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目的探讨中西医结合治疗慢性肺源性心脏病(chronic pulmonary heart disease,CPHD)并发顽固性心力衰竭(refractory heart failure,RHF)的疗效。方法选取2012年6月—2015年6月本院收治的CPHD并发RHF患者共110例作为研究对象,随机分为对照组(52例)与观察组(58例)。对照组接受西医常规治疗,包括祛痰,吸氧,强心,利尿,抗感染,扩张血管等;观察组在西医常规治疗基础上联合使用苓桂术甘汤。计量资料比较采用t检验,计数资料比较采用χ2检验,P<0.05为差异有统计学意义。结果治疗后观察组患者右心室射血分数(right ventricular ejection fraction,RVEF)、右心室短轴缩短率(right ventricular shortening fraction,RVFS)[(43.3±1.6)、(26.5±1.0)%]显著高于对照组[(40.5±2.7)、(23.4±2.5)%],右心室舒张末期容积(right ventricular end diastolic volume,RVVd)、右心室收缩末期容积(right ventricular end systolic volume,RVVs)[(45.3±1.9)、(36.7±1.6)ml]显著低于对照组[(48.0±2.7)、(39.4±2.1)ml],差异均有统计学意义(均P<0.05)。治疗后观察组患者中医症状积分、Lee氏心衰积分[(9.4±2.8)、(2.5±0.5)分]均显著低于对照组[(15.7±4.6)、(4.2±0.8)分];日常生活活动能力(activities of daily living,ADL)评分为(64.6±7.8)分,显著高于对照组的(55.1±10.3)分,差异均有统计学意义(均P<0.05)。观察组患者治疗总有效率为93.10%,显著高于对照组的78.85%,差异有统计学意义(P<0.05)。结论中西医结合治疗CPHD并发RHF的疗效确切,值得临床推广应用。
Objective To investigate the curative effect of integrative traditional Chinese and western medicine on chronic pulmonary heart disease (CPHD) complicated with refractory heart failure (RHF). Methods A total of 110 patients with CPHD complicated with RHF admitted in our hospital from June 2012 to June 2015 were selected as study subjects and randomly divided into control group (52 cases) and observation group (58 cases). The control group received routine treatment of Western medicine, including expectorant, oxygen, cardiac, diuretic, anti-infective, dilation of blood vessels; observation group on the basis of conventional Western medicine combined with Lingguizhugan decoction. Measurement data were compared using t test, count data were compared using χ2 test, P <0.05 for the difference was statistically significant. Results In the observation group, right ventricular ejection fraction (RVEF) and right ventricular shortening fraction (RVFS) [(43.3 ± 1.6), (26.5 ± 1.0)%] were significantly higher in observation group (40.5 ± 2.7), (23.4 ± 2.5)%], right ventricular end diastolic volume (RVVd), right ventricular end systolic volume (RVVs) [(45.3 ± 1.9), (36.7 ± 1.6) ml] were significantly lower than those in the control group [(48.0 ± 2.7) and (39.4 ± 2.1) ml], respectively, with statistical significance (all P <0.05). After treatment, the TCM symptom score, Lee’s heart failure score [(9.4 ± 2.8), (2.5 ± 0.5) points] in the observation group were significantly lower than those in the control group [(15.7 ± 4.6), (4.2 ± 0.8) The activity of daily living (ADL) score was (64.6 ± 7.8) points, which was significantly higher than that of the control group (55.1 ± 10.3) points, the difference was statistically significant (all P <0.05). The total effective rate of observation group was 93.10%, significantly higher than 78.85% of control group, the difference was statistically significant (P <0.05). Conclusion The treatment of traditional Chinese medicine and western medicine combined with RHF is effective and worthy of clinical application.