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目的:观察参附注射液穴位注射治疗慢性充血性心力衰竭对患者NT-pro BNP、6MWD的影响。方法:将206例符合诊断标准的慢性充血性心力衰竭的患者随机分为对照组和观察组,2组均给予常规治疗:ACEI,不能耐受时使用ARB,β受体阻滞剂选用卡维地洛或者酒石酸美托洛尔,利尿剂选用双克和(或)螺内酯,观察组在此基础上使用参附注射液各2m L注射足三里和阴陵泉穴,对照组在常规治疗的基础上,使用0.9%Na Cl各2 m L,在足三里和阴陵泉穴附近进针,2组疗程均为14 d,隔日1次。治疗前后检测患者心功能、NT-pro BNP,进行6 min步行实验(6MWT)。结果:1)观察组与对照组治疗前后6 min步行距离比较差异均有统计学意义(均P<0.05),观察组6 min步行距离改善情况明显优于对照组,差异有统计学意义(P<0.05)。2)心功能临床疗效比较,观察组总有效率为92.3%,对照组总有效率为77.4%,观察组优于对照组,差异有统计学意义(P<0.05)。3)治疗前,观察组NT-pro BNP的平均水平为1 973.4 pg/m L,对照组为1 944.6 pg/m L,差异无统计学意义(P>0.05),治疗后,2组NT-pro BNP的水平均较治疗前下降(P<0.01),观察组的水平明显低于对照组,差异有统计学意义(P<0.05)。结论:在西医常规治疗的基础上加用参附注射液穴位注射,能提高慢性充血性心力衰竭患者的心功能,降低NT-pro BNP的水平,增加6 min步行距离。
Objective: To observe the effect of Shenfu injection acupoint injection on NT-pro BNP and 6MWD in patients with chronic congestive heart failure. Methods: A total of 206 patients with congestive heart failure who met the diagnostic criteria were randomly divided into control group and observation group. Both groups were given conventional therapy: ACEI, ARB when they were intolerant, cardiomyocytes with β-blocker Dextrose or metoprolol tartrate, diuretic use of two grams and (or) spironolactone, the observation group on the basis of the use of Shenfu injection of 2m L injection of Zusanli and Yinlingquan, the control group based on conventional treatment , Using 0.9% NaCl each 2 m L, in Zusanli and Yinlingquan point near the needle, the two courses were 14 d, every other day. Heart function, NT-pro BNP, were measured before and after treatment, and 6-min walking test (6MWT) was performed. Results: 1) There was significant difference in walking distance between observation group and control group at 6 min before and after treatment (all P <0.05). The improvement of walking distance at 6 min in observation group was significantly better than that in control group (P <0.05). 2) Comparison of clinical efficacy of cardiac function, the total effective rate was 92.3% in the observation group, the total effective rate was 77.4% in the control group, the observation group was superior to the control group, the difference was statistically significant (P <0.05). 3) Before treatment, the average level of NT-pro BNP in the observation group was 1 973.4 pg / m L, and the control group was 1 944.6 pg / m L, with no significant difference (P> 0.05). After treatment, pro BNP levels were lower than before treatment (P <0.01), the level of the observation group was significantly lower than the control group, the difference was statistically significant (P <0.05). Conclusion: Based on routine treatment of traditional Chinese medicine, Shenfu injection acupoint injection can improve the heart function, reduce the level of NT-pro BNP and increase the walking distance 6 minutes in patients with chronic congestive heart failure.