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| 附子理中汤合五苓散加减联合利尿剂对慢性心力衰竭患者心功能、内皮功能指标及生活质量的影响研究 |
| Effects of Modified Fuzi Lizhong Decoction Combined with Wuling Powder and Diuretics on Cardiac Function, Endothelial Function, and Quality of Life in Patients with Chronic Heart Failure |
| 投稿时间：2025-04-21 修订日期：2025-04-21 |
| 中文关键词: 慢性心力衰竭 附子理中汤 五苓散加减 阳虚水泛证 利尿剂 慢性心力衰竭 心功能 内皮功能 生活质量 |
| 英文关键词: Chronic heart failure Modified Fuzi Lizhong Decoction combined with Wuling Powder Diuretics Cardiac function Endothelial function Quality of life |
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| 中文摘要: |
| 目的 探讨基于附子理中汤与五苓散加减相结合的治疗方法,联合利尿剂对慢性心力衰竭(CHF)患者在心功能、内皮功能指标以及生活质量方面的影响。方法 2023年1月至2025年1月在浙江省永康市第二人民医院阳虚水泛证患者82例。采用随机数字表法分为对照组与观察组,两组各41例。对照组仅使用标准西医基础治疗,包括利尿剂,而观察组在此基础上增加附子理中汤合五苓散的治疗,均治疗4周。对治疗前两组的临床疗效,治疗前后两组的症状评分、心功能、内皮功能、生活质量、不良反应进行比较。结果 经过4周的治疗,观察组的总有效率显著优于对照组 (P < 0.05)；治疗后两组的症状评分、左室舒张末期内径(LVEDD)、内皮素-1(ET-1)水平以及明尼苏达心力衰竭生活质量问卷(MLHFQ)评分较治疗前均下降 (P < 0.05),且观察组均低于对照组 (P < 0.05)。同时,两组患者的左心室射血分数(LVEF)、E/A比值、一氧化氮(NO)、血管内皮生长因子(VEGF)水平及6分钟步行距离(6MWT)等指标均显著提高 (P < 0.05),观察组的改善程度亦高于对照组 (P < 0.05)。在整个治疗期间,双组均未出现明显的不良反应,包括肝肾功能损害和胃肠道反应等。结论 附子理中汤合五苓散加减联合利尿剂可提升CHF患者临床疗效,有效改善心功能、调节内皮功能,改善患者生活质量和运动耐量,且安全性良好。 |
| 英文摘要: |
| Objective: To investigate the therapeutic effect of a modified Fuzi Lizhong Tang combined with Wuling San, in conjunction with diuretics, on cardiac function, endothelial function indicators, and quality of life in patients with chronic heart failure (CHF). Methods: Eighty-two patients with Yang deficiency and water retention syndrome were recruited from the Second People"s Hospital of Yongkang City, Zhejiang Province, between January 2023 and January 2025. Using a random number table method, patients were divided into a control group and an observation group, with 41 patients in each group. The control group received standard Western medicine-based treatment, including diuretics, while the observation group received Fuzi Lizhong Tang combined with Wuling San in addition to the standard Western medicine-based treatment. Both groups received treatment for 4 weeks. Clinical efficacy, symptom scores, cardiac function, endothelial function, quality of life, and adverse reactions were compared between the two groups before and after treatment. Results: After 4 weeks of treatment, the total effective rate in the observation group was significantly better than that in the control group (P < 0.05). After treatment, symptom scores, left ventricular end-diastolic diameter (LVEDD), endothelin-1 (ET-1) levels, and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores in both groups decreased significantly compared to before treatment (P < 0.05), and all were lower in the observation group than in the control group (P < 0.05). Simultaneously, left ventricular ejection fraction (LVEF), E/A ratio, nitric oxide (NO), vascular endothelial growth factor (VEGF) levels, and the 6-minute walk test (6MWT) distance were significantly improved in both groups (P < 0.05), and the degree of improvement was greater in the observation group compared to the control group (P < 0.05). No significant adverse reactions, including liver and kidney function impairment and gastrointestinal reactions, were observed in either group throughout the treatment period. Conclusion: Modified Fuzi Lizhong Tang combined with Wuling San, in conjunction with diuretics, can improve the clinical efficacy in CHF patients, effectively improve cardiac function, regulate endothelial function, improve patients" quality of life and exercise tolerance, and has good safety. |
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