益气通络刺法对气虚血瘀型慢性心力衰竭患者心功能及血清NT-proBNP、炎症因子的影响  

Effects of Yi Qi Tong Luo Needling Method on Cardiac Function and Serum NT-proBNP and Inflammatory Factors in Patients with Chronic Heart Failure of Qi Deficiency and Blood Stagnation Pattern

作　　者：张玉焕[1] 刘薇[1] 李争[1] ZHANG Yu-huan;LIU Wei;LI Zheng(Tangshan Hospital of Traditional Chinese Medicine,Tangshan 063000,China)

机构地区：[1]唐山市中医医院,唐山063000

出　　处：《上海针灸杂志》2020年第10期1225-1229,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河北省中医药管理局中医药类科研计划课题(2018319)。

摘　　要：目的观察基于玄府理论益气通络刺法对气虚血瘀型慢性心力衰竭患者心功能及血清NT-proBNP、炎症因子的影响。方法将70例气虚血瘀型慢性心力衰竭患者随机分为对照组和观察组,每组35例。对照组接受规范西药治疗(螺内酯片、盐酸贝那普利片、富马酸比索洛尔片、地高辛片);观察组在对照组基础上接受基于玄府理论益气通络刺法。治疗前后观察Lee氏心衰评分、6 min步行距离、心脏彩超检查指标,检测N末端B型利钠肽原及血清炎症因子,统计临床疗效。结果治疗后观察组和对照组心功能疗效总有效率分别为91.4%、74.2%,两组比较差异有统计学意义(P<0.05)。观察组治疗后Lee氏心衰评分、血清NT-proBNP、血清炎症因子[超敏C反应蛋白(Hs-CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)]、左室收缩末期内径(LVEDs)、左室舒张末期内径(LVEDd)、室间隔厚度(IVST)、左室心肌质量指数(LVMI)均低于对照组,6 min步行距离、左室射血分数(EF)高于对照组,差异均有统计学意义(P<0.05)。结论基于玄府理论益气通络刺法联合西药治疗能明显提高气虚血瘀型慢性心力衰竭患者的临床疗效,改善患者的左室收缩功能,同时可以明显降低血清NT-proBNP、炎症因子的水平。Objective To observe the effects of Yi Qi Tong Luo(qi-supplementing and collateral-unblocking)needling method originated from Xuanfu(qi microcirculation system)theory on cardiac function and serum N-terminal pro-B-type natriuretic peptide(NT-proBNP)and inflammatory factors in patients with chronic heart failure(CHF)of qi deficiency and blood stagnation pattern.Method Seventy patients with CHF of qi deficiency and blood stagnation pattern were randomized into a control group and an observation group,with 35 cases in each group.The control group received standard Western medication treatment(Spironolactone,Benazepril hydrochloride,Bisoprolol fumarate and Digoxin tablets);the observation group received additional Xuanfu theory-based Yi Qi Tong Luo needling method.Before and after treatment,Lee’s heart failure score,6-min walk distance and cardiac color Doppler ultrasound parameters were tested,and NT-proBNP and serum inflammatory factors were detected.The clinical efficacy was estimated.Result After treatment,the total effective rate for heart function was 91.4%in the observation group and 74.2%in the control group,and the between-group difference was statistically significant(P<0.05).After treatment,Lee’s heart failure score,serum NT-proBNP and inflammatory factors[hypersensitive C-reactive protein(Hs-CRP),tumor necrosis factor(TNF)-αand interleukin(IL)-6],left ventricular end-systolic dimension(LVEDs),left ventricular end-diastolic dimension(LVEDd),interventricular septal thickness(IVST)and left ventricular mass index(LVMI)were lower in the observation group than in the control group,and the 6-min walk test result and left ventricular ejection fraction(EF)were higher in the observation group than in the control group,and the differences were statistically significant(P<0.05).Conclusion Yi Qi Tong Luo needling method based on Xuanfu theory plus Western medication can notably enhance the clinical efficacy in treating patients with CHF of qi deficiency and blood stagnation pattern;it can improve the left ventric

关 键 词：针刺疗法 针药并用 气虚血瘀 心力衰竭 玄府理论 益气通络刺法 Lee氏心衰评分 6 min步行距离 超声检查 N末端B型利钠肽原 

分 类 号：R246.1[医药卫生—针灸推拿学]