参桂护心汤结合穴位贴敷治疗冠心病并慢性心衰(心肾阳虚型)临床研究  

Clinical Study of Using Shengui Huxin Decoction Combined with Acupoint Application in the Treatment of Chronic Heart Failure(Heart-Kidney Yang Deficiency Type)

作　　者：胡慧英[1] 王亚莉[1] 田国芳[1] 杨会杰 宋兰英[1] HU Huiying;WANG Yali;TIAN Guofang(Mingren Hospi-tal of Handan(Hebei Handan 056006,China))

机构地区：[1]邯郸明仁医院,河北邯郸056006

出　　处：《四川中医》2020年第4期107-110,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(编号:2018407)。

摘　　要：目的:观察参桂护心汤结合穴位贴敷治疗冠心病(CHD)并慢性心衰(心肾阳虚型)效果。方法:选取2018年6月~2019年6月于我院就诊的CHD并慢性心衰(心肾阳虚型)患者90例,根据随机数字表法分为对照组与观察组,每组45例,对照组给予常规治疗,在对照组的基础上,观察组加用参桂护心汤结合中药穴位贴敷治疗,比较两组治疗后的临床疗效、中医证候积分、心功能指标﹝左室射血分数(LVEF)、舒张早期二尖瓣血流速度与舒张晚期二尖瓣血流速度比值(E/A)、左室舒张末内径(LVDD)和脑钠肽(NT-proBNP)﹞和血浆中的基质金属蛋白酶2(MMP-2)、基质金属蛋白酶9(MMP-9)及金属肽酶含血小板反应蛋白1(ADAMTs-1)水平。结果:治疗后,对照组的总有效率为82.22%,观察组为95.56%,组间差异显著(P<0.05);治疗后,两组的心悸胸闷、面肢浮肿、畏寒肢冷、腰酸尿少积分均显著降低(P<0.05),且治疗后观察组的上述指标变化幅度大于对照组(P<0.05);治疗后,两组的LVEF、E/A均显著升高(P<0.05),LVDD、NT-proBNP均显著降低(P<0.05),且治疗后观察组的上述指标变化幅度大于对照组(P<0.05);治疗后,两组的血浆MMP-2、MMP-9、ADAMTs-1水平均显著降低(P<0.05),且治疗后观察组的上述指标变化幅度大于对照组(P<0.05)。结论:参桂护心汤结合穴位贴敷治疗CHD并慢性心衰(心肾阳虚型)效果及对中医症候、心功能和血浆MMPs、ADAMTs-1水平的效果显著,值得推介。Objective:To observe the effect of using Shengui Huxin Decoction combined with acupoint application in the treatment of coronary heart disease(CHD)and chronic heart failure with heart-kidney Yang deficiency type.Methods:A total of 90patients with CHD and chronic heart failure(heart-Yang deficiency type)who were admitted to our hospital from June 2018to June 2019were enrolled.According to the random number table method,they were divided into controlled group and observation group,with 45cases in each group.The controlled group was given conventional treatment,and the observation group was treated with Shengui Huxin Decoction combined with traditional Chinese medicine acupoint application on the basis of the controlled group.The clinical efficacy,TCM syndromes scores,cardiac function indexes[left ventricular ejection fraction(LVEF),ratio of early diastolic mitral flow velocity and late diastolic mitral flow velocity(E/A),left ventricular end-diastolic diameter(LVDD),and brain natriuretic peptide(NT-proBNP)]and levels of plasma matrix metalloproteinase 2(MMP-2),matrix metalloproteinase 9(MMP-9)and adisintegrin and metalloprotease with thrombospongding type1motifs(ADAMTs-1)were compared between the two groups after treatment.Results:After treatment,the total effective rate was 82.22%in the controlled group and was 95.56%in the observation group(P<0.05).After treatment,the scores of palpitations and chest tightness,ede-ma of face and limbs,extreme chilliness and soreness of waist and oliguria in the two groups were significantly decreased(P<0.05),and the changes of the above indexes in the observation group after treatment were larger than those in the controlled group(P<0.05).After treatment,the LVEF and E/A in the two groups were significantly increased(P<0.05)while the LVDD and NT-proBNP were significantly decreased(P<0.05),and the changes of above-mentioned indicators in the observation group were significantly larger than those in the controlled group after treatment(P<0.05).After treatment,the levels of plasma M

关 键 词：参桂护心汤 穴位贴敷 CHD 慢性心衰 心肾阳虚型 

分 类 号：R541.4[医药卫生—心血管疾病] R541.6[医药卫生—内科学]