【摘要】 目的:观察真武汤治疗舒张性心衰阳虚水泛证的临床疗效。方法:将舒张性心衰阳虚水泛证患者48例按随机数字表法分为观察组和对照组各24例。对照组给予西医常规治疗;观察组在对照组基础上采用真武汤治疗,治疗8周后检测两组患者治疗前后左心房内径(left atrial diameter,LA)、左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左室收缩末期内径(left ventricular end systolic diameter,LVESD)、室间隔厚度(interventricular septum thickness,IVST)、左室后壁厚度(left ventricular posterior wall thickness,LVPWT)、流速峰值比值(early and advanced flow velocity peak,E/A)及血浆脑钠肽(brain natriuretic peptide,BNP)水平;观察两组患者治疗前后心功能改善程度、生活质量评分及中医证候积分;记录不良反应。结果:治疗后两组患者心功能改善方面观察组总有效率为91.7%(22/24),优于对照组的62.5%(15/24)(P<0.05);治疗后两组患者LA、LVEDD、LVESD、BNP及生活质量评分、中医证候积分较治疗前降低,观察组低于对照组(P<0.05);两组IVST及LVPWT较治疗前无明显变化(P>0.05)。治疗后两组患者E/A较治疗前提高,观察组高于对照组(P<0.05)。两组均无明显不良反应。结论:真武汤联合常规西医治疗舒张性心衰阳虚水泛证临床疗效优于单纯常规西医治疗,其机制可能与增强心肌收缩力,抑制神经内分泌,改善心室重构有关。更多还原

【Abstract】 Objective: To observe clinical effects of Zhenwu Tang in treating diastolic heart failure(DHF) of Yang deficiency and water flooding pattern. Methods: All 48 patients were allocated to the observation group and the control group according to random number table method, 24 cases each group. The control group accepted conventional therapy of Western medicine, and the observation group took Zhenwu Tang based on Western medicine, to detect LA, LVEDD, LVESD, IVST, LVPWT, E/A and BNP between both groups eight weeks after treating; to observe the improvements of cardiac function, the scores of quality of life and TCM syndrome score before and after treating in both groups; to record adverse reaction. Results: After treating, total effective rate of the observation group in the improvements of cardiac function was 91.7%(22/24), superior to 62.5%(15/24) of the control group(P<0.05); after treating, LA, LVEDD, LVESD, BNP, the scores of quality of life and TCM syndrome scores reduced compared with these before treating, the observation group was lower than the control group(P<0.05);IVST and LVPWT of both groups showed no obvious changes than before treating(P>0.05). After treating, E/A lifted in both groups, the observation group was higher than the control group(P<0.05). No obvious adverse reaction happened in both groups. Conclusion: Zhenwu Tang combined with conventional therapy of Western medicine in treating the patients are superior to only conventional therapy of Western medicine, and its mechanism might be related to enhancing myocardial contractility, inhibiting neuroendocrine and improving ventricular remodeling.更多还原