摘要
目的观察辨证针刺结合西医常规疗法治疗慢性心力衰竭(CHF)的临床疗效。方法纳入72例CHF(心功能Ⅱ级)患者,随机分为治疗组与对照组,每组各36例。治疗组患者给予西医基础治疗结合辨证针刺治疗,对照组患者给予西医基础治疗结合安慰针刺治疗。两组疗程均为1个月,评价患者的临床疗效;治疗后随访2个月,检测并比较两组患者治疗前后及随访2个月时的左室射血分数(LVEF)、N末端B型利钠肽原(NT-proBNP)水平。结果①试验期间,治疗组1例患者退出,对照组1例患者脱落、1例患者剔除,最终纳入统计分析者治疗组35例、对照组34例。②治疗后,治疗组和对照组患者的临床总有效率分别为85.7%、61.8%,治疗组的疗效优于对照组(P<0.05)。③治疗后及随访时,两组患者的LVEF较治疗前均明显升高(P<0.05)、NT-proBNP水平较治疗前明显降低(P<0.05),且治疗后治疗组患者的LVEF高于对照组(P<0.05)。与治疗后比较,随访时,两组患者的LVEF均降低(P<0.05)、NT-proBNP水平均升高(P<0.05),组间差异无统计学意义(P>0.05)。结论辨证针刺结合西医常规疗法可有效改善CHF患者的心功能指标,缓解患者的临床症状,但其远期疗效尚有待进一步探讨。
Objective To observe the clinical efficacy of acupuncture based on syndrome differentiation combined with conventional western medicine in the treatment of chronic heart failure(CHF).Methods Seventy-two patients with CHF(heart function gradeⅡ)were included and randomly divided into the treatment group and the control group,36 cases in each group.The patients in the treatment group were treated with basic western medicine combined with acupuncture based on syndrome differentiation,and the patients in the control group were treated with basic western medicine combined with placebo acupuncture.The course of treatment in both groups was 1 month.The clinical efficacy of the two groups was evaluated;follow-up for 2 months after treatment,the levels of left ventricular ejection fraction(LVEF)and N-terminal B-type natriuretic peptide(NT-proBNP)were detected and compared before and after treatment and at follow-up for 2 months.Results①During the trial,one patient in the treatment group withdrew,and one patient dropped off and one patient was removed in the control group.Finally,35 patients in the treatment group and 34 patients in the control group were included in the statistical analysis.②After treatment,the total clinical effective rates of the treatment group and the control group were 85.7%and 61.8%respectively,and the curative effect of the treatment group was better than that of the control group(P<0.05).③After treatment and at follow-up,the level of LVEF in both groups was significantly increased(P<0.05)and the level of NT-proBNP was significantly decreased(P<0.05)compared with those before treatment,and after treatment,the level of LVEF in the treatment group was higher than that in the control group(P<0.05).At follow-up,the level of LVEF was decreased(P<0.05)and the level of NT-proBNP was increased(P<0.05)in both groups compared with those after treatment,with no statistical differences between the two groups(P>0.05).Conclusion Acupuncture based on syndrome differentiation combined with conventional western medicine can effectively improve the cardiac function indexes and relieve the clinical symptoms in treating patients with CHF,but its long-term effect needs to be further explored.
作者
贺卫
朱慧英
奚安
吴国强
秦莹
HE Wei;ZHU Huiying;XI An;WU Guoqiang;QIN Ying(Department of Cardiology,Shanghai Pudong New Area Hospital of Traditional Chinese Medicine,Shanghai 201299,China)
出处
《上海中医药杂志》
2021年第1期47-51,共5页
Shanghai Journal of Traditional Chinese Medicine
基金
上海市浦东新区科技发展基金资助项目(PKJ2017-Y59)。
关键词
慢性心力衰竭
针刺
证候要素
辨证
随机对照试验
chronic heart failure
acupuncture
syndrome elements
syndrome differentiation
randomized controlled trial
