参桂胶囊联合西药治疗冠心病慢性心力衰竭阳虚血瘀证患者临床疗效研究  

Clinical Effect of Shengui Capsule (参桂胶囊) Combined with Western Medicine on Patients with Coronary Heart Disease and Chronic Heart Failure with Yang Deficiency and Blood Stasis Syndrome

作　　者：庄锐 吴旸[2] 常佩芬[3] 刘小芸 贺小芳 王尔玉 魏大为 张玲霞 朱海燕[3] ZHUANG Rui;WU Yang;CHANG Peifen;LIU Xiaoyun;HE Xiaofang;WANG Eryu;WEI Dawei;ZHANG Lingxia;ZHU Haiyan(Beijing University of Chinese Medieine,Beijing 100029,China;Dongfang Hospital of Beijing University of Chinese Medicine.Beijing 100078,China;Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100078 [3]北京中医药大学东直门医院,北京100700

出　　处：《辽宁中医药大学学报》2021年第6期54-58,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金(81703902)。

摘　　要：目的观察参桂胶囊联合西药治疗冠心病慢性心力衰竭阳虚血瘀证临床疗效。方法将57例冠心病慢性心力衰竭阳虚血瘀证患者按照随机数字表法分为治疗组30例,对照组27例。两组均予规范化药物治疗,治疗组在此基础上联合使用参桂胶囊,每次1.2 g,每日3次,两组均治疗8周;比较治疗前后两组患者纽约心脏协会(New York Heart Association,NYHA)心功能分级、中医证候积分、N端B型脑钠肽前体(NT-proBNP)、超声心动图指标及心肌能量消耗值(MEE),并分析MEE与NT-proBNP相关性。结果治疗后两组NYHA心功能分级比较,治疗组优于对照组(P<0.05),治疗组心功能疗效总有效率(70.0%)优于对照组(37.0%)(P<0.05)。与治疗前相比,两组患者治疗后阳虚症状积分、血浆NT-proBNP水平均明显下降(P<0.05);治疗后治疗组气喘、气短、乏力、畏寒肢冷症状评分及血浆NT-proBNP水平改善优于对照组(P<0.05)。与治疗前相比,两组患者治疗后左室每搏输出量(LVSV)、二尖瓣舒张早期与舒张晚期血流速峰值比值(E/A)、左室射血分数(LVEF)均升高(P<0.05),治疗组LVSV、E/A、LVEF较对照组升高更明显(P<0.05)。与治疗前相比,治疗组MEE明显降低(P<0.05),治疗组MEE降低优于对照组(P<0.05)。Pearson相关性分析结果显示,MEE水平与NT-proBNP呈正相关(r=0.320,P=0.015)。结论参桂胶囊联合常规标准化西医治疗能显著改善冠心病慢性心力衰竭阳虚血瘀证患者临床症状、心脏舒张功能,并降低心肌能量消耗水平。Objective To observe the clinical effect of Shengui Capsule(参桂胶囊)combined with Western medicine on chronic heart failure with chronic heart failure and Yang deficiency and blood stasis syndrome. Methods A total of 57 patients with coronary heart disease and chronic heart failure with Yang deficiency and blood stasis syndrome were randomly divided into treatment group of 30 cases and control group of 27 cases. Both groups were treated with standardized Western medicine. The treatment group was treated with standardized Western medicine and Shengui Capsule,1.2 g each time,3 times a day,both groups were treated for 8 weeks. Then New York Heart Association(NYHA)cardiac function classification,TCM syndrome score,N-terminal B-type brain natriuretic peptide(NT-proBNP),echocardiographic indicators,and myocardial energy expenditure(MEE)were compared between the two groups. Results For the comparison of NYHA cardiac function classification between the 2 groups after treatment,the treatment group was better than the control group(P<0.05). The total effective rate of NYHA cardiac function in the treatment group(70.0%)was better than that of the control group(37.0%)(P<0.05). After treatment,Yang deficiency symptoms scores and NT-proBNP levels in the two groups decreased significantly(P<0.05). In the treatment group,asthma,shortness of breath,fatigue,chilling limb cold symptom score,and NT-proBNP levels improved better than the control group(P<0.05). After treatment,left ventricular output per stroke(LVSV),peak mitral valve velocity comparison(E/A),and left ventricular ejection fraction(LVEF)were increased in both groups(P<0.05),and the LVSV,E/A,LVEF of the treatment group were significantly higher than those of the control group(P<0.05). After treatment,myocardial energy expenditure(MEE)in the treatment group was significantly reduced(P<0.05),and the MEE reduction in the treatment group was better than that in the control group(P<0.05). Pearson correlation coefficient showed that MEE level was positively correlated wi

关 键 词：慢性心力衰竭 阳虚血瘀证 参桂胶囊 心功能 心肌能量消耗值 

分 类 号：R541.4[医药卫生—心血管疾病] R541.6[医药卫生—内科学]