摘要
目的探讨甘草泻心汤联合李可肾四味加减治疗老年冠状动脉粥样硬化性心脏病(简称冠心病)伴衰弱的临床疗效。方法选取医院2021年9月至2024年9月收治的老年冠心病伴衰弱患者268例,按随机数字表法分为对照组和观察组,各134例。两组患者均予常规西药治疗,观察组患者加用甘草泻心汤联合李可肾四味加减。两组患者均连续治疗12周。结果观察组总有效率为94.78%,显著高于对照组的85.07%(P<0.05)。治疗后,两组患者的中医证候积分、Fried衰弱量表评分、计时起立行走试验时间、简版老年抑郁量表(GDS-15)评分均显著降低(P<0.05),且观察组均显著低于对照组(P<0.05);6 min步行试验距离、血红蛋白、前白蛋白、总蛋白、白蛋白水平、微型营养评估简表(MNA-SF)评分、简易精神状态检查量表(MMSE)评分、血浆Alarin、胰岛素样生长因子1水平均显著升高(P<0.05),且观察组均显著高于对照组(P<0.05)。观察组和对照组患者治疗期间不良反应发生率相当(5.97%比4.48%,P>0.05)。结论甘草泻心汤联合李可肾四味加减治疗老年冠心病伴衰弱的临床疗效良好,能有效改善患者的衰弱状态和躯体功能,提升机体的营养指标和认知功能,且安全性良好。
Objective To investigate the clinical efficacy of Gancao Xiexin Decoction combined with modified Li Ke´s Shensiwei in the treatment of elderly patients with coronary heart disease(CHD)complicated with frailty.Methods A total of 268 elderly patients with CHD complicated with frailty admitted to the hospital from September 2021 to September 2024 were selected and randomly divided into the control group and the observation group by the random number table method,with 134 cases in each group.The patients in the two groups treated with conventional Western medicine,while the patients in the observation group were additionally treated with Gancao Xiexin Decoction combined with modified Li Ke´s Shensiwei on this basis.Both groups were treated continuously for 12 weeks.Results The total effective rate in the observation group was 94.78%,which was significantly higher than 85.07%in the control group(P<0.05).After treatment,the traditional Chinese medicine(TCM)syndrome scores,Fried Frailty Scale scores,Timed Up and Go Test(TUGT)time,and Simplified Geriatric Depression Scale(GDS-15)scores in the two groups significantly decreased,and those in the observation group were significantly lower than those in the control group(P<0.05).The 6-Minute Walk Test(6MWT)distance,levels of hemoglobin(HB),prealbumin(PA),total protein(TP)and albumin(Alb),Mini-Nutritional Assessment-Short Form(MNA-SF)scores,Mini-Mental State Examination(MMSE)scores,and the levels of plasma Alarin,and insulin-like growth factor 1(IGF-1)in the two groups significantly increased,and those in the observation group were significantly higher than those in the control group(P<0.05).During the treatment,the incidence of adverse reactions was comparable between the observation group and the control group(5.97%vs.4.48%,P>0.05).Conclusion Gancao Xiexin Decoction combined with modified Li Ke´s Shensiwei has a good clinical efficacy and safety in the treatment of elderly patients with CHD complicated with frailty,which can effectively improve the patient´s frailty and physical function,and enhance the nutritional indicators and cognitive function.
作者
马树灿
李茹
刘智芬
肖红
英俊岐
MA Shucan;LI Ru;LIU Zhifen;XIAO Hong;YING Junqi(Hengshui People′s Hospital,Hengshui,Hebei 053000,China)
出处
《中国药业》
2026年第1期103-107,共5页
China Pharmaceuticals
基金
河北省中医药管理局科研计划项目[2020540]。
