温肾活血方联合沙库巴曲缬沙坦治疗缺血性心肌病心力衰竭的疗效观察  

Effects of Wenshen Huoxue Recipe Combined with Shakubactrvalsartan on Heart Failure in Ischemic Cardiomyopathy

作　　者：薛秋 袁佳[1] 彭杰[1] 宋菲 刘凡[1] XUE Qiu;YUAN Jia;PENG Jie;SONG Fei;LIU Fan(Chongqing Traditional Chinese Medicine Hospital,Chongqing 400011,China)

机构地区：[1]重庆市中医院,重庆400011

出　　处：《中西医结合心脑血管病杂志》2021年第7期1086-1090,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的探讨沙库巴曲缬沙坦(LCZ696)联合温肾活血方对缺血性心肌病心力衰竭病人生存质量及N末端-脑钠肽前体(NT-proBNP)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)的影响。方法选取2017年12月—2019年5月在重庆市中医院心内科就诊的90例缺血性心肌病心力衰竭病人,根据随机数字表法分为对照组和治疗A组、治疗B组,每组30例。对照组予基础抗心力衰竭治疗,治疗A组在对照组基础上口服沙库巴曲缬沙坦,治疗B组在治疗A组基础上加用温肾活血方治疗,3组均以治疗8周为1个疗程。比较各组治疗前后中医证候积分、美国纽约心脏病学会(NYHA)心功能分级、6 min步行试验距离和NT-proBNP、LVEF、LVEDD的变化。结果与对照组相比,治疗A组、治疗B组中医证候疗效更佳(均P<0.05),且NYHA分级提高更显著(P<0.05),NT-proBNP水平降低更明显(P<0.05),改善LVEF更为明显(均P<0.05)。治疗B组较对照组6 min步行试验距离增加(P<0.05),而治疗A组6 min步行试验距离较对照组比较差异无统计学意义(P>0.05);治疗B组在改善中医证候、改善6 min步行距离方面优于治疗A组(P<0.05)。而在改善NYHA分级、降低NT-proBNP、升高LVEF、缩小LVEDD方面治疗A组、治疗B组比较差异无统计学意义(P>0.05)。结论对缺血性心肌病心力衰竭病人在常规抗心力衰竭治疗基础上加用沙库巴曲缬沙坦可改善中医证候,提高NYHA分级,降低NT-proBNP,升高LVEF,降低LVEDD,但沙库巴曲缬沙坦在增加6 min步行距离方面与常规抗心力衰竭治疗比较改善不明显,在沙库巴曲缬沙坦基础上加用温肾活血方可明显改善病人6 min步行距离,并进一步改善中医证候。Objective To observe the effect of Wenshen Huoxue Recipe combined with shakubactrvalsartan(LCZ696)and Wenshen Huoxue prescription on life quality and N-terminal brain natriuretic peptide precursor(NT-proBNP),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)in patients with heart failure and ischemic cardiomyopathy disease.Methods Ninety patients with heart failure and ischemic cardiomyopathy disease were randomly divided into the control group,treatment group A,treatment group B,with 30 cases in each group.The control group was treated with basic anti-heart failure treatment for 8 weeks,the treatment group A was treated with LCZ696 on the basis of control group for 8 weeks,and the treatment group B was treated with Wenshen Huoxue Recipe on the basis of treatment group A for 8 weeks.Traditonal Chinese medicine(TCM)syndrome score,New York Heart Association(NYHA)cardiac function grading,6 minute walking test,NT-proBNP,and LVEF were compared between three groups.Results The TCM syndromes,NYHA grading,NT-proBNP,and LVEF in treatment group A and treatment group B were better than those in control group(P<0.05).Compared with the treatment group A,6 minute walking test distance in the treatment group B significantly increased(P<0.05).Compared with the treatment group A,the efficacy of TCM syndrome and 6 minute walking test distance were better in the treatment group B(P<0.05).There was no statistical significance in NYHA grade,NT-proBNP,LVEF,and LVEDD between treatment group A and treatment group B.Conclusion Basic anti-heart failure treatment combined with shakubactrvalsartan could improve TCM syndrome,improve NYHA grading,decrease NT-proBNP,increase LVEF and LVEDD in the treatment of heart failure with ischemic cardiomyopathy disease.Wenshen Huoxue Recipe combined with shakubactrvalsartan could obviously improve 6 minite walking test,and TCM syndromes.

关 键 词：缺血性心肌病 温肾活血方 沙库巴曲缬沙坦 心力衰竭 左室射血分数 

分 类 号：R542.2[医药卫生—心血管疾病] R541.6[医药卫生—内科学]