逐水粉六穴贴敷在慢性心力衰竭顽固性水肿患者中的应用

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摘要目的观察逐水粉六穴贴敷对慢性心力衰竭（CHF）顽固性水肿患者的疗效。方法选取2020 年1 月至2021年3 月广州中医药大学顺德医院确诊的70 例CHF 顽固性水肿患者为研究对象，采用随机数字表法分为观察组与对照组，每组各35 例。两组均给予常规药物治疗及常规护理，在此基础上，观察组采用逐水粉六穴贴敷，对照组采用安慰剂六穴贴敷，1 次/d，每次6 h，5 d 为1 个疗程，干预2 个疗程。观察两组的每天尿量、体重、呼吸困难及肢体肿胀变化；干预第10 天，观察两组的静脉血B 型尿钠肽（BNP）浓度、美国纽约心脏病协会（NYHA）分级及生活自理能力评定（Barthel）；观察两组的住院期压疮发生率、死亡率与住院时间。结果观察组干预后的尿量、体重下降高于对照组，呼吸困难及肢体肿胀评分低于对照组，差异均有统计学意义（P＜0.05）。治疗第10 天，观察组的静脉血BNP 浓度低于对照组，Barthel 评分高于对照组，观察组的NYHA 评定Ⅰ级/Ⅱ级达45.71%，而对照组为15.15%，差异均有统计学意义（P＜0.05）；两组的住院期死亡率均为0，差异无统计学意义（P＞0.05），但观察组的压疮发生率为 0，对照组压疮发生率为 12.12%，差异有统计学意义（P＜0.05）。观察组的住院时间为（9.25±2.12）d，短于对照组的（11.85±5.23）d，差异有统计学意义（P＜0.05）。结论逐水粉六穴贴敷对CHF 顽固性水肿患者有明显利水作用，有效增加患者尿量，减轻体重与肢体肿胀，缓解机体器官淤血引起的临床症状，延缓心脏功能恶化，降低压疮发生率，提高患者生活自理能力及生活质量，值得临床推广。

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关键词 ：逐水粉, 六穴贴敷, 慢性心力衰竭, 顽固性水肿

Abstract：Objective To observe the effect of Zhushui Powder applied at six acupoints on refractory edema in patients with chronic heart failure (CHF). Methods From January 2020 to March 2021, 70 patients diagnosed as refractory edema of CHF in Shunde Hospital of Guangzhou University of Traditional Chinese Medicine were selected as the research objects. They were divided into the observation group (35 cases) and the control group (35 cases) according to randon number table method. Both groups were given routine drug treatment and routine nursing. On this basis, the observation group was given Zhushui Powder applied at six acupoints, the control group was given placebo applied at six acupoints,once a day, 6 hours each time, 5 days as a course of treatment, intervention for 2 courses. The changes of urine volume,weight, dyspnea and swelling of limbs were observed in the two groups. On the 10th day of intervention, the concentration of B-type natriuretic peptide (BPN) in venous blood, NYHA classification and self-care ability of the two groups were observed. The incidence of pressure ulcer, mortality and length of hospital stay of the two groups were observed. Results After the intervention, the urine volume and weight loss of the observation group were higher than those of the control group, and the scores of dyspnea and limb swelling of the observation group were lower than those of the control group, the differences were statistically significant (P＜0.05). On the 10th day of treatment, the BNP concentration in the observation group was lower than that in the control group, Barthel evaluation was higher than that in the control group, NYHA grade Ⅰ/Ⅱ in the observation group was 45.71%, while that in the control group was 15.15%, the differences were statistically significant(P＜0.05). Both groups of the mortality of in-hospital were 0, the difference was not statistically significant (P＞0.05).The incidence of pressure ulcer was 0 in the observation group and 12.12% in the control group, the difference was statistically significant (P＜0.05). The time of hospitalization in the observation group was (9.25±2.12) d, which was shorter than that of control group of (11.85±5.23) d, the difference was statistically significant (P＜0.05). Conclusion Zhushui Powder applied at six acupoints has obvious diuretic effect on refractory edema in patients with CHF. It can effectively increase the urine volume of patients, reduce weight and limb swelling, relieve the clinical symptoms caused by organ congestion, delay the deterioration of heart function, reduce the occurrence of pressure ulcers, and improve the selfcare ability and quality of life of patients, which is worthy of clinical promotion.

Key words： Zhushui Powder Application of six acupoints Chronic heart failure Refractory edema

收稿日期: 2021-06-11

基金资助:广东省佛山市科技创新自筹经费类科技计划项目（1920001001787）

通讯作者: 肖南海（1982-），男，广东韶关人，硕士，副主任医师，研究方向：心血管内科疾病的诊治

作者简介: 吕丽芬（1978-），女，广东佛山人，副主任护师，护理部副主任，研究方向：心血管内科疾病护理、心病中医护理

引用本文:

吕丽芬；范焕珍；康峰光；肖南海. 逐水粉六穴贴敷在慢性心力衰竭顽固性水肿患者中的应用[J]. 中国当代医药, 2021, 28(35): 207-212.
LYU Li-fen1 FAN Huan-zhen2 KANG Feng-guang2 XIAO Nan-hai3▲. Application of Zhushui Powder applied at six acupoints on refractory edema in patients with chronic heart failure. 中国当代医药, 2021, 28(35): 207-212.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I35/207

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