【摘要】 【目的】观察暖心胶囊治疗舒张性心力衰竭(DHF)的疗效。【方法】采用随机分组方法将80例患者分为治疗组(41例)和对照组(39例)。两组均给予利尿剂、扩血管药物、血管紧张素转化酶抑制剂(ACEI)、β-受体阻滞剂和钙拮抗剂等常规西药治疗,治疗组在此基础上加服暖心胶囊(由红参、熟附子、薏苡仁、橘红、三七等组成),对照组则服用外观、口感与暖心胶囊相似的安慰剂,疗程均为9个月。观察两组临床总疗效和治疗前后中医证候评分、心功能分级评估、6 min步行距离的变化情况,观察两组复发率、病死率及不良反应情况。【结果】治疗组2例失访,对照组1例失访。治疗组临床近期治愈10例,显效21例,有效4例,无效4例,总有效率为89.74%;对照组临床近期治愈7例,显效14例,有效9例,无效8例,总有效率为78.94%。两组疗效比较,治疗组疗效优于对照组(P<0.05)。两组治疗后均能改善气促、胸闷、心悸、倦怠乏力、四肢浮肿、纳呆、尿少、口唇紫暗等症状评分(与治疗前比较,P<0.05),且治疗组在改善气促、胸闷、纳呆、口唇紫暗等症状方面优于对照组(P<0.05)。随访12个月,治疗组复发入院9例,死亡2例,复发率和病死率分别为23.08%和5.13%;对照组复发入院17例,死亡7例,复发率和病死率分别为44.73%和18.42%。两组比较,治疗组的复发率和病死率均低于对照组(P<0.05)。两组均能提高心衰患者的6 min步行距离,且治疗组较对照组提高更显著(P<0.05)。治疗期间,治疗组未发现因药物引起的不良反应,对照组有1例出现皮疹。【结论】暖心胶囊对于DHF患者有确切疗效,能改善DHF患者的临床症状,降低DHF患者的复发率和病死率,及提高患者的6 min步行距离。更多还原

【Abstract】 【Objective】To observe the therapeutic effect of Nuanxin Capsule(NC) prescribed by Professor Deng Tietao for diastolic heart failure(DHF).【Methods】Eighty DHF patients were randomized into two groups.The two groups were given routine western medicines such as diuretics,vasodilators,angiotensin-converting enzyme inhibitor(ACEI),beta-receptor blocker and calcium antagonists.Group A(N=41)received NC(mainly composed of Radix Ginseng Rubra,Radix Aconiti Lateralis Preparata,Semen Coicis,Exocarpium Citri Rubrum,Radix Notoginseng),and group B(N=39)received placebo additionally.The treatment lasted 9 months.The total therapeutic effect,TCM syndrome scoring,cardiac function classification,walking distance within 6 min were evaluated,and the recurrence rate,mortality rate and adverse reaction were observed in the two groups after treatment.【Results】There were 2 patients in group A and 1 in group B loss of follow-up.In group A,10 patients were short-term cured,21 markedly effective,4 effective,4 ineffective and the total effective rate was 89.74%;In group B,7 patients were short-term cured,14 markedly effective,9 effective,8 ineffective and the total effective rate was 78.94%;the therapeutic effect in group A was better than that in group B(P<0.05).Symptoms and signs of short breath,chest distress,palpitation,lassitude,edema of the limbs,anorexia,scanty urine,cyanotic lips were relieved in the two groups(P<0.05),and group A has a better effect on relieving short breath,chest distress,anorexia,cyanotic lips(P<0.05).The follow-up for 12 months showed that recurrence was found in 9 patients of group A and 17 of group B,death in 2 of group A and 7 of group B.The recurrence rate and mortality rate were 23.08% and 5.13% in group A respectively,and 44.73% and 18.42% in group B respectively.The differences of the recurrence rate and mortality rate between the two groups were significant(P<0.05).The walking distance within 6 min was prolonged in the two groups,the effect in group A being better than that in group B(P<0.05).Only one patient had skin rash in group B during treatment,and no adverse reaction was found in other patients.【Conclusion】NC has certain effect for DHF by relieving symptoms and signs,decreasing the recurrence rate and mortality rate,increase walking distance within 6 min.更多还原