益气宁心汤联合重组人脑利钠肽治疗急性心肌梗死伴心力衰竭的临床研究  

Clinical Study of Yiqi Ningxin Decoction Combined with Recombinant Human Brain Natriuretic Peptide in the Treatment of Acute Myocardial Infarction with Heart Failure

作　　者：纪焕春[1] 姚福梅[1] 王霞[1] 彭威[1] 杨龙[1] 李村淑[1] JI Huanchun;YAO Fumei;WANG Xia;PENG Wei;YANG Long;LI Cunshu(Dalian Second People′s Hospital,Dalian Hospital of Integrated Traditional Chinese and Western Medicine,Dalian 116000,Liaoning,China)

机构地区：[1]大连市第二人民医院/大连市中西医结合医院,辽宁大连116000

出　　处：《中西医结合心脑血管病杂志》2022年第1期95-99,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：大连市医学科学研究计划项目(No.20Z11011,20Z11005,2020.023x)。

摘　　要：目的观察益气宁心汤联合重组人脑利钠肽(rhBNP)治疗急性心肌梗死(AMI)伴心力衰竭(HF)的临床疗效。方法选取大连市第二人民医院2019年3月—2021年2月收治的AMI伴HF病人113例为研究对象,通过抽签法随机分为联合组(57例)和对照组(56例),两组病人均给予常规药物治疗,在此基础上,对照组给予rhBNP治疗,联合组在对照组基础上加用益气宁心汤治疗,比较两组临床疗效、心功能[左室射血分数(LVEF)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)及舒张早期二尖瓣血流速度与舒张晚期二尖瓣血流速度(E/A)比值]、血管内皮功能[一氧化氮(NO)、血管内皮素-1(ET-1)、超敏C反应蛋白(hs-CRP)和血栓素B_(2)(TXB_(2))]及血清肌酸激酶同工酶(CK-MB)、脂联素(APN)和肌钙蛋白I(cTnI)水平。结果治疗后,联合组总有效率为96.49%,明显高于对照组的83.93%(P<0.05)。治疗后,两组LVEF、E/A比值、NO、APN水平均较治疗前明显升高(P<0.05),LVEDV、LVESV、ET-1、hs-CRP、TXB_(2)、CK-MB和cTnI水平均较治疗前明显降低(P<0.05);联合组治疗后LVEF、E/A比值、NO、APN水平均高于对照组(P<0.05),LVEDV、LVESV、ET-1、hs-CRP、TXB_(2)、CK-MB和cTnI水平均低于对照组(P<0.05)。结论益气宁心汤联合rhBNP治疗AMI伴HF病人,可明显提高心功能和血管内皮功能,改善血清CK-MB、APN和cTnI水平,提高临床疗效。Objective To explore the effect of Yiqi Ningxin Decoction combined with recombinant human brain natriuretic peptide(rhBNP)in the treatment of acute myocardial infarction(AMI)with heart failure(HF).Methods A total of 113 AMI patients with HF were selected,and divided into combined group(57 cases)and control group(56 cases)by lottery method.The patients in both groups were treated with conventional drugs.The patients in control group were treated with conventional drugs plus rhBNP,and the patients in combined group were treated with Yiqi Ningxin Decoction on the basis of control group.The clinical efficacy,cardiac function[left ventricular ejection fraction(LVEF),left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),and the ratio of peak early mitral velocity to peak late mitral velocity(E/A ratio)],vascular endothelial function[nitric oxide(NO),vascular endothelin-1(ET-1),high-sensitivity C-reactive protein(hs-CRP),thromboxane B_(2)(TXB_(2))],the levels of creatine kinase isoenzyme(CK-MB),adiponectin(APN),and cardiac troponin I(cTnI)were compared between the two groups after treatment.Results The total effective rate of combined group was significantly higher than that of control group(96.49%and 83.93%,P<0.05).After treatment,LVEF,E/A ratio,and the levels of NO,APN,of two groups were higher than those before treatment(P<0.05),while LVEDV,LVESV,and the levels of ET-1,hs-CRP,TXB_(2),CK-MB,and cTnIwere lower than those before treatment(P<0.05).After treatment,LVEF,E/A ratio,and the levels of NO,and APN,in combined group were higher than those in control group(P<0.05),while LVEDV,LVESV,and the levels of ET-1,hs-CRP,TXB_(2),CK-MB,and cTnI were lower than those in control group(P<0.05).Conclusion Yiqi Ningxin Decoction combined with rhBNP can improve the cardiac function,vascular endothelial function,the levels of serum CK-MB,APN,and cTnI,and clinical effect in the treatment of AMI patients with HF.

关 键 词：急性心肌梗死 心力衰竭 益气宁心汤 重组人脑利钠肽 心功能 血管内皮功能 肌酸激酶同工酶 脂联素 肌钙蛋白I 

分 类 号：R54[医药卫生—心血管疾病]