防己黄芪汤治疗心力衰竭所致水肿的临床研究

曹军　张永光　徐璐薇

【摘要】 目的：探讨防己黄芪汤治疗心力衰竭所致水肿的临床效果。方法：选取2016年6月-2017年12月在本院接受治疗的心力衰竭所致水肿患者166例，根据随机数表法将其分为对照组和观察组，每组各83例。对照组采用利尿剂联合中药安慰剂治疗，观察组在对照组基础上加用防己黄芪汤治疗。两组均治疗14 d。比较两组24 h尿量、心功能指标、疗效及不良反应。结果：治疗14 d，观察组24 h尿量多于对照组，氨基末端脑钠肽前体（NT-proBNP）水平低于对照组，左心射血分数（LVEF）水平高于对照组，比较差异均有统计学意义（P<0.05）；观察组总有效率93.98%，高于对照组的75.90%，比较差异有统计学意义（字2=10.596，P=0.001）；观察组不良反应总发生率3.61%，低于对照组的10.84%，比较差异无统计学意义（P>0.05）。结论：防己黄芪汤可有效改善心力衰竭致水腫患者心功能，增加24 h尿量，提高治疗效果，且安全性较好。

【关键词】 心力衰竭； 水肿； 防己黄芪汤； 心功能； 24 h尿量

Clinical Study on the Treatment of Edema Caused by Heart Failure by Fangji Huangqi Decoction/CAO Jun，ZHANG Yongguang，XU Luwei，et al.//Medical Innovation of China，2018，15（16）：0-075

【Abstract】 Objective：To explore the clinical effect of Fangji Huangqi Decoction in the treatment of edema caused by heart failure.Method：A total of 166 patients with heart failure caused by edema from June 2016 to December 2017 in our hospital were selected，according to the random number table method，they were divided into control group and observation group，83 cases in each group.The control group was treated with diuretics combined with traditional Chinese medicine placebo，and observation group was additionally treated with Fangji Huangqi Decoction on the basis of the control group.The 24 h urine volume，cardiac function index，curative effect and adverse reactions were compared between two groups.Result：In the treatment of 14 d，the 24 h urine volume in observation group was more than that of control group，the level of N-terminal pro brain natriuretic peptide（NT-proBNP） was lower than that of control group，and the level of left ventricular ejection fraction（LVEF） was higher than that of control group，the differences were statistically significant（P<0.05）.The total effective rate of observation group was 93.98% higher than 75.90% of control group，the difference was statistically significant（字2=10.596，P=0.001）.The total incidence of adverse reactions in observation group was 3.61% lower than 10.84% in control group，the difference was not statistically significant（P>0.05）.Conclusion：Fangji Huangqi Decoction can effectively improve the heart function of patients with edema caused by heart failure，increase the amount of 24 h urine，improve the therapeutic effect，and have good safety.

【Key words】 Heart failure； Edema； Fangji Huangqi Decoction； Heart function； 24 h urine volume

First-authors address：Taizhou Hospital of Traditional Chinese Medicine of Jiangsu，Taizhou 225300，China

doi：10.3969/j.issn.1674-4985.2018.16.021

慢性心力衰竭是指各种结构性或功能性心脏病造成心室充盈和射血功能损伤而造成的一种临床综合征，而其产生的毛细血管内流体静力压力升高将增加水肿发生率，严重危及患者生命安全[1-2]。目前，西药多采用利尿剂对心力衰竭所致水肿的病症进行治疗，其中以呋塞米和螺内酯最为常见，可有效降低静脉压，促进水肿症状减轻，但其长时间使用仍存在一定的局限性[3]。防己黄芪汤是由《宋·太平惠民和剂局方》中裁化而来，主治风湿相搏，客在皮肤，关节烦疼，腰脚浮肿，上轻下重，不能屈伸，且在心衰性水肿病症治疗中获得较好的效果[4-5]。基于此，本研究对本院166例心力衰竭所致水肿患者展开研究，旨在探讨防己黄芪汤治疗心力衰竭所致水肿的临床效果，进一步优化心力衰竭所致水肿的治疗方案。……