摘要
目的探讨平喘贴、热敏灸两者单一及联合对心肺气虚型心力衰竭患者的临床治疗效果。方法选取2023年11月至2024年8月符合心肺气虚型心力衰竭诊断标准并入住南京市中医院心血管科的患者105例,按照随机数字表法分组分为穴位贴敷组(n=35例)、热敏灸组(n=35例)及联合组(n=35例)。三组患者治疗方案均参照《中国心力衰竭诊断和治疗指南2018》及南京市中医院心血管科诊疗方案实施,穴位贴敷组在基础方案上运用宽胸平喘贴进行穴位贴敷,热敏灸组在基础方案中加入热敏灸技术,联合组在基础方案中加入两项技术,遵循“先灸后贴”原则,比较三组患者治疗前后心功能水平、明尼苏达心功能不全生命质量量表(MLHFQ)评分、临床症状及血清N末端B型利钠肽原(NT⁃proBNP)的变化。结果干预后热敏灸组和联合组的心功能分级下降(P<0.05),穴位贴敷组干预前后心功能分级差异无统计学意义(P>0.05)。干预前及干预后三组患者MLHFQ评分比较差异无统计学意义(P>0.05),干预后三组患者的MLHFQ评分均较干预前降低(P<0.05)。干预前及干预后三组患者中医症状积分比较差异无统计学意义(P>0.05),干预后三组患者的中医症状积分均较干预前降低(P<0.05)。干预后三组患者治疗后NT⁃proBNP水平比较差异有统计学意义(P<0.05),联合组的NT⁃proBNP水平显著低于热敏灸组和穴位贴敷组(P<0.05),穴位贴敷组和热敏灸组间差异无统计学意义(P>0.05)。结论穴位贴敷技术、热敏灸技术及二者联合均对心肺气虚型心力衰竭有一定的临床疗效,总体临床疗效为联合技术>热敏灸技术>穴位贴敷技术。
Objective To investigate the clinical efficacy of single and combined therapies(Kuanxiong Pingchuan patch and heat-sensitive moxibustion)for patients with Qi deficiency in both heart and lung-heart failure.Methods A total of 105 patients diagnosed with cardiopulmonary Qi deficiency-type heart failure in the Cardiovascular Department at Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine between November 2023and August 2024,were randomly assigned to three groups:acupoint patch group(n=35),heat-sensitive moxibustion group(n=35),and combined group(n=35).All treatment protocols referred to the Chinese Guideline for the Diagnosis and Management of Heart Failure 2018 and the Diagnosis and Treatment Plan of the Cardiovascular Department,Nanjing Hospital of Traditional Chinese Medicine.The acupoint patch group received Kuanxiong Pingchuan patch,the heat-sensitive moxibustion group received additional moxibustion therapy,and the combined group received both techniques.The treatment sequence adhered to the principle of"moxibustion before patch application".Changes in cardiac function classification,Minnesota Living with Heart Failure Questionnaire(MLHFQ)values,clinical symptoms,and serum N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels before and after treatment among three groups of patients were compared.Results Post-treatment,cardiac function classification decreased significantly in both the heat-sensitive moxibustion group and combined group(P<0.05),while no significant difference was observed in the acupoint patch group(P>0.05).There was no statistically significant difference in MLHFQ scores among the three groups before and after the intervention(P>0.05).After the intervention,the MLHFQ scores of al three groups decreased compared to those before the intervention(P<0.05).Similarly,no statistically significant difference was observed in Chinese medicine symptom scores among the three groups before and after the intervention(P>0.05),while the Chinese medicine symptom scores of all three groups decreased after the intervention compared to pre-intervention levels(P<0.05).After the intervention,a statistically significant difference was observed in NTproBNP levels among the three groups(P<0.05).The NT-proBNP level in the combined group was significantly lower than that in both the heat-sensitive moxibustion group and the acupoint patch group(P<0.05).However,no statistically significant difference was observed between the acupoint patch group and the heat-sensitive moxibustion group(P>0.05).Conclusion Acupoint patch,heat-sensitive moxibustion and combined technology all have certain clinical efficacy on Qi deficiency in both heart and lung-heart failure,and the overall clinical efficacy is combined technology>heat-sensitive moxibustion>acupoint patch.
作者
洪艳燕
顾宁
李健
嵇灵
张敏
王丽
王思懿
HONG Yanyan;GU Ning;LI Jian;JI Ling;ZHANG Min;WANG Li;WANG Siyi(Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210022,China)
出处
《中国临床研究》
2025年第11期1766-1770,共5页
Chinese Journal of Clinical Research
基金
江苏省中医药科技发展计划项目(MS2022044)。
关键词
中医外治法
穴位贴敷
热敏灸
心力衰竭
心肺气虚
External treatment of Chinese medicine
Acupoint patching
Heat⁃sensitive moxibustion
Heart failure
Qi deficiency in both heart and lung
