【摘要】 目的:探讨真武汤合参附汤加减对扩张型心肌病急慢性心衰竭患者心功能及心室重构的影响。方法:将72例扩张型心肌病急慢性心衰竭患者随机分为两组各36例,对照组给予西医常规治疗,治疗组在对照组治疗基础上加服真武汤合参附汤加减,观察两组临床疗效及治疗前后血浆脑钠肽(BNP)、左心室射血分数(LVEF)、左心室舒张末内径(LVEDD)、左室质量指数(LVMI)及3个月内不良心血管事件发生率。结果:显效率、总有效率治疗组分别为38.9%、97.2%,高于对照组的19.4%、88.9%,组间比较,差异有统计学意义(P<0.05);两组治疗后血浆BNP水平、LVEDD、LVMI均较治疗前明显下降,LVEF明显增高,差异有统计学意义(P<0.05),且各项指标治疗后组间比较,差异亦有统计学意义(P<0.05);治疗组的不良心血管事件发生率较对照组亦显著减少(P<0.05)。结论:真武汤合参附汤加减能显著改善扩张型心肌病心衰患者的心功能,并明显逆转心室重构而改善患者预后。更多还原

【Abstract】 Objective: To investigate the effects of modified Zhenwu decoction combined with Shenfu decoction on cardiac function and ventricular remodeling in patients with dilated cardiomyopathy and acute or chronic heart failure. Methods: A total of 72 patients with dilated cardiomyopathy and acute or chronic heart failure were equally and randomly divided into control group and treatment group. The control group received conventional Western medicine treatment,while the treatment group received modified Zhenwu decoction combined with Shenfu decoction in addition to the conventional Western medicine treatment. The treatment outcomes of the two groups were assessed. Plasma brain natriuretic peptide( BNP) level,left ventricular ejection fraction( LVEF),left ventricular end-diastolic diameter( LVEDD),and left ventricular mass index( LVMI) of the two groups before and after treatment and the 3-month incidence rates of adverse cardiovascular events after treatment were observed. Results: The treatment group had significantly higher marked response rate and overall response rate than the treatment group( 38. 9%vs19. 4%,P < 0. 05; 97. 2% vs88. 9%,P < 0. 05). After treatment,both groups showed significant decreases in plasma BNP level,LVEDD,and LVMI and a significant increase in LVEF( P < 0. 05). And there were significant differences in the above indices between the two groups after treatment( P < 0. 05). The treatment group had a significantly lower incidence rate of adverse cardiovascular events than the control group( P < 0. 05). Conclusion: For patients with dilated cardiomyopathy and heart failure,modified Zhenwu decoction combined with Shenfu decoction can significantly improve cardiac function and reverse ventricular remodeling to improve the prognosis of patients.更多还原