文章编号：1672-7134(2019)10-0559中图分类号：R256.29文献标志码：BDOI：10.16448/j.qtcm.2019.0559中医心脏康复联合温阳利水活血汤治疗慢性心力衰竭疗效分析*祁鹏'，巩倩惠胡雪松'，许一帆'，石立鹏2,黄路梅2,刘明怀21湖南中医药大学研究生院湖南长沙4102082重庆市垫江中医院心病科重庆垫江408300摘要目的：观察中医心脏康复联合温阳利水活血汤治疗阳虚水泛血瘀证心力衰竭的临床疗效，初步探讨中医康复治疗心力衰竭的作用机制。方法:将符合纳入标准的90例随机分为A、B、C3组，每组各30例，A组予以西药常规基础治疗，B组在A组基础治疗上加用温阳利水活血汤治疗，C组在B组治疗的基础上加用中医心脏康复治疗。4周为1个疗程,2个疗程后.比较3组临床疗效、中医证候积分、血浆NT-proBNP水平、心脏超声指标、炎性因子水平的变化情况。结果：3组治疗后在临床疗效、中医证候疗效较治疗前改善明显.其中组间比较,C组均优于A组和B组.B组优于A组，差异有统计学意义(PV0.05);三组治疗后的血浆NT-proBNP水平、心脏超声指标、炎性因子较治疗前改善明显，差异有显著统计学意义(P<0.05).组间比较差异同样具有统计学意义(P<0.05)o安全性指标在治疗前后未见明显变化.不具有统计学差异(P>0.05)o结论：中医心脏康夏联合温阳利水活血汤治疗慢性心力衰竭疗效确切，安全性高，可明显改善患者临床症状和中医证候，提高心功能和心脏射血分数.降低血浆NT-proBNP水平和炎性因子水平。关键词中医心脏康夏；温阳利水活血汤;心力衰竭；炎性因子；血浆NT-proBNPClinicalStudyofTraditionalChineseHeartRehabilitationCombinedwithWenyangLishuiHuoxueDecoctiononChronicHeartFailureQIPeng1,GONGQianhui',HUXuesong1,XUYifan1,SHILipeng2,HUANGLumei2,LIUMinghuar1HunanUniversityofChineseMedicineHunanChangsha410208,China2DianjiangTraditionalChineseMedicineHospitalChongqingDianjiang408300,ChinaABSTRACTObjective:ToobservetheclinicalstudyofTraditionalChineseheartrehabilitationcombinedwithWen-yangLishuiHuoxuedecoctioninthetreatmentofYangdeficiency,waterandbloodstasissyndromeofheartfailure,andtopreliminarilyexplorethemechanismofTraditionalChineseheartrehabilitationtreatmentofheartfailure.Methods:The90patientsweredividedintothreegroupsaccordingtotherandomnumbertable:groupAreceivedconventionalbasicwesternmedicinetreatment,groupBreceivedWYLSHXTinadditiontothebasictreatmentofgroupA,andgroupCreceivedTraditionalChineseheartrehabilitationtreatmentinadditiontothetreatmentofgroupB.Fourweekswasonecourseoftreatment,aftertwocoursesoftreatment,thechangesofclinicalefficacy,TraditionalChinesesyndromescore,plasmaNT-proBNPlevel,cardiacultrasoundindexesandinflammatoryfactorsinthethreegroupswerecom-pared.Results:TheclinicalefficacyandTraditionalChinesesyndromeefficacyofthethreegroupsweresignificantlyimprovedaftertreatment,amongwhich,groupCwasbetterthangroupAandgroupB,andgroupBwasbetterthangroupA,withstatisticallysignificantdifferences(P<0.05).PlasmaNT-proBNPlevels,cardiacultrasoundindexesand•基金项目：市庆市垫江县科技专项资金支持项目(djkjxm2O18j”fysfyyO48);慎庆市电江科技项目笔金(djkjxm2017jcixyglcx004)通讯作者：刘明怀.男(1963-),硕士研究生导师.主任中医弥，瓶庆市名中医.国务院特殊津贴专家，研究方向：中医药防治心血管耕：E-mail：Imh95f50d03@l63.eom作者简介：祁鹏.男(1994-),硕上研究生，研究方向：中医药防治心血管疾病E-mail：144ll86318@qq.comClinicaljournaloftraditionalChinesemedicineinflammatoryfactorsinthethreegroupsweresignificantlyimprovedaftertreatmentcomparedwiththosebeforetreat-ment,withstatisticallysignificantdifferences(P〈0.05).Therewasnosignificantchangeinsafetyindexbeforeandaftertreatment,andtherewasnostatisticaldifference(P>0.05).Conclusion:TraditionalC...