中西医结合治疗扩张型心肌病的临床观察

作者	单位
杨英珍	复旦大学医学院附属中山医院
陈瑞珍	复旦大学医学院附属中山医院
张寄南	南京医科大学附属第一医院
荣烨之	上海第二医科大学新华医院
赵美华	上海第二医科大学新华医院
陈曙霞	上海第二医科大学仁济医院
刘治全	西安医科大学第一附属医院
廖玉华	同济医科大学协和医院
李隆贵	重庆第三军医大学新桥医院
金炜	上海市第一人民医院
范维琥	复旦大学医学院附属华山医院
黄元伟	浙江医科大学附属第一医院
段宝祥	南京市第一人民医院
祝玉成	南通医学院附属医院

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中文摘要:

目的 :观察中西医结合治疗扩张型心肌病的疗效。方法 :对 32 0例临床诊断扩张型心肌病患者随机分为两组 ,治疗组 164例 ,用中西医结合治疗 (黄芪、生脉、牛磺酸、泛葵利酮及强心、利尿、扩血管等 ) ,对照组 156例 ,用常规治疗 (极化液、泛葵利酮及强心、利尿、扩血管等 )。结果 :治疗组临床症状的好转明显高于对照组 (P <0 0 1) ,心功能改善优于对照组 (P <0 0 5)。随访中两组死亡总数基本相似 ,但治疗 3～ 6个月内对照组死亡人数明显多于治疗组。而治疗组中坚持治疗 1年者 ,1年后的死亡人数明显低于治疗 3～ 6个月者 (分别为 1例及 11例 )。结论 :在目前对扩张型心肌病无明显特效药物治疗的情况下 ,采用中西医结合治疗不失为一种可取的药物治疗手段。

英文摘要:

Objective: To observe the therapeutic effect of integrated traditional Chinese and western medicine (TCM WM) in treating dilated cardiomyopathy (DCM). Methods: Patients of DCM were randomly divided into two groups, the 164 patients in the TCM WM group were treated with combination therapy of traditional Chinese and western medicine, consisting of conventional western medicine, such as cardiac diuretic, vasodilative agents, taurine, coenzyme Q10, antiarrhythmics, β blockers and Chinese herbal preparations such as Astragalus membranaceus and Shengmai injection; while the 156 cases in the control group were treated with conventional western medicine alone, including polarized liquid therapy, etc. Results: The improvement of clinical symptoms and heart function in the TCM WM group was significantly better than that in the control group. Although the total number of deceased cases in the two groups were similar, the dead number in 3 6 months in the TCM WM group was less than that in the control group. Moreover, 1 year later, the deceased number of patients insisted with TCM WM treatment for over 1 year was significantly less than in those treated for only 3 6 months (1 case vs 11 cases). Conclusion: Under the condition that there is no specific effective drugs, TCM WM therapy can yet be regarded as an acceptable therapy for treatment of dilated cardiomyopathy.

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