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补气活血药治疗气虚血瘀型心力衰竭的临床观察

Use of Qi(气)-Replenishing and Stasis-Removing Herbs in Treating Patients with Heart Failure of Qi Deficiency and Blood Stasis Type

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【作者】 朱伯卿; 戴瑞鸿; 王受益; 龚志铭; 沈筱同; 徐稚民; 高肇基;

【Author】 Zhu Boqing Dai Ruihong Hua Shan Hospital,Shanghai Medical University,Shanghai

【机构】 上海医科大学华山医院; 上海医科大学华山医院; 上海医科大学基础医学研究所; 上海市浦东中心医院; 上海市中医药研究院;

【摘要】 52例气虚血瘀型心力衰竭患者中,A 组8例作气囊漂浮导管监测血液动力学,在推注黄芪或滴注黄芪与丹参后,心脏指数等均明显增加;B 组44例在滴注丹参2周后,临床心功能、气虚证与血瘀证分级均有改善,在加用黄芪2周后则有进一步改善,高切率的全血比粘度、纤维蛋白原及血小板聚集功能等血液流变学指标均明显降低。

【Abstract】 There were 52 cases with heart failure of Qi deficiency and blood stasis type.Group A consisted of 8 cases monitoring cardiac hemodynamics by Swan-Ganz catheter.After intravenous injection of Astragalus membranaceus,Codonopsis pilosula and Astragalus,and Salvia miltiorrhiza,the cardiac index,cardiac output, stroke volume and stroke index were increased in the former two groups,but not after Salvia injection. Group B consisted of 44 cases which was given intravenous dripping of Salvia(24 gm/day)for 2 weeks,then added injection of Astragalus(24 gm/day)for 2 weeks.After therapy not only the clinical cardiac performance,PEP/LVET,severity of Qi deficiency and blood stasis were improved.Besides,the platelet aggregation function was markedly inhibited.According to experimental study of contraction curves of isolated papillary muscle of rabbits’heart,the results showed that Astragalus had positive inotropic effect and Salvia had no such effect.The synergistic effect of these two herbs can be demonstrated.The results of clinical and experimental study indicated that Astragalus and Salvia have synergistic effect.So the article supports the traditional theory of correlation between Qi and blood.

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