保元汤加减联合督灸对阳气亏虚血瘀证非HFrEF患者的影响OA
Effect of combined use of modified Baoyuan Decoction and Du-Moxibustion on patients with heart failure with non-reduced ejection fraction due to Yang Qi deficiency and blood stasis
目的 观察保元汤加减联合督灸对阳气亏虚血瘀证非射血分数减低型心衰(HFrEF)患者的影响,初步评价其临床疗效与安全性.方法 研究对象来源于2023年1月～2024年10月就诊于北京中医药大学深圳医院(龙岗)的 76 例非 HFrEF 患者,随机将患者分为常规治疗组(RT 组)和保元汤加减联合督灸治疗组(BYDDM 组),其中RT 组 39 例,BYDDM 组 37 例.RT 组给予西医常规治疗,BYDDM 组则在西医常规治疗基础上再予以保元汤加减联合督灸治疗,观察周期为 4 周.比较两组治疗前后血液粘度相关指标(HCT、RDW、RDW-CV、PLT、PCT)、FS-14 评分、KCCQ-12 评分和心功能指标(NT-proBNP、LVEF、FS、LA 和 LV)的改变情况,比较两组的临床疗效、肝肾功(ALT、AST、Scr、BUN)、凝血功能指标(PT、APTT 和 D-D)和不良情况的发生率.结果 联合应用保元汤加减和督灸治疗后 FS-14 评分明显下降(P<0.001),KCCQ-12 评分明显升高(P<0.01),NT-ProBNP 水平下降(P<0.01),临床疗效和中医证候疗效更优(P 分别<0.01 和<0.001).两组 LVEF 值和 FS 值均较治疗前明显升高(P<0.05),但两组间未见显著差异.LV 值在应用保元汤加减和督灸治疗后较治疗前下降(P<0.05),但和RT 组比,两组治疗后 LA 值、LV 值均未见显著统计学差异(P>0.05).ALT、AST、Scr、BUN 和 PT、APTT 和 D-D在治疗后均仍在正常范围.结论 采用保元汤加减联合督灸的方法治疗阳气亏虚血瘀证非 HFrEF 患者的疗效显著,能够有效改善其血液粘度,改善疲劳,提高生活质量和心功能,改善中医证候,同时对肝肾功、凝血功能无明显影响,安全可靠,值得在临床推广应用.
Objectives To observe the effect of modified Baoyuan Decoction combined with Du-moxibustion on patients with heart failure(HF)with non-reduced ejection fraction(HFrEF)due to Yang Qi deficiency and blood stasis,and to preliminarily evaluate its clinical efficacy and safety.Methods The study subjects were 76 non-HFrEF patients who visited the Beijing University of Chinese Medicine Shenzhen Hospital(Longgang)from January 2023 to October 2024.The patients were randomly divided into a conventional treatment group(RT group)and a combined treatment group of modified Baoyuan Decoction and Du-moxibustion(BYDDM group),with 39 patients in the RT group and 37 patients in the BYDDM group.The RT group was treated with standard Western medicine treatment,while the BYDDM group was treated with modified Baoyuan Decoction combined with Du-moxibustion on the basis of standard Western medicine treatment.The observation period was 4 weeks.Changes in blood viscosity-related indicators(HCT,RDW,RDW-CV,PLT,PCT),FS-14 scale score,KCCQ-12 score,and cardiac function indicators(NT-proBNP,LVEF,FS,LA,and LV)were compared between the two groups before and after treatment.The clinical efficacy,liver and kidney function(ALT,AST,Scr,BUN),coagulation function indicators(PT,APTT,and D-D),and incidence of adverse events were also compared between the two groups.Results After the combined application of modified Baoyuan decoction and Du-moxibustion treatment,the FS-14 score and the NT-proBNP level were significantly reduced(P<0.01).And the KCCQ-12 score significantly improved(P<0.01).The clinical efficacy and TCM syndrome relief efficacy were also better(P<0.01 and P<0.001,respectively)than that of the RT group.The LVEF and FS values in both groups were significantly increased after treatment(P<0.05),but no significant difference was observed.After treatment,the LV value decreased(P<0.05),but still no significant statistical difference was found in LA and LV values between the two groups after treatment(P>0.05).The level of ALT,AST,Scr,BUN,PT,APTT,and D-D were still in the normal ranges after intervention.Conclusions Modified Baoyuan Decoction combined with Du-moxibustion has significant therapeutic effects on non-HFrEF patients with Yang Qi deficiency and blood stasis syndrome.It can effectively improve blood viscosity,reduce fatigue,improve quality of life,enhance cardiac function,and improve overall symptoms with no significant impact on the liver,kidney and coagulating system,indicating a favorable safety profile that worths wide clinical application.
吴佳芸;蔡小静;徐则;彭衍;杨金果
北京中医药大学深圳医院(龙岗),广东 深圳 518100北京中医药大学深圳医院(龙岗),广东 深圳 518100北京中医药大学深圳医院(龙岗),广东 深圳 518100北京中医药大学深圳医院(龙岗),广东 深圳 518100北京中医药大学深圳医院(龙岗),广东 深圳 518100
医药卫生
保元汤加减督灸阳气亏虚血瘀证非HFrEF
Modified Baoyuan decoctionDu-moxibustionYang Qi deficiency and blood stasis syndromeHeart failure with non-reduced ejection fraction
《四川中医》 2026 (3)
49-57,9
龙岗区科技创新局课题(LGWJ2022-80).
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