穴位贴敷联合艾灸治疗气虚血瘀型慢性心力衰竭的临床疗效  

Curative Effects of Acupoint Application and Moxibustion on Chronic Heart Failure with Qi Deficiency and Blood Stasis Syndrome

作　　者：付玉娜[1] 贾运时 刘丽杰[1] 马秀娟[1] 宋温婷 韩杰[1] 唐静[1] FU Yuna;JIA Yunshi;LIU Lijie;MA Xiujuan;SONG Wenting;HAN Jie;TANG Jing(Second Department of Heart Disease,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang,Hebei 050000,China)

机构地区：[1]石家庄市中医院心病二科,河北石家庄050000

出　　处：《湖南中医药大学学报》2020年第6期739-743,共5页Journal of Hunan University of Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2020333)。

摘　　要：目的分析探究穴位贴敷联合艾灸治疗气虚血瘀型慢性心力衰竭的临床效果及对患者心功能以及炎性细胞因子影响。方法选取2017年1月至2018年1月于本院接受针对性治疗的慢性心力衰竭患者90例,按照数字随机表法分为研究组和对照组,每组45例。两组患者均接受抗利尿、扩血管等西药常规治疗,对照组患者接受艾灸治疗,研究组患者接受艾灸联合穴位贴敷治疗,对比治疗后两组患者的疾病治疗有效率,对比治疗前后两组患者的心功能[左室射血分数(left ventricular ejection fraction,LVEF)、左心室收缩末期容积(Left ventricular end systolic volume,LVESV)、左心室舒张末期内径(left ventricular end diastolic dimension,LVEDd)、左室质量指数(Left ventricular mass index,LVMI)及每搏输出量(stroke volume,SV)]以及血清炎性细胞因子[白细胞介素-10(interleukin-10,IL-10)、IL-6、肿瘤坏死因子-α(tumor necrosis factor,TNF-α)、超敏C反应蛋白(hypersensitive C-reactive protein,hsCRP)、脑钠肽(brain natriuretic peptide,BNP)]水平变化,并对治疗方案的安全性进行评估。结果研究组患者临床总有效率明显高于对照组(P<0.01);与治疗前相比,两组患者治疗后LVEF、SV及血清IL-10水平均明显升高(P<0.01),而LVESV、LVEDd、LVMI、血清IL-6、TNF-α、hs-CRP及BNP水平均显著降低(P<0.01);同时研究组患者治疗后上述心功能指标和血清炎性细胞因子水平的改善情况均明显优于对照组(P<0.05);两组患者不良反应发生率之间的差异无统计学意义(P>0.05)。结论穴位贴敷联合艾灸治疗气虚血瘀型慢性心力衰竭可明显提高患者的治疗有效率,改善患者心功能,降低炎性细胞因子表达水平,且优于单纯艾灸组,值得临床推广使用。Objective To analyze the clinical efficacy of acupoint application combined with moxibustion on chronic heart failure with Qi deficiency and blood stasis syndrome and its influence on cardiac function and inflammatory cytokines.Methods A total of 90 patients with chronic heart failure treated in our hospital from January 2017 to January 2018 were randomly divided into a study group and a control group according to random number table,with 45 cases in each group.Both groups of patients received conventional treatment with western medicines such as antidiuresis and vasodilation.The control group received moxibustion treatment,and the study group received acupoint application combined with moxibustion treatment.The efficiency of the 2 groups of patients was compared after treatment.The cardiac function[left ventricular ejection fraction(LVEF),left ventricular end systolic volume(LVESV),left ventricular end-diastolic diameter(LVEDd),left ventricular mass index(LVMI)and stroke volume(SV)]and serum inflammatory cytokines[interleukin 10(IL-10),IL-6,tumor necrosis factor-α(TNF-α),hypersensitive c-reactive protein(hs-CRP)and brain natriuretic peptide(BNP)]level of 2 groups of patients before and after the treatment were compared.In addition,the safety of the treatment was evaluated.Results The total clinical effective rate of the study group was significantly higher than that of the control group(P<0.01).Compared with before treatment,the LVEF,SV and serum level of IL-10 of the 2 groups after treatment significantly increased(P<0.01),while the LVESV,LVEDd,LVMI,serum IL-6,TNF-α,hs-CRP and BNP levels were significantly decreased(P<0.01).Meanwhile,the improvement of cardiac function and serum inflammatory cytokines of the study group after the treatment were significantly better than that of control group(P<0.05);There was no significant difference in the incidence of adverse reactions between the 2 groups(P>0.05).Conclusion Acupoint application combined with moxibustion in the treatment of chronic heart failure with Qi d

关 键 词：慢性心力衰竭 穴位贴敷 艾灸 心率 射血分数 炎性细胞因子 

分 类 号：R246.1[医药卫生—针灸推拿学]