基于证候要素辨证针刺治疗慢性心力衰竭（心功能Ⅱ级）的临床观察
Clinical observation on acupuncture treatment of chronic heart failure (heart function grade Ⅱ) based on syndrome elements
- 上海中医药杂志 2021年55卷第1期 页码：47-51
- 作者机构：
1.上海市浦东新区中医医院心内科（上海 201299）
- 作者简介：
贺卫，男，硕士，主治医师，主要从事中西医结合诊疗心血管疾病的临床研究工作
秦莹，主任医师;E-mail：qinying73@sina.com
- 基金信息：上海市浦东新区科技发展基金资助项目(PKJ2017-Y59)
DOI：10.16305/j.1007-1334.2021.1908154
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贺卫, 朱慧英, 奚安, 等. 基于证候要素辨证针刺治疗慢性心力衰竭（心功能Ⅱ级）的临床观察[J]. 上海中医药杂志, 2021,55(1):47-51.
Wei HE, Huiying ZHU, An XI, et al. Clinical observation on acupuncture treatment of chronic heart failure (heart function grade Ⅱ) based on syndrome elements[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(1):47-51.
贺卫, 朱慧英, 奚安, 等. 基于证候要素辨证针刺治疗慢性心力衰竭（心功能Ⅱ级）的临床观察[J]. 上海中医药杂志, 2021,55(1):47-51. DOI： 10.16305/j.1007-1334.2021.1908154.
Wei HE, Huiying ZHU, An XI, et al. Clinical observation on acupuncture treatment of chronic heart failure (heart function grade Ⅱ) based on syndrome elements[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(1):47-51. DOI： 10.16305/j.1007-1334.2021.1908154.
摘要
目的,2,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,2,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,2,①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,2,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。
Abstract
Objective,2,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,2,Seventy-two patients with CHF (heart function grade Ⅱ) 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.,Results,2,①During 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,2,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.
关键词
慢性心力衰竭针刺证候要素辨证随机对照试验
Keywords
chronic heart failureacupuncturesyndrome elementssyndrome differentiationrandomized controlled trial
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