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1.广西中医药大学 第一附属医院,南宁 530001
2.儋州市中医医院,海南 儋州 571700
庞延,硕士,主治医师,从事中西医结合心血管病防治研究,E-mail:271528495@qq.com
卢健棋,主任医师,教授,博士生导师,从事中西医结合心血管病防治研究,E-mail:lujianqi666@163.com
收稿日期:2022-08-20,
网络出版日期:2022-10-31,
纸质出版日期:2023-02-20
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庞延,林浩,卢健棋等.强心汤联合八段锦治疗老年慢性心力衰竭伴衰弱患者的临床疗效[J].中国实验方剂学杂志,2023,29(04):104-109.
PANG Yan,LIN Hao,LU Jianqi,et al.Clinical Efficacy of Qiangxin Decoction Combined with Baduanjin in Treatment of Elderly Patients with Chronic Heart Failure and Weakness[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(04):104-109.
庞延,林浩,卢健棋等.强心汤联合八段锦治疗老年慢性心力衰竭伴衰弱患者的临床疗效[J].中国实验方剂学杂志,2023,29(04):104-109. DOI: 10.13422/j.cnki.syfjx.20230497.
PANG Yan,LIN Hao,LU Jianqi,et al.Clinical Efficacy of Qiangxin Decoction Combined with Baduanjin in Treatment of Elderly Patients with Chronic Heart Failure and Weakness[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(04):104-109. DOI: 10.13422/j.cnki.syfjx.20230497.
目的
2
慢性心力衰竭(CHF)是心血管疾病的终末阶段,CHF伴衰弱患者的心血管不良事件明显增加,传统中医治疗CHF具有良好疗效,然而中药联合传统养生功法治疗老年CHF伴衰弱患者的临床观察,目前鲜有相关报道。该研究拟探讨强心汤联合八段锦治疗老年慢性心力衰竭伴衰弱患者的临床疗效。
方法
2
选取2020年1月至2021年12月在广西中医药大学第一附属医院心血管科住院确诊为气虚血瘀水停证型的CHF患者60例,对照组遵循指南给予常规西药治疗,观察组在对照组基础上给予强心汤和八段锦锻炼。观察两组治疗前和治疗1个月后两组血清N末端B型脑钠肽前体(NT-proBNP)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、游离脂肪酸(FFA)、左室射血分数(LVEF)、左室舒张末期内经(LEVDD)、6 min步行试验(6MWD)、明尼苏达心力衰竭生活质量表(MLHFQ)和Tilburg衰弱量表评分,同时对比两组3个月内再住院情况。
结果
2
两组一般资料及治疗前各疗效指标比较差异均无统计学意义。与本组治疗前比较,两组患者治疗后NT-proBNP、CK、LDH、FFA、LVEDD、MLHFQ评分、Tilburg衰弱量表评分均明显降低(
P
<
0.05,
P
<
0.01),LVEF、6MWD水平均明显升高(
P
<
0.05,
P
<
0.01)。与对照组治疗后比较,观察组效果更优(
P
<
0.05,
P
<
0.01)。3个月内再住院率观察组(7.1%,2/28)明显低于对照组(30.8%,8/26)(
χ
2
=4.897,
P
<
0.05)。
结论
2
强心汤联合八段锦有助于改善老年CHF伴衰弱患者机体能量代谢、心功能、生活质量和衰弱水平,减少再住院率。
Objective
2
Chronic heart failure (CHF) is the terminal stage of cardiovascular disease. The adverse cardiovascular events of CHF patients with weakness have increased significantly. Traditional Chinese medicine (TCM) has a good effect on CHF. However,there are few reports on the clinical observation of the treatment of CHF with weakness in elderly patients by TCM combined with conventional health-preserving exercises. This study aimed to explore the clinical efficacy of Qiangxin decoction combined with Baduanjin in the treatment of elderly patients with CHF and weakness.
Method
2
Sixty CHF patients with Qi deficiency,blood stasis,and water retention syndrome admitted to the Cardiovascular Department of the First Affiliated Hospital of Guangxi University of Chinese Medicine from January 2020 to December 2021 were enrolled. The patients in the control group were treated with conventional western medicine according to the guidelines,while those in the treatment group received additional Qiangxin decoction and Baduanjin exercise based on the therapeutic protocol of the control group. The levels of serum N-terminal B-type brain natriuretic peptide precursor (NT-proBNP),creatine kinase (CK),lactate dehydrogenase (LDH),free fatty acid (FFA),left ventricular ejection fraction (LVEF),left ventricular end-diastolic dimension (LEVDD),6-minute walk distance (6MWD),Minnesota Living with Heart Failure Questionnaire (MLHFQ), and Tilburg Frailty Indicator (TFI) scores of the two groups were observed before and one month after treatment. At the same time,the re-admission within three months was compared between the two groups.
Result
2
There was no significant difference between the two groups in terms of the general data and the therapeutic indexes before treatment. After treatment,the NT-proBNP,CK,LDH,FFA,LVEDD,MLHFQ, and TFI scores of the two groups were lower than those before treatment(
P
<
0.05,
P
<
0.01), and the LVEF and 6MWD were higher(
P
<
0.05,
P
<
0.01). The efficacy of the treatment group was superior to that of the control group after treatment (
P
<
0.05,
P
<
0.01). The re-admission rate within three months in the treatment group was 7.1% (2/28), lower than 30.8% (8/26) in the control group (
χ
2
=4.897,
P
<
0.05).
Conclusion
2
Qiangxin decoction combined with Baduanjin is helpful to improve the body energy metabolism,heart function,quality of life,and weakness level of elderly CHF patients with weakness, and reduce the rate of re-admission.
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