加味稳心汤治疗气虚血瘀型急性心肌梗死后心力衰竭的疗效及对外周血心房钠尿肽、脑钠肽和利钾尿肽的影响  

Curative effect of modified Wenxin Decoction for post-myocardial infarction heart failure of qi deficiency and blood stasis and how it impacts on atrial natriuretic peptide,brain natriuretic peptide and kaliuretic peptide

作　　者：杨涛[1] 张振鹏[1] 曹琳琳 李军[1] YANG Tao;ZHANG Zhenpeng;CAO Linlin;LI Jun(Department of Cardiology,Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053)

机构地区：[1]中国中医科学院广安门医院心血管科,北京100053

出　　处：《河北中医》2022年第9期1434-1438,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：首都卫生发展科研专项项目(编号:2020-1-4151)。

摘　　要：目的 观察加味稳心汤治疗气虚血瘀型急性心肌梗死后心力衰竭的疗效及对外周血心房钠尿肽(ANP)、脑钠肽(BNP)和利钾尿肽(KP)的影响。方法 将94例气虚血瘀型急性心肌梗死后心力衰竭患者按照随机数字表法分为2组,对照组47予西医常规治疗,治疗组47例在对照组治疗基础上应用加味稳心汤治疗,2组均治疗12周。比较2组疗效;比较2组治疗前后中医证候评分变化;比较2组治疗前后心功能指标左室射血分数(LVEF)、左心室收缩末期容积指数(LVESVI)、左心室舒张末期容积指数(LVEDVI)变化;比较2组治疗前后血清ANP、BNP及KP变化;比较2组不良反应发生情况。结果 治疗组总有效率82.98%(39/47),对照组总有效率61.70%(29/47),治疗组疗效优于对照组(P<0.05)。2组治疗后中医证候各项评分及总评分均较本组治疗前降低(P<0.05),治疗后治疗组各项中医证候评分及总评分均低于对照组(P<0.05)。2组治疗后LVEF、LVEDVI均较本组治疗前升高(P<0.05),LVESVI均较本组治疗前降低(P<0.05);治疗后治疗组LVEF、LVEDVI均高于对照组(P<0.05),LVESVI均低于对照组(P<0.05)。2组治疗后血清ANP、BNP及KP均较本组治疗前降低(P<0.05),治疗后治疗组血清ANP、BNP及KP均低于对照组(P<0.05)。治疗组不良反应总发生率12.77%(6/47),对照组不良反应总发生率8.51%(4/47),2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论 加味稳心汤治疗气虚血瘀型急性心肌梗死后心力衰竭疗效确切,可改善患者临床症状和心功能,下调患者外周血ANP、BNP及KP水平,且安全可靠。Objective To observe the curative effect of modified Wenxin Decoction for post-myocardial infarction heart failure of qi deficiency and blood stasis and how it impacts on atrial natriuretic peptide(ANP),brain natriuretic peptide(BNP)and kaliuretic peptide(KP).Methods Totally 94 patients with post-myocardial infarction heart failure(qi deficiency and blood stasis)were randomly assigned into the treatment group and the control group,47 cases in each group.All patients were managed by routine Western medicine,and those in the treatment group were additionally treated with modified Wenxin Decoction.A 12-week treatment was performed,traditional Chinese medicine(TCM)syndrome score,cardiac function index(CFI)(left ventricular ejection fraction[LVEF],left ventricular end-systolic volume(LVESV)-index(LVESVI),left ventricular end-diastolic volume(LVEDV)-index(LVEDVI),serum ANP,BNP and KP were included as comparators;the adverse reaction and curative effect were assessed.Results The overall effective rate in the treatment group was better than that in the control group(82.98%[39/47]vs 61.70%[29/47],[P<0.05],respectively).After treatment,TCM symptom scores in groups were decreased(P<0.05),which were decreased in the treatment group compared with the control group(P<0.05);LVEF and LVEDVI]in groups were increased(P<0.05),while LVESVI in groups was decreased(P<0.05);higher LVEF and LVEDVI,and lower LVESVI were detected in the treatment group than those in the control group(all P<0.05);the serum ANP,BNP and KP in groups were decreased(P<0.05),the reduction in the treatment group was more common(P<0.05).The total incidence of adverse reactions in the treatment group and the control group was 12.77%(6/47)and 8.51%(4/47),respectively,the difference of two groups being not significant(P>0.05).Conclusion For patients with post-myocardial infarction heart failure(qi deficiency and blood stasis),modified Wenxin Decoction has definite curative effect,which can improve clinical symptoms and cardiac function,down-regulate the levels of AN

关 键 词：急性心肌梗死 心力衰竭 中药疗法 

分 类 号：R541[医药卫生—心血管疾病] R289.6[医药卫生—内科学]