穴位贴敷联合耳穴压豆对阳虚水泛证慢性心力衰竭患者应用效果的观察

Observation on the Clinical Effect of Acupoint Application Combined with Auricular Point Pressing in Patients with Chronic Heart Failure of Yang-Deficiency and Water-Flooding Syndrome

摘要: 目的：评价穴位贴敷联合耳穴压豆对阳虚水泛证慢性心力衰竭患者的干预效果。方法：采用随机对照设计，纳入2025年3月~2026年3月在广西中医药大学第二附属医院住院的60例阳虚水泛型慢性心力衰竭患者，按随机数字表法分为对照组和干预组，每组30例。两组均接受慢性心力衰竭常规西医治疗及护理，干预组另给予穴位贴敷联合耳穴压豆，干预持续4周。比较两组干预前后的N末端B型利钠肽原(NT-proBNP)、左心室射血分数(LVEF)、中医证候积分、6分钟步行距离(6MWD)及明尼苏达心力衰竭生活质量问卷(MLHFQ)评分。结果：干预组总有效率为83.33%，对照组为73.33%，组间差异无统计学意义(P = 0.64)。干预前，两组主要观察指标差异均无统计学意义；干预4周后，干预组LVEF和6MWD高于对照组，NT-proBNP、中医证候积分及MLHFQ评分低于对照组，差异均有统计学意义(均P < 0.05)。结论：在西医常规治疗及护理基础上加用穴位贴敷联合耳豆压穴，能够进一步改善阳虚水泛型慢性心力衰竭患者的心功能、减轻中医证候、增强运动耐力并提升生存质量，该联合方案具备临床推广价值。

Abstract: Objective: To evaluate the intervention effect of acupoint application combined with auricular acupressure in patients with chronic heart failure (CHF) of yang deficiency and water flooding syndrome. Methods: A randomized controlled design was adopted. Sixty patients with CHF of yang deficiency and water flooding syndrome hospitalized in the Second Affiliated Hospital of Guangxi University of Chinese Medicine from March 2025 to March 2026 were enrolled and divided into a control group and an intervention group by random number table method, with 30 cases in each group. Both groups received routine Western medicine treatment and nursing for CHF, while the intervention group additionally received acupoint application combined with auricular acupressure for 4 weeks. N-terminal pro-B-type natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF), TCM syndrome score, 6-minute walking distance (6MWD), and Minnesota Living with Heart Failure Questionnaire (MLHFQ) score were compared between the two groups before and after intervention. Results: The total effective rate was 83.33% in the intervention group and 73.33% in the control group, with no statistically significant difference between groups (P = 0.64). Before intervention, there were no statistically significant differences in the main outcome measures between the two groups. After 4 weeks of intervention, LVEF and 6MWD in the intervention group were higher than those in the control group, while NT-proBNP, TCM syndrome score, and MLHFQ score were lower than those in the control group, with statistically significant differences (all P < 0.05). Conclusion: On the basis of routine Western medicine treatment and nursing, the addition of acupoint application combined with auricular acupressure can further improve cardiac function, alleviate TCM syndromes, enhance exercise tolerance, and improve quality of life in patients with CHF of yang deficiency and water flooding syndrome. This combined regimen has clinical value for promotion.