化痰通脉汤治疗痰饮阻滞型慢性心力衰竭的临床疗效评价

化痰通脉汤治疗痰饮阻滞型慢性心力

衰竭的临床疗效评价

摘要：目的：评价化痰通脉汤治疗痰饮阻滞型慢性心力衰竭的

临床疗效。方法：选取2016年1月至2018年6月，我院收治

的80例痰饮阻滞型慢性心力衰竭患者，随机分为治疗组(40

例)和对照组(40例)。治疗组给予口服化痰通脉汤联合西

药治疗，对照组给予西药治疗。比较两组治疗前后的临床症状、

肺功能及心功能指标等方面的差异。结果：治疗组治疗后，体

征指标及FEV1、FVC及PEF均较治疗前均有显著性改善

(PV0.05)；治疗组总有效率(92.5%)显著优于对照组

(72.5%)(P<0.05)o结论：化痰通脉汤治疗痰饮阻滞型慢

性心力衰竭具有较好的临床疗效，可以作为一种有效的治疗方

法应用于临床。

关键词：化痰通脉汤；痰饮阻滞型慢性心力衰竭；临床疗效；

肺功能；心功能

Abstract:Objective:Toevaluatetheclinicalefficacy

ofHuatanTongmaiDecoctioninthetreatmentofphlegm

obstructiontypechronicheartfailure.Methods:

Eightypatientswithphlegmobstructiontypechronic

heartfailureadmittedtoourhospitalfromJanuary

2016toJune2018wererandomlydividedintotreatment

group(40cases)andcontrolgroup(40cases).The

treatmentgroupwasgivenHuatanTongmaiDecoction

combinedwithwesternmedicinetreatment,andthe

controlgroupwasgivenwesternmedicinetreatment

alone.Thedifferencesinclinicalsymptoms,pulmonary

functionandheartfunctionindicatorsbeforeand

aftertreatmentwerecomparedbetweenthetwogroups.

Results:Aftertreatment,thephysicalsigns,FEV1,

FVCandPEFinthetreatmentgroupweresignificantly

improvedcomparedwiththosebeforetreatment(P<0.05);

Thetotaleffectiverateinthetreatmentgroup(92.5%)

wassignificantlyhigherthanthatinthecontrol

group(72.5%)(P<0.05).Conclusion:HuatanTongmai

Decoctionhasgoodclinicalefficacyintreating

phlegmobstructiontypechronicheartfailureandcan

beusedasaneffectivetreatmentmethodinclinical

practice.

Keywords:HuatanTongmaiDecoction;phlegmobstruction

typechronicheartfailure;clinicalefficacy;

pulmonaryfunction;heartfunction

Chronicheartfailure(CHF)isamajorpublichealth

issueworldwide,withahighmorbidityandmortality

rate.PhlegmobstructiontypeCHFisacomplexand

difficulttotreattypeofCHF,characterizedby

phlegmaccumulationinthelungsandincreasedbody

fluidretention.

HuatanTongmaiDecoction,atraditionalChinese

medicine(TCM)formula,hasbeenusedfortreatingCHF

inChinaforcenturies.Itiscomposedofvarious

herbalingredients,includingPineiliaternata,

Ephedrasinica,Poriacocos,andRadixGlycyrrhizae.

AccumulatingevidencesuggeststhatHuatanTongmai

Decoctioncanimprovephlegmremovaland

cardiovascularfunctioninCHFpatients.

Inthisstudy,weevaluatedtheclinicalefficacyof

HuatanTongmaiDecoctioninphlegmobstructiontype

CHFpatients.Ourresultsshowedthatafter4weeksof

treatment,patientsinthetreatmentgrouphad

significantlyimprovedpulmonaryfunctionandheart

function,ascomparedtothecontrolgroup.In

addition,thetotaleffectiverateinthetreatment

groupwassignificantlyhigherthanthatinthe

controlgroup.

OurfindingssuggestthatHuatanTongmaiDecoctionis

asafeandeffectivetreatmentstrategyforphlegm

obstructiontypeCHF.TCMpractitionersand

cardiologistsshouldconsiderusingHuatanTongmai

DecoctionasacomplementarytherapyforCHFpatients.

However,furtherclinicaltrialswithlargersample

sizesandlongertreatmentdurationsareneededto

confirmtheseresults

InadditiontolluatanTongmaiDecoction,other

traditionalChinesemedicine(TCM)interventionshave

alsobeenstudiedfortheirpotentialbenefitsinthe

managementofCHF.Acupuncture,forexample,hasbeen

showntoimprovecardiacfunction,exercisetolerance,

andqualityoflifeinCHFpatientsthroughvarious

mechanisms,suchasreducingsympatheticnervous

systemactivityandinflammation,improving

endothelialfunction,andpromotingmyocardial

regeneration.Arecentmeta-analysisof11randomized

controlledtrialsinvolving1082participantsfound

thatacupuncturewasassociatedwithasignificant

improvementinleftventricularejectionfraction,6-

minutewalkdistance,NewYorkHeartAssociation

functionalclass,andB-typenatriureticpeptide

1evelscomparedwithconventionaltherapy.Moreover,

noseriousadverseeventswerereportedinanyofthe

studies,suggestingthatacupunctureisasafeand

well-toleratedinterventionforCHF.

AnotherTCMinterventionthathasgainedattentionfor

itspotentialbenefitsinCHFisqigong,amind-body

practicethatinvolvesslowmovements,deepbreathing,

andmeditation.Qigonghasbeenshowntoimprove

cardiacfunction,exercisecapacity,qualityoflife,

andpsychologicalwell-beinginCHFpatientsby

reducingsympatheticnervoussystemactivity,

oxidativestress,andinflammation,andimproving

arterialcomplianceandendothelialfunction.A

systematicreviewandmeta-analysisof10randomized

controlledtrialsinvolving842participantsfound

thatqigongwasassociatedwithasignificant

improvementinleftventricularejectionfraction,6-

minutewalkdistance,qualityoflife,and

depression/anxietyscorescomparedwithusualcareor

exercisecontrol.Moreover,noseriousadverseevents

werereportedinanyofthestudies,indicatingthat

qigongisasafeandfeasibleinterventionforCHF.

DespitethepromisingresultsoftheseTCM

interventions,morehigh-qualityandwell-designed

clinicaltrialsareneededtoconfirmtheirefficacy

andsafetyinCHFpatients,andtoexploretheir

optimaldosage,duration,andcombinationwith

conventionaltherapy.Moreover,theunderlying

mechanismsoftheseinterventionsinCHFneedtobe

furtherelucidated,bothatthemolecularand

psychosociallevels,soastoprovideamore

comprehensiveandpersonalizedapproachtoCHF

management.Nonetheless,theintegrationofTCMinto

theconventionalcareofCHFrepresentsapromising

directionforimprovingtheoutcomesandqualityof

lifeofCHFpatients,andwarrantsfurtherattention

andinvestmentfromresearchers,clinicians,and

policymakers

Inadditiontotheabove-mentionedinterventions,

thereareseveralotherpromisingstrategiesthathave

beenexploredinthemanagementofCHF.Onesuch

approachistheuseofstemcelltherapy,which

involvesthetransplantationofstemcellsintothe

hearttopromoteregenerationofdamagedtissuesand

improvecardiacfunction.Whileinitialstudieshave

reportedsomebeneficialeffectsofthistherapy,

furtherresearchisneededtooptimizeitsclinical

applicabilityandsafety.

AnotherareaofinvestigationinCHFmanagementisthe

useofnovelbiomarkerstoimprovediagnosisandrisk

stratificationofpatients.Forinstance,studieshave

shownthatthemeasurementofcirculatingcardiac

troponins,whicharereleasedintothebloodstream

followingmyocardialinjury,canprovidevaluable

informationabouttheseverityofCHFandits

prognosticimplications.Otherbiomarkersthathave

shownpromiseinthisregardincludenatriuretic

peptides,galectin-3,andsolubleST2.

Furthermore,recentadvancesindigitalhealth

technologieshaveopenedupnewavenuesforimproving

themonitoringandmanagementofCHF.Forexample,

wearabledevicessuchassmartwatchesandfitness

trackerscanprovidereal-timedataonheartrate,

activitylevel,andotherparametersthatcanbeused

totrackdiseaseprogressionandguidetreatment

decisions.Additionally,telehealthplatformsthat

enableremotemonitoringandvirtualconsultations

withhealthcareprovidershavebeenshowntoimprove

patientoutcomesandreducehealthcarecostsinCHF.

Inconclusion,CHFremainsasignificantpublichealth

concernwithhighmorbidityandmortalityrates.While

conventionaltherapiessuchasmedicationsanddevice

therapieshavebeeneffectiveinimprovingoutcomes,

thereisaneedformorecomprehensiveand

personalizedapproachestoCHFmanagementthat