CAJ | 학술논문

目的：观察鹿角方对慢性心力衰竭合并肾功能不全(心肾阳虚证)患者的临床疗效。方法入选慢性心力衰竭合并肾功能不全(心肾阳虚型)患者45例，随机分为治疗组和对照组，随访1个月。观察鹿角方干预前后临床疗效、心功能分级、相关生化指标血浆脑利钠肽[血浆脑利纳肽(BNP)、血管紧张素Ⅱ(ATⅡ)、肾素(PRA)、醛固酮(ALD)、尿酸(UA)、血清肌酐(Scr)、肌酐清除率(Ccr)]及左心功能指标[左室射血分数(LVEF)、舒张期室间隔厚度(IVSTd)、舒张期左室厚度(PWT)、左室收缩末内径(LVESD)、左室舒张末内径(LVEDD)]的变化情况。结果治疗后，治疗组和对照组中医证候总有效率分别为81.82%和52.17%，治疗组在改善中医症候方面疗效优于对照组(P<0.05)。两组治疗前后心功能分级有效率无统计学意义(P>0.05)。治疗组治疗后血浆 BNP水平明显改善(P<0.01)；且治疗组治疗后血浆 BNP改善水平明显优于对照组(P<0.05)。治疗组治疗后血浆Ccr水平明显下降(P<0.05)；且治疗组经治疗后血浆Ccr下降水平明显优于对照组(P<0.01)；两组治疗前后Scr、UA水平差异无统计学意义(P>0.05)。治疗组治疗后 PRA、ATⅡ水平明显改善(P<0.05)；且治疗组经治疗后 PRA、ATⅡ改善水平明显优于对照组(P<0.05)；两组治疗前后 ALD水平差异无统计学意义(P>0.05)。治疗组治疗后 LVEF水平明显改善(P<0.01)；且治疗组治疗后 LVEF改善水平明显优于对照组(P<0.01)；两组治疗前后 IVSTd、PWT、LVESD、LVEDD水平差异无统计学意义(P>0.05)。结论鹿角方能有效改善慢性心力衰竭合并肾功能不全(心肾阳虚证)患者的心肾功能。
목적：관찰록각방대만성심력쇠갈합병신공능불전(심신양허증)환자적림상료효。방법입선만성심력쇠갈합병신공능불전(심신양허형)환자45례，수궤분위치료조화대조조，수방1개월。관찰록각방간예전후림상료효、심공능분급、상관생화지표혈장뇌리납태[혈장뇌리납태(BNP)、혈관긴장소Ⅱ(ATⅡ)、신소(PRA)、철고동(ALD)、뇨산(UA)、혈청기항(Scr)、기항청제솔(Ccr)]급좌심공능지표[좌실사혈분수(LVEF)、서장기실간격후도(IVSTd)、서장기좌실후도(PWT)、좌실수축말내경(LVESD)、좌실서장말내경(LVEDD)]적변화정황。결과치료후，치료조화대조조중의증후총유효솔분별위81.82%화52.17%，치료조재개선중의증후방면료효우우대조조(P<0.05)。량조치료전후심공능분급유효솔무통계학의의(P>0.05)。치료조치료후혈장 BNP수평명현개선(P<0.01)；차치료조치료후혈장 BNP개선수평명현우우대조조(P<0.05)。치료조치료후혈장Ccr수평명현하강(P<0.05)；차치료조경치료후혈장Ccr하강수평명현우우대조조(P<0.01)；량조치료전후Scr、UA수평차이무통계학의의(P>0.05)。치료조치료후 PRA、ATⅡ수평명현개선(P<0.05)；차치료조경치료후 PRA、ATⅡ개선수평명현우우대조조(P<0.05)；량조치료전후 ALD수평차이무통계학의의(P>0.05)。치료조치료후 LVEF수평명현개선(P<0.01)；차치료조치료후 LVEF개선수평명현우우대조조(P<0.01)；량조치료전후 IVSTd、PWT、LVESD、LVEDD수평차이무통계학의의(P>0.05)。결론록각방능유효개선만성심력쇠갈합병신공능불전(심신양허증)환자적심신공능。
Objective To observe the clinical efficacy of Lujiao decoction(LJD)in chronic heart failure (CHF)patients with chronic re-nal dysfunction (CRD)and heart kidney yang deficiency syndrome.Methods Forty five CHF patients with CRD and heart kid-ney yang deficiency syndrome were randomly divided into the control group and the treatment group.After one month,the clinical ef-ficiency,heart function classification,relative biochemical marks and the left ventricle function were observed.Results After treat-ment,the total effective rate of syndromes were 81.82% in treatment group and 52.17% in control group,respectively.The clinical efficiency in treatment group was better than that in control group(P<0.05).The heart function classification showed no difference between two groups (P>0.05).The level of the plasma BNP was very significantly improved after treatment(P<0.01).Compared with the control group,the level of the plasma BNP in treatment group was significantly improved(P<0.05).The level of Ccr was significantly decreased after treatment(P<0.05).Compared with the control group,the level of Ccr in treatment group was very significantly improved(P<0.01).There was no improvement in serum UA,Scr levels(P>0.05).The level of serum PRA and ser-um ATⅡwas obviously improved after treatment(P<0.05).Compared with the control group,the level of serum PRA and serum ATⅡin treatment group was significantly improved(P<0.05).There was no great improvement in the level of serum ALD(P>0.05).The level of the LVEF was obviously improved after treatment(P<0.01).Compared with the control group,the LVEF level was significantly elevated in the treatment group (P<0.01).Conclusion LJD could improve heart and kidney function in CHF pa-tients with CRD and heart kidney yang deficiency syndrome.