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[目的]观察补阳还五汤联合西药治疗气虚血瘀风湿性心脏病并发脑栓塞疗效。[方法]使用前瞻性设计方法,对42例住院及门诊患者利尿、改善心功能、抗凝等对症治疗。补阳还五汤(黄芪30g,当归尾、赤芍、地龙、川穹、桃仁各15g,红花10g;失语显著加菖蒲,郁金;气阴两虚显著加五味子;胸闷、心悸显著加单手、瓜蒌、生龙牡、桂枝;3周内出院,可带药)。连续治疗3周为1疗程。观测临床症状、证候积分、心衰积分、脑功能缺损评分、左室短轴缩短分数(FS)、左室短轴缩短分数(FS)、舒张早晚期充盈速度最大值比值(E/A)、不良反应。连续治疗1疗程,判定疗效。[结果]临床治愈19例,显效13例,有效6例,无效3例,加重1例。证候积分、心衰积分、脑功能缺损评分、LVEF、FS、E/A水平改善明显(P<0.05)。[结论]补阳还五汤联合西药治疗气虚血瘀风湿性心脏病并发脑栓塞,疗效满意,无副作用,值得推广。
[Objective] To observe the efficacy of Buyang Huanwu Decoction combined with western medicine in treating Qi-deficiency and blood-stasis rheumatic heart disease complicated with cerebral embolism. [Methods] Using prospective design method, 42 cases of inpatients and outpatients diuretic, improve cardiac function, anticoagulation and other symptomatic treatment. Buyang Huanwu Tang (Astragalus 30g, Angelica tail, red peony, earthworm, Chuan dome, peach kernel 15g, safflower 10g; aphasia significantly with iris, turmeric; Qi and Yin significantly plus Schisandra; chest tightness, palpitations significantly One-handed, Guazhu, Health Long Mu, Guizhi; discharged within 3 weeks, can take medicine). Continuous treatment for 3 weeks for a course of treatment. Symptom scores, syndrome scores, heart failure scores, brain function deficit scores, left ventricular fractional shortening fraction (FS), left ventricular fractional shortening fraction (FS) and maximum / maximum diastolic filling rate (E / A) ,Adverse reactions. Continuous treatment of a course of treatment to determine the efficacy. [Result] Nineteen cases were cured clinically, 13 cases were markedly effective, 6 cases were effective, 3 cases were ineffective and 1 case was aggravated. Syndrome points, heart failure scores, brain function impairment scores, LVEF, FS, E / A levels improved significantly (P <0.05). [Conclusion] Buyang Huanwu Decoction combined with western medicine in treatment of Qi-deficiency and blood-stasis, rheumatic heart disease complicated with cerebral embolism has satisfactory curative effect and no side effects and is worth popularizing.