重症充血性心力衰竭几种治法的对比分析

作者	单位
楼正家	杭州市中医院杭州 310006
祝光礼	杭州市中医院杭州 310006
孙西璐	杭州市中医院杭州 310006
陈智新	杭州市中医院杭州 310006

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中文摘要:

单用西药和中西药结合治疗观察127例重症充血性心力衰竭（CHF）,西药3组分别用地高辛加双氢克尿噻或开搏通加心痛定或多巴酚丁胺。中西药结合3组分别在上述西药基础上用济生肾气丸加减。通过对各组的治疗结果分析,笔者认为:（1）CHF的治疗必须做到个体化用药,才能取得最佳疗效。（2）中西药结合治疗能明显提高疗效,减少毒副作用,降低病死率。（3）济生肾气丸能明显改善心室舒张功能,其机理可能是使下降的β₁受体密度增高。

英文摘要:

Western medicines (WM) and the combining WM-TCM were used to treat congestive heartfailure (CHF). The three groups of WM were: Digoxin with dihydro-chlorothiazide, captopril withnifedipium, and dobutamine. The three groups of combining WM-TCM were: the above-mentionedthree groups of WM with Jisen Shenqi Pill (JSSQ) respectively. The result observed:Total effective rate was 82%, marked effective rate was 43%, the rates of the WM groups were 77%and 36% respectively, and the groups of combining WM-TCM were 88% and 53%. Total mortalitywas 8.66% (the WM groups was 11.76%, the groups of combining WM-TCM 5%). Cardio-functionindexes observed in the groups of combining WM-TCM were obviously improved, including HR, SV,CI, EF, FS and A/E (P<0.01). HR, CI and SV in the groups of WM were also significantly improved(P<0.05) except for EF, FS and A/E (P>0.05). Conclusions: (1) The treatment of CHF shoulddepend on various conditions and different symptoms in selecting medicines, so that individualtreatment could reach the optimal effects. (2) The treatment method of combining WM-TCM could significantly promote effective rate, reduce toxic and side-effects and lower the rate of mortality.(3) JSSQ could obviously improve the function of ventricular diastole and its mechanism might bethat the reduced density of β-receptor was increased.

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