参芪养心颗粒治疗舒张性心力衰竭气阴两虚兼血瘀型临床疗效及对脑钠肽的影响  

Clinical effect of Shenqi Yangxin Granule on diastolic heart failure of qi and yin deficiency and blood stasis and its influence on brain natriuretic peptide

作　　者：付立彪 陈光瑞[1] 张天庆 姚建斌[1] 刘洋洋 王朝亮[1] FU Libiao;CHEN Guangrui;ZHANG Tianqing;YAO Jianbin;LIU Yangyang;WANG Chaoliang(Second Department of Cardiology,Anhui Province Taihe Hospital of Traditional Chinese Medicine,Taihe,Anhui 236600)

机构地区：[1]安徽省太和县中医院心病二科,安徽太和236600

出　　处：《河北中医》2021年第10期1628-1631,1657,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：阜阳市卫生和计划生育委员会2017年度市级中医药科研课题(卫中〔2017〕150号)。

摘　　要：目的观察参芪养心颗粒治疗舒张性心力衰竭(DHF)气阴两虚兼血瘀型的临床疗效及对脑钠肽(BNP)的影响。方法将82例DHF气阴两虚兼血瘀型患者按照随机数字表法分为2组,对照组41例予西医常规治疗,治疗组41例在对照组治疗基础上应用参芪养心颗粒治疗,2组均治疗4周。比较2组疗效;观察2组治疗前后健康调查简表(SF-36)评分、中医证候评分变化;观察2组治疗前后心功能指标左室射血分数(LVEF)、舒张早期经二尖瓣血液流速峰值与舒张晚期流速峰值的比值(E/A)、左室舒张末期内径(LVEDD)变化;观察2组治疗前后6 min步行试验(6MWT)距离变化;比较2组治疗前后BNP水平变化。结果治疗组总有效率92.68%(38/41),对照组总有效率73.17%(30/41),治疗组疗效优于对照组(P<0.05)。2组治疗后SF-36各项评分均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05)。2组治疗后中医证候各项评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后LVEF、E/A均较本组治疗前升高(P<0.05),LVEDD较本组治疗前降低(P<0.05);治疗后治疗组LVEF、E/A均高于对照组(P<0.05),LVEDD低于对照组(P<0.05)。2组治疗后6MWT距离均较本组治疗前增加(P<0.05),且治疗组增加更明显(P<0.05)。2组治疗后BNP水平均较本组治疗前降低(P<0.05),且治疗组较对照组降低更明显(P<0.05)。结论参芪养心颗粒治疗DHF气阴两虚兼血瘀型,可改善患者中医症状及心功能,提高生活质量,降低BNP水平。Objective To observe the clinical effect of Shenqi Yangxin Granule on diastolic heart failure(DHF)of qi and yin deficiency and blood stasis and its influence on brain natriuretic peptide(BNP).Methods Totally 82 patients with DHF(qi and yin deficiency and blood stasis)were randomly divided into two equal groups,control group received conventional Western medicine,and treatment group additionally received Shenqi Yangxin Granule on the basis of control group.The treatment continued for 4 weeks,aiming to compare curative effect,36-item short-form health survey questionnaire(SF-36),traditional Chinese medicine(TCM)syndrome score,cardiac function index including left ventricular ejection fraction(LVEF),the mitral ratio of peak early to late diastolic filling velocity(E/A),left ventricular end diastolic diameter(LVEDD);6-Minute Walking Test(6MWT)distance,BNP.Results The total effective rates were 92.68%(38/41)in treatment group,higher than those of 73.17%(30/41)in control group(P<0.05).After treatment,SF-36 scores in groups were increased than those before treatment(P<0.05),which were more common in treatment group in comparison with control group(P<0.05);TCM syndrome scores in groups were lower than before treatment(P<0.05),which were significantly decreased in treatment group than in control group(P<0.05);LVEF and E/A in groups were increased than those before treatment,which were increased in treatment group in comparison with control group(P<0.05);LVEDD in groups was decreased,which was lower in treatment group than in control group(P<0.05);6MWT distance in groups was increased after treatment(P<0.05),improvement of which in treatment group was significantly better compared with control group(P<0.05);BNP in groups was decreased(P<0.05),which was decreased in treatment group vs control group(P<0.05).Conclusion For patients with DHF(qi and yin deficiency and blood stasis),Shenqi Yangxin Granule is capable of improving TCM symptoms,heart function,and quality-of-life,and reducing BNP levels.

关 键 词：心力衰竭 心舒期 中药疗法 颗粒 

分 类 号：R541[医药卫生—心血管疾病] R283.627[医药卫生—内科学]