破格救心汤治疗扩张型心肌病并发重症心衰验案一则
Treatment of Dilated Cardiomyopathy Complicated with Severe Heart Failure Treated with the method of Poge Jiuxin Decoction:a Case Report
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1.重庆市中医院,中医经典科,重庆 400021
2.贵州中医药大学,第二临床医学院,贵阳 550002
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杨彤, 魏丹丹, 曹晋, 等. 破格救心汤治疗扩张型心肌病并发重症心衰验案一则[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=29636311&Fpath=home&index=0
YANG Tong, WEI Dandan, CAO Jin, et al. Treatment of Dilated Cardiomyopathy Complicated with Severe Heart Failure Treated with the method of Poge Jiuxin Decoction:a Case Report[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=29636311&Fpath=home&index=0
杨彤, 魏丹丹, 曹晋, 等. 破格救心汤治疗扩张型心肌病并发重症心衰验案一则[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=29636311&Fpath=home&index=0 DOI:
YANG Tong, WEI Dandan, CAO Jin, et al. Treatment of Dilated Cardiomyopathy Complicated with Severe Heart Failure Treated with the method of Poge Jiuxin Decoction:a Case Report[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=29636311&Fpath=home&index=0 DOI:
病史摘要,2,患者杨某某,男,57岁,因“反复气促2年,再发1月,加重9天”于2021年7月12日至我院中医经典科门诊就诊。2年前因劳累及受凉感冒后出现咳嗽、气促,活动后加重,于首都医科大学附属北京安贞医院就诊诊断“扩张性心肌病、慢性心力衰竭”。1月前患者因受凉后复发,于重庆市人民医院急诊就诊时查左室舒张末期内径62mm,左室收缩末期内径51 mm,左室射血分数37%。9天前患者受凉后症状加重,门诊以“慢性心力衰竭急性加重 心功能Ⅳ级”收入中医经典科。四诊信息:患者少神、表情痛苦,面色无华,腹部稍膨隆,双下肢浮肿,精神较差、四肢厥冷、语声低微、言语清晰、喘息;无异常气味;舌淡紫,苔薄白腻,脉沉细、数促无力。中医诊断 心衰(少阴证)西医诊断 1.慢性心力衰竭急性加重 心功能Ⅳ级;2.扩张型心肌病;3.心房颤动干预措施 中医以温运少阴、利水消肿为治法,予破格救心汤合五苓散、生脉散等口服;西医以对症治疗,予以面罩吸氧改善缺氧及强心、抗凝等。疗效转归 患者精神状态好,气虚乏力明显改善,可自由活动,活动后无胸部憋闷感,无夜间阵发性呼吸困难,可平躺入睡。患者治疗后N末端脑钠肽由6 738降至500 pg/mL,心脏彩超射血分数由30%提升至45%,左室舒张末内径由73缩小至63 mm,各项症状明显好转。
Summary of case history, Patient Yang, male, 57 years old, visited the outpatient department of traditional Chinese medicine in our hospital on July 12, 2021 due to "recurrent shortness of breath for 2 years, recurrence for 1 month, and aggravation for 9 days". Two years ago, due to fatigue and cold, he developed cough and shortness of breath, which worsened after exercise. He was diagnosed with "dilated cardiomyopathy and chronic heart failure" at ,Beijing Anzhen Hospital Affiliated to Capital Medical University,. One month ago, the patient relapsed after catching cold. When he visited the emergency department of Chongqing People's Hospital, the left ventricular end-diastolic diameter was 62 mm, the left ventricular end-systolic diameter was 51 mm, and the left ventricular ejection fraction was 37%. Nine days ago, the patient's symptoms worsened after catching cold, and the outpatient service was admitted to the Department of Classical Chinese Medicine with "acute exacerbation of chronic heart failure, cardiac function grade Ⅳ". Symptoms and signs: The patient is shy, painful, dull complexion, slightly distended abdomen, edema of both lower extremities, poor spirit, cold limbs, low voice, clear speech, wheezing; no abnormal smell; lilac tongue, thin white coating Greasy, thin pulse, rapid and weak pulse.,TCM disease and syndrome, Heart failure (Shaoyin syndrome),Western medicine diagnosis, 1. Acute exacerbation of chronic heart failure, cardiac function class Ⅳ;2. Dilated cardiomyopathy;3. Atrial fibrillation.,TCM treatment, Warming and transporting Shaoyin, promoting diuresis and reducing swelling,Therapeutic methods, Traditional Chinese medicine treats the disease by warming Shaoyin, invigorating water and reducing swelling, and taking Poge Jiuxin Decoction together with Wuling Powder and Shengmai Powder orally. Symptomatic treatment, face mask oxygen inhalation to improve hypoxia and cardiotonic, anticoagulation and so on.,Clinical outcomes, The patient's mental state is good, the qi deficiency and fatigue are significantly improved, and the patient can move freely. After the activity, there is no chest tightness, no nocturnal paroxysmal dyspnea, and he can lie down and fall asleep. After treatment, the N-terminal brain natriuretic peptide of the patient decreased from 6738 to 500 pg/mL, the cardiac echocardiography ejection fraction increased from 30% to 45%, the left ventricular end-diastolic diameter decreased from 73 to 63 mm, and the symptoms improved significantly.
破格救心汤扩张型心肌病重症心衰
Poge Jiuxin decoctiondilated cardiomyopathysevere heart failure
陈灏珠.实用心脏病学.上海:上海科学技术出版社,2016:1055-1062.
吕仕超,张军平.扩张型心肌病中医药治疗进展[J].时珍国医国药,2010,21(6):1496-1497.
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