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目的:观察中西医结合治疗ICU内急性心力衰竭的临床疗效。方法:按随机数字表法收集入住我院ICU内符合纳入标准的患者共35例,随机分为对照组(16例)和治疗组(19例)。对照组采用西医的标准方法治疗(参照《2010年中华医学会心血管病学分会中国心力衰竭诊治指南》进行),治疗组在对照组基础上,加用加味柴牡四物汤,50ml口服或鼻饲每6小时1次,疗程为14天。记录治疗前后超声心动图左心射血分数LVEF(Left Ventricular Ejection Fraction)(%)、左心室舒张末期内径LVEDD(left ventricular end-diastolic diameter)及脑钠肽(NT-pro BNP)结果,随访28天患者发生心力衰竭次数及心衰病死率。结果:治疗组总有效率为84.2%,对照组为50.0%,有效率及两组患者血浆NT-pro BNP值比较差异有统计学意义(P<0.05);两组治疗前后超声测值左心射血分数LVEF(%)及左心室舒张末期内径LVEDD比较差异无统计学意义(P>0.05);两组患者28天心衰病死率比较,差异无统计学意义(P>0.05);两组患者28天心力衰竭再发作次数比较,治疗组优于对照组,差异有统计学意义(P<0.05)。结论:对于ICU内急性心力衰竭的治疗,中西医结合治疗疗效优于单纯西医治疗。
Objective: To observe the clinical efficacy of integrated traditional Chinese and western medicine in treating acute heart failure in ICU. Methods: According to the random number table, 35 patients who met the inclusion criteria in our hospital were randomly divided into control group (n = 16) and treatment group (n = 19). The patients in the control group were treated with the standard method of Western medicine (refer to “Guidelines for Diagnosis and Treatment of Heart Failure in the Chinese Medical Association’s Cardiology Section in 2010”). The treatment group was treated with Jia Chai Si Si Decoction, 50ml orally or Nasal feeding every 6 hours 1, treatment for 14 days. The echocardiographic left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD) and brain natriuretic peptide (NT-pro BNP) were recorded before and after treatment. The follow-up of 28 The number of patients with heart failure and heart failure mortality. Results: The total effective rate was 84.2% in the treatment group and 50.0% in the control group, and the effective rate and plasma NT-pro BNP level in the two groups were significantly different (P <0.05). The left heart LVEF (%) and left ventricular end-diastolic diameter (LVEDD) had no significant difference (P> 0.05). There was no significant difference in the mortality of 28-day heart failure between the two groups (P> 0.05) The number of re-attacks of heart failure in 28 days was significantly higher in the treatment group than in the control group, with significant difference (P <0.05). Conclusion: For the treatment of acute heart failure in the ICU, the combination of traditional Chinese and western medicine is superior to western medicine alone.