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目的观察益气温阳活血利水方辅助治疗心肾综合征的临床疗效。方法 123例心肾综合征患者随机分为治疗组62例和对照组61例,对照组采用西医对症治疗,治疗组在对照组治疗基础上加用益气温阳活血利水方口服,每日1剂,两组疗程均为20天。疗程结束后观察两组患者临床疗效、心功能改善情况、内生肌酐清除率(Ccr),利尿剂使用剂量及不良反应。结果治疗组临床疗效总有效率为83.33%,对照组总有效率为61.67%,治疗组高于对照组(P<0.01)。治疗组治疗后较治疗前心脏射血分数(EF)及Ccr均明显提高(P<0.01),对照组治疗前后比较差异均无统计学意义(P>0.05)。疗程结束后,治疗组原口服联合静脉利尿剂47例患者静脉利尿剂的剂量较治疗前减半或者停用,原单纯口服利尿剂的13例患者较治疗前剂量减半;对照组60例使用利尿剂的剂量治疗前后差异无统计学意义(P>0.05)。对照组治疗过程中,患者出现不同程度的电解质紊乱(40例)、利尿剂抵抗(32例)及脂代谢紊乱(25例);而治疗组中出现轻度电解质紊乱(20例)、利尿剂抵抗(15例),治疗组不良反应明显少于对照组(P<0.01)。结论益气温阳活血利水方辅助治疗心肾综合征能提高临床疗效,且能明显减少西药所致的不良反应。
Objective To observe the clinical effect of Yiqi Wenyanghuoxueliu Recipe in the treatment of cardiorenal syndrome. Methods A total of 123 patients with cardio-renal syndrome were randomly divided into treatment group (n = 62) and control group (n = 61). The control group was treated with western medicine. The treatment group was treated with Yiqi Wenyang Huoxue Li Shui Fang on the basis of the control group. Two groups of treatment are 20 days. After treatment, clinical efficacy, cardiac function improvement, endogenous creatinine clearance (Ccr), diuretic dosage and adverse reactions were observed. Results The total effective rate of the treatment group was 83.33%. The total effective rate of the control group was 61.67%. The treatment group was higher than the control group (P <0.01). The EF and Ccr in the treatment group were significantly higher than those before treatment (P <0.01), but there was no significant difference in the control group before and after treatment (P> 0.05). After treatment, the treatment group, the original oral combined intravenous diuretic 47 patients intravenous diuretic dose than before treatment halved or discontinued, the original simple oral diuretic in 13 patients than before treatment dose reduced by half; 60 cases in the control group There was no significant difference in diuretic dose before and after treatment (P> 0.05). In the control group, patients experienced electrolyte imbalance (n = 40), diuretic resistance (n = 32) and lipid metabolism (n = 25) in the treatment group. In the treatment group, mild electrolyte disturbances (n = 20) Resistance (15 cases), the treatment group was significantly less adverse reactions than the control group (P <0.01). Conclusion Yiqi Wenyang Huoxueliu Recipe in the treatment of cardiorenal syndrome can improve clinical efficacy, and can significantly reduce the adverse reactions caused by Western medicine.