补阳还五汤对气虚血瘀型冠心病患者左室重构的影响  

Effects of Buyang Huanwu Decoction on Left Ventricular Remodeling in Patients with Coronary Heart Disease of Qi Deficiency and Blood Stasis Type

作　　者：商丹 彭飞 SHANG Dan;PENG Fei(Shangluo Central Hospital,Shangluo 726000,China)

机构地区：[1]陕西省商洛市中心医院,商洛726000

出　　处：《世界中医药》2020年第15期2275-2279,共5页World Chinese Medicine

基　　金：国家自然科学基金项目(81202502)。

摘　　要：目的:分析补阳还五汤对气虚血瘀型冠心病患者左室重构的影响。方法:选取2017年1月至2018年1月商洛市中心医院收治的气虚血瘀型冠心病患者102例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组51例。对照组行冠心病常规西医治疗,观察组在常规西医治疗基础上再予以补阳还五汤治疗,2组患者均连续治疗8周为1个疗程。2组患者治疗前、后均行超声心动图检查明确左室结构指标和左室功能指标,血清炎性反应递质C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6),血压、心率数据及临床疗效变化。结果:2组患者左室舒张末期内径(LVED)、左室收缩末期内径(LVES)、前降支(LAD)、左室后壁厚度(LVPW)、室间隔厚度(IVST)、左室质量指数(LVMI)、CRP、TNF-α、IL-6均较治疗前明显下降,左室短轴缩短率(LVFS)、射血分数(EF)、E/A均较治疗前明显上升,观察者优于对照组,差异有统计学意义(P<0.05)。2组患者收缩压、舒张压、心率均较治疗前明显下降,且观察者低于对照组,差异有统计学意义(P<0.05)。观察组患者临床总有效率高于对照组,差异有统计学意义(P<0.05)。2组不良反应率差异无统计学意义(P>0.05)。结论:补阳还五汤对气虚血瘀型冠心病患者左室重构具有较好的改善作用,其可能与其有效改善炎性状态及提升血流动力学水平,促进心肌细胞功能恢复有关。Objective:To analyze the effects of Buyang Huanwu Decoction on left ventricular remodeling in patients with coronary heart disease with qi deficiency and blood stasis type.Methods:A total of 102 patients with coronary heart disease with qi deficiency and blood stasis type were randomly divided into a control group(n=51)and an observation group(n=51).The control group was given routine Western medicine treatment of coronary heart disease,and the observation group was treated with Buyang Huanwu Decoction on the basis of routine Western medicine treatment.Patients in both groups were treated continuously for 8 weeks as a course of treatment.Changes of the left ventricular structure and function indexes,serum inflammatory indexes(CRP,TNF-α,IL-6),blood pressure,heart rate and therapeutic effects were determined by echocardiography before and after treatment in both groups.Results:1)The levels of LVED,LVES,LAD,LVPW,IVST,LVMI,CRP,TNF-αand IL-6 in the 2 groups were significantly lower than those before treatment,while LVFS,EF and E/A were significantly higher than those before treatment,and those in the observation group were better than the control group(P<0.05).2)The systolic blood pressure,diastolic blood pressure and heart rate in the 2 groups were significantly lower than those in the control group(P<0.05).3)The total clinical effective rate in the observation group was higher than that in the control group(P<0.05).There was no significant difference in adverse reaction rate between the 2 groups(P>0.05).Conclusion:Buyang Huanwu Decoction can better improve left ventricular remodeling in patients with coronary heart disease with qi deficiency and blood stasis type,which may be related to its effective improvement of inflammatory state,hemodynamic level and the recovery of cardiomyocyte function.

关 键 词：气虚血瘀型冠心病 补阳还五汤 左室结构 左室功能 左室重构 血流动力学 炎性反应递质 临床疗效 作用机制 

分 类 号：R289.5[医药卫生—方剂学] R541[医药卫生—中药学]