首页|基于"心与小肠相表里"评价温阳通络安肠方治疗慢性心力衰竭合并肠功能障碍的临床疗效

基于"心与小肠相表里"评价温阳通络安肠方治疗慢性心力衰竭合并肠功能障碍的临床疗效

Clinical efficacy evaluation of Wenyang Tongluo Anchang Formula in the treatment of chronic heart failure combined with intestinal dysfunction based on'interior and exterior of heart and intestine'

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目的:评价温阳通络安肠方联合西医治疗慢性心力衰竭(CHF)合并肠功能障碍(ID)的疗效及安全性.方法:将2022年10月至2023年9月就诊于山东中医药大学附属医院的72例CHF合并ID心脾阳虚、痰瘀阻络证患者随机分为2组:对照组(36例)予西医常规治疗,试验组(36例)在西医常规治疗基础上加用温阳通络安肠方浓煎口服,疗程均为8周.治疗前后观察患者中医证候积分、堪萨斯城心肌病患者生活质量量表(KCCQ)、急性胃肠损伤(AGI)分级和六分钟步行试验(6MWT)变化情况.检测超声心动图、N末端脑钠肽前体(NT-Pro BNP)、二胺氧化酶(DAO)、脂多糖(LPS)以及安全性指标;统计3个月内再入院率.结果:试验组总有效率[87.88％(29/33)]显著优于对照组[65.63％(21/32)](P＜0.05).与对照组比较,治疗后试验组患者左心室舒张末期内径(LVEDD)、NT-Pro BNP、DAO及LPS显著降低(P＜0.05,P＜0.01),6MWT距离显著提高(P＜0.05).试验组3个月内再入院率显著低于对照组(P＜0.05).两组患者在治疗期间均未出现明显的不良反应.结论:温阳通络安肠方治疗CHF合并ID疗效显著,能够改善心功能和肠功能,提高患者生活质量,降低再入院率,具有较好的安全性.
Objective:To assess the therapeutic efficacy and safety of Wenyang Tongluo Anchang Formula(WTAF)in combination with Western medicine for the management of chronic heart failure(CHF)combined with intestinal dysfunction(ID).Methods:A total of 72 patients with CHF combined with ID who presented with heart-spleen-yang deficiency and phlegm-stasis-obstruction syndrome received treatment in at the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from October 2022 to September 2023 were randomly divided into two groups:control group(36 patients)receiving conventional Western medicine treatment,and experimental group(36 patients)receiving oral administration of WTAF for 8 weeks.Traditional Chinese medicine syndrome score scale,KCCQ scores,AGI grade,and 6MWT results were assessed before and after treatment.Echocardiography measurements along with concentrations of serum NT-Pro BNP,DAO,LPS as well as safety indexes were determined.The readmission rate within a 3-month period was recorded.Results:The overall effective rate in the experimental group[87.88％(29/33)]was significantly higher than that in the control group[65.63％(21/32)](P＜0.05).Following treatment,compared to the control group,the experimental group exhibited significantly lower LVEDD,NT-Pro BNP levels along with DAO and LPS concentrations(P＜0.05,P＜0.01)while showing increased distance covered during the 6MWT(P＜0.05).Moreover,the experimental group had a significantly lower readmission rate within three months compared to the control group(P＜0.05).No significant adverse reactions occurred in either groups during the treatment period.Conclusion:WTAF demonstrates remarkable efficacy in treating CHF combined with ID by improving cardiac function as well as intestinal function,resulting in enhanced quality of life,reduced readmission rates,and excellent safety profile.

Interior and exterior of heart and intestineChronic heart failure(CHF)Intestinal dysfunction(ID)Wenyang Tongluo Anchang FormulaSimultaneous treatment of the heart and intestinesClinical efficacy

刘佳卉、王彤、王咏、姜凌宇、王丽丽、张苗苗、李雨、程艳、迟莉丽

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山东中医药大学,济南 250014

山东中医药大学附属医院,济南 250014

心与小肠相表里 慢性心力衰竭 肠功能障碍 温阳通络安肠方 心肠同治 临床疗效

国家自然科学基金项目济南市科技计划临床医学科技创新计划齐鲁中医药优势专科集群建设项目山东中医药大学附属医院青年科研创新团队项目

821047972021340242021-02001

2024

中华中医药杂志
中华中医药学会

中华中医药杂志

CSTPCD北大核心
影响因子：1.135
ISSN：1673-1727
年,卷(期)：2024.39(7)
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