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[目的]观察参附强心汤联合西药治疗重症心力衰竭疗效。[方法]使用随机平行对照方法,将120例住院患者按抛硬币法简单随机分为两组。对照组60例常规治疗:吸氧、严密的心电监护、记录24H出入量、开通静脉通道,针对情况予小剂量硝普钠静脉泵入控制血压,依情况用美托洛尔控制心率;纠正水电解质紊乱及恶性心律失常,治疗原发病如溶栓、抗感染、抗过敏。治疗组60例参附强心汤(人参10g,黄芪30g,附子10g,生大黄5g,桂枝10g,毛冬青30g,水蛭粉3g,泽兰10g,冬葵子5g,滑石10g,牵牛子5g,葶苈子、桑白皮各10g,大腹皮15g,白术10g,甘草6g,防己10g,茯苓15g),水煎100m L,1h内口服,1次/d;西药治疗同对照组。连续治疗14d为1疗程。观测临床症状、左室收缩末容积(LVESV)、左心射血分数(LVEF)、每搏心输出量(SV)、心输出量(CO)不良反应。连续治疗2疗程,疗程间隔3d,判定疗效。[结果]治疗组显效34例,有效16例,无效10例,总有效率83.33%。对照组显效22例,有效23例,无效15例,总有效率75.00%。治疗组疗效优于对照组(P<0.05)。心功重症心力衰竭是由各种外界环境或内在原因致心功能短期内急剧恶化,心脏泵血功能降低,病情危重、进展迅速、预后凶险,严重甚至导致死亡[1-2]。我们使用参附强心汤联合西药治疗重症心力衰竭,获满意疗效,与单纯西药治疗对照,现报告如下。能指标两组均有改善(P<0.05),治疗组改善优于对照组(P<0.05)。[结论]参附强心汤联合西药治疗重症心力衰竭疗效满意,无副作用,值得推广。
[Objective] To observe the curative effect of Shenfu Qiangxin Decoction combined with western medicine on severe heart failure. [Methods] Using randomized parallel control method, 120 inpatients were randomly divided into two groups according to the coin-tossing method. Control group of 60 cases of conventional treatment: oxygen, strict ECG, record the amount of 24H, open the venous access, in response to low-dose intravenous sodium nitroprusside into the control of blood pressure, according to the situation with metoprolol to control heart rate; Electrolyte disorders and malignant arrhythmia, the treatment of primary disease such as thrombolysis, anti-infection, anti-allergy. Treatment group, 60 cases of Shenfu Qiangxin Decoction (ginseng 10g, Astragalus 30g, monkshood 10g, rhubarb 5g, Guizhi 10g, Mao Dongqing 30g, leech powder 3g, Zeeland 10g, Dong Kui Zi 5g, talc 10g, , 葶 苈 子, Morus alba 10g, 大皮皮 15g, Atractylodes 10g, licorice 6g, 10g, Poria 15g), decoction 100m L, 1h oral, 1 / d; Western medicine treatment with the control group. Continuous treatment 14d for a course of treatment. The clinical symptoms, LVESV, LVEF, SV and SV were observed. Continuous treatment 2 courses, treatment interval 3d, determine the efficacy. [Results] The treatment group markedly effective in 34 cases, effective in 16 cases, ineffective in 10 cases, the total effective rate was 83.33%. In the control group, 22 cases were markedly effective, 23 cases were effective, 15 cases were ineffective, and the total effective rate was 75.00%. The treatment group was better than the control group (P <0.05). Severe heart failure is caused by a variety of external environment or internal causes of heart failure in the short term rapid deterioration of the heart pump blood function decreased, critically ill, rapid progress, the prognosis dangerous, severe and even lead to death [1-2]. We use Shen Fu Qiang Tang combined with Western medicine treatment of severe heart failure, satisfactory results, and Western medicine treatment alone, are as follows. The indexes of both groups improved (P <0.05), and the treatment group improved better than the control group (P <0.05). [Conclusion] Shenfu Qiangxin Decoction combined with Western medicine in treating severe heart failure has satisfactory curative effect and no side effects, which is worth to be popularized.