升陷活血利水汤加减对心肌梗死后慢性心力衰竭患者运动耐量、BNP及LVEF的影响  

Effects of Shengxian Huoxue Lishui Decoction on Exercise Tolerance,BNP and LVEF in Patients with Chronic Heart Failure after Myocardial Infarction

作　　者：朱婷婷[1] 宋彦洁 王丽彦[1] ZHU Tingting;SONG Yanjie;WANG Liyan(Beijing Sixth Hospital,Beijing 100007,China;Qingdao Haici Medical Group,Qingdao,Shandong 266000,China)

机构地区：[1]北京市第六医院,北京100007 [2]青岛市海慈医疗集团,山东青岛266000

出　　处：《湖南中医药大学学报》2020年第5期621-625,共5页Journal of Hunan University of Chinese Medicine

基　　金：北京中医药薪火传承“3+3”工程项目(KJ2013-6)。

摘　　要：目的探讨升陷活血利水汤加减联合西药治疗对心肌梗死后慢性心力衰竭患者运动耐量、B型钠尿肽(B-type natriuretic peptid,BNP)及左室射血分数(left ventricular ejection fraction,LVEF)的影响。方法将心肌梗死后慢性心力衰竭患者98例按随机数字表法分为观察组和对照组,每组49例。对照组行常规西医治疗,观察组在此基础上加以升陷活血利水汤加减治疗。观察两组患者治疗前后中医证候积分、6分钟步行距离(6 minutes walking distance,6MWD)、纽约心脏病协会(New York Heart Association,NYHA)心功能分级、BNP及LVEF变化。结果观察组总有效率为90.91%,明显高于对照组的76.09%(P<0.05)。治疗后观察组患者胸闷、气短、心悸、面肢浮肿、自汗及尿少证候积分低于对照组(P<0.05),6MWD增加较对照组显著(P<0.05),LVEF升高优于对照组(P<0.05),BNP下降优于对照组(P<0.05)。观察组治疗后NYHA分级Ⅰ~Ⅱ级者86.36%,明显高于对照组的67.39%(P<0.05)。结论升陷活血利水汤加减联合西药治疗可明显提高心肌梗死后慢性心力衰竭患者临床疗效,降低BNP、提高LVEF及6MWD、改善心功能。Objective To investigate the effects of modified Shengxian Huoxue Lishui Decoction combined with western medicine on exercise tolerance,B-type Natriuretic Peptid(BNP)and left ventricular ejection fraction(LVEF)in patients with chronic heart failure after myocardial infarction.Methods A total of 98 patients with chronic heart failure after myocardial infarction who were divided into an observation group and a control group by random number table method,with 49 cases in each group.The control group received routine western medicine treatment,and the observation group was added modified Shengxian Huoxue Lishui Decoction.Clinical parameters such as traditional Chinese medicine(TCM)symptom score,6 minutes walking distance(6 MWD),New York Heart Association(NYHA)cardiac function grading,BNP and LVEF were compared between the 2 groups before and after treatment.Results The total effective rate of the observation group was 90.91%,which was significantly higher than 76.09%of the control group(P<0.05).Scores of clinical symptoms such as the chest tightness,shortness of breath,palpitations,edema of face and limbs,spontaneous sweating and oliguria were significantly in the observation group were significantly lower than the control group after treatment(P<0.05).The increase of 6 MWD was significant than the control group(P<0.05),and the increase of LVEF was better than the control group(P<0.05).The decrease of BNP was better than the control group(P<0.05).The grading of NYHA level I to II in the observation group was 86.36%in proportion,which was significantly higher than67.39%in the control group(P<0.05).Conclusion Shengxian Huoxue Lishui Decoction can significantly improve the efficacy of patients with chronic heart failure after myocardial infarction,reduce BNP,increase LVEF,increase 6 MWD,and improve cardiac function.

关 键 词：心肌梗死 慢性心力衰竭 升陷活血利水汤 B型钠尿肽 6分钟步行距离 左室射血分数 

分 类 号：R256.2[医药卫生—中医内科学]