参芪山萸心衰方治疗急性心肌梗死合并心力衰竭临床疗效研究  

Clinical Observation of Shenqi Shanyu Xinshuai Decoction in Acute Myocardial Infarction with Heart Failure

作　　者：郑珂[1] 王勃[1] 赵明[1] Zheng Ke;Wang Bo;Zhao Ming(The Fourth Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Liaoning,Shenyang 110101,China)

机构地区：[1]辽宁中医药大学附属第四医院,辽宁沈阳110101

出　　处：《中国中医急症》2021年第7期1211-1214,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：辽宁省自然科学基金指导计划(201602500)。

摘　　要：目的观察参芪山萸心衰方对急性心肌梗死合并心力衰竭患者疗效的影响。方法患者90例随机分为对照组与观察组各45例,对照组予西医常规西药治疗,观察组在此基础上予以参芪山萸心衰方口服,观察两组中医证候积分、心脏彩超指标、综合疗效。结果治疗后,观察组中医证候积分显著低于对照组(P<0.05),6 min步行试验(6-MWT)及氨基末端脑钠肽前体(NT-proBNP)指标改善显著优于对照组(P<0.05)。治疗后两组左室射血分数(LVEF)、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)、左心室室壁厚度(LVPWT)较治疗前均有显著改善(P<0.05),组间比较,观察组治疗后LVEF、LVESV、LVEDV水平显著低于对照组(P<0.05),LVPWT水平优于对照组,但差异无统计学意义(P> 0.05);治疗后,观察组心功能Ⅰ级患者比例显著高于对照组,心功能Ⅲ级患者比例显著低于对照组(P<0.05);观察组总有效率为93.33%,显著高于对照组的73.33%(P<0.05)。结论参芪山萸心衰方治疗心肌梗死合并心力衰竭可以大幅缓解患者症状,改善心功能,提高临床疗效,其机制可能与延缓心室重构进展有关。Objective:To investigate the effect of Shenqi Shanyu Xinshuai Decoction on acute myocardial infarction complicated with heart failure.Methods:Patients with chronic cardiac insufficiency were randomly divided into control group and observation group,45 cases in each group.The observation group was treated with Shenqi Shanyu Xinshuai Decoction,while the control group was treated with conventional western medicine.The TCM syndrome score,cardiac color Doppler ultrasound index,comprehensive curative effect of the two groups were observed.Results:1)After treatment,the TCM symptom score of the observation group was significantly better than that of the control group(P<0.05).2)After treatment,the 6-MWT and NT-proBNP indexes of the observation group were significantly better than those of the control group(P<0.05).3)After treatment,the levels of LVEF,LVESV,LVEDV and LVPWT in the two groups were significantly improved(P<0.05);the levels of LVEF,LVESV and LVEDV in the observation group after treatment were significantly better than those in the control group(P<0.05);the LVPWT level of the observation group was better than that of the control group,but there was no statistical significance(P>0.05);4)After treatment,the proportion of patients with cardiac function gradeⅠin the observation group was significantly higher than that in the control group,and the proportion of patients with cardiac function gradeⅢin the observation group was significantly lower than that in the control group(P<0.05).5)The total effective rate of the observation group was 93.33%,which was significantly higher than 73.33%of the control group(P<0.05).Conclusion:Shenqi Shanyu Xinshuai Decoction in the treatment of myocardial infarction complicated with heart failure can significantly relieve the symptoms of patients,improve the cardiac function of patients,and improve the clinical efficacy.The mechanism may be related to the fact that it can effectively delay the progress of ventricular remodeling in patients.

关 键 词：急性心肌梗死 心力衰竭 参芪山萸心衰方 心室重构 疗效 

分 类 号：R542.22[医药卫生—心血管疾病]