭标准化治疗合益气泻肺利水方,对照组给予慢性心力衰竭标准化治疗合安慰剂,治疗8周后,比较2组患者室性早搏指数、室性早搏频数、T波峰-末间期(Tp-e)、Tp-e/QT等动态心电图指标以及左室射血分数(LVEF)、血清氨基末端B型尿钠肽前体水平(NT-pro BNP)、6分钟步行试验(6MWT)、明尼苏达心力衰竭生存质量量表评分(MLHF-Q)、中医证候积分等指标的变化。结果 治疗后2组患者Tp-e/QT值、室性早搏频数、室性早搏指数均较治疗前改善(P<0.05),且试验组Tp-e/QT值优于对照组(P<0.05);与对照组相比,试验组的NT-pro BNP、6MWT、MLHF-Q、中医证候积分均显著改善(P<0.05);心功能分级和室性早搏频数疗效评价差异无统计学意义,但试验组的中医疗效优于对照组(P<0.05)。结论 益气泻肺利水方能在西医标准化治疗基础上进一步改善患者的心功能和生活质量;并能改善室性早搏指数、Tp-e,降低发生恶性心律失常的风险。

关键词: 益气泻肺利水方, 慢性心力衰竭, 室性期前收缩, 阳虚水泛证

Abstract: Objective To evaluate the efficacy and safety of qi-boosting lung-dredging water-draining formula (Yiqi Xiefei Lishui Fang, YXLF) in the treatment of chronic heart failure with premature ventricular contraction (PVC). Methods Randomized doubled blinded placbo-controlled design was used. 60 patients with chronic heart failure combined with PVC, whose TCM diagnosesn were water diffusion due to deficiency of yang, were randomly divided into experimental group and control group(n=30 in each group). The experimental group received YXLF on the basis of standard treatment for chronic heart failure. Patients in the control group were given standard treatment of chronic heart failure and placebo. The course of treatment was 8 weeks. Outcome measures included the prematurity index, PVC frequency, the Tp-e interval, the Tp-e/QT Electrocardiogram and LVEF, NT-pro BNP, 6-minute walking test, Minnesota Heart Failure Quality of Life Scale (MLHF-Q), TCM Syndrome score and others were compared between the two groups. Results Tp-e / QT value, PVC frequency, and prematurity index were improved compared with those before treatment (P<0.05). But there was no significant difference between the two groups (P>0.05). The Tp-e / QT value of the test group was significantly better than that of the control group (P<0.05). Compared with the control group, the NT-pro BNP, 6MWT, MLHF-Q and TCM Syndrome score of experimental group were all improved (P <0.05), but there was no significant difference in LVEF between the two groups (P> 0.05). In terms of efficacy evaluation with cardiac function classification and PVC frequency, there was no difference of statistical significance between the two groups. But TCM treatment effectiveness of experimental group was superior to that of the control group (P<0.05). Conclusion Qi-boosting lung-dredging water-draining formula can improve the heart function and quality of life in patients with chronic heart failure and ventricular premature beats on the basis of conventional treatment. And it can improve the prematurity index, Tp-e interval, and reduce the risk of malignant arrhythmia.

Key words: Yiqi Xiefei Lishui Fang, chronic heart failure, premature ventricular contraction, patten of yang deficiency with wate flooding

中图分类号: 

  • R256.2